Abstract
Acute myocarditis (AM) in children is a rare disease and most often
has viral ethiology but can also arise from bacterial, parasitic,
autoimmune, fungal, toxic, drug-related causes. Myocarditis is
connected with high mortality in small children and the diagnosis
can be missed.
The objectives of the study were to analyse all cases of AM treated
or discovered during autopsy in our hospital during years 2010-
2015.
Methods All the cases with AM were selected from hospitals
database and/or autopsy register. We analyzed case histories to
explore the course of disease, causative agents, echocardiographic
findings and the outcome.
Results: There were 11 cases of AM diagnosed during hospitalization: 4 girls and 7 boys (63%), age 8.9 ±4 years. 63,6% complained about chest pain, but 27% were too young to complain,
72,7% had heart rhythm disorders, all 11 patients had elevated
troponin I (3,6 ± 2,7ng/L), 45,5% of patients were in need of
inotropic support, 3- ventilation. Causative agents found in 5 cases
(1- Coxacie B, 1- rheumatic fever, 1-EBV, 1-Dyphteria,
1-Rotavirus). There were 3 cases of death (27,3%): 7 months old
girl with large VSD, pneumonia (cause unrecognized, moderate
myocardial intersticial lymphoid cell infiltration on autopsy),10
year old girl with severe heart rhythm disorders (atrial fibrillation,
undulation), cause of myocarditis unclear, autopsy revealed large
regions of myolysis, severe lymphocytic and moderate leucocytar
interstitial infiltrations, 4 months old girl with atypical haemolyticuremic syndrome and myocarditis with poor cardiac function (EF
30%) (only Rotavirus positive found).
There were 10 cases where myocarditis as a part of diagnosis was
revealed only during autopsy, 6 boys (60%), 4 girls, mean age
1,17± 2,5years (5 days to 8 years), causative agent recognized
in 90%(8 patients with severe septicaemia (2-Acinetobacter
Baumani, 1-Micrococcus lutheus, 1- Pseudomona aeruginosa,
1-Serratia marcescens, 1- Salmonella enteritidis, 1- Clebsiella
oxytoca, 1- Staphylococcus epidermidis (two cases in combination
with RSV),1 -Influenza AH1N1. 4 of the patients were newborn
(3 premature).
Conclusions: AM remains serious disease with high mortality rates
and diagnosis is still often recognized only post mortem. Miocardial damage should be evaluated in patients with severe disease
with a rapid, progressive, downhill course.
has viral ethiology but can also arise from bacterial, parasitic,
autoimmune, fungal, toxic, drug-related causes. Myocarditis is
connected with high mortality in small children and the diagnosis
can be missed.
The objectives of the study were to analyse all cases of AM treated
or discovered during autopsy in our hospital during years 2010-
2015.
Methods All the cases with AM were selected from hospitals
database and/or autopsy register. We analyzed case histories to
explore the course of disease, causative agents, echocardiographic
findings and the outcome.
Results: There were 11 cases of AM diagnosed during hospitalization: 4 girls and 7 boys (63%), age 8.9 ±4 years. 63,6% complained about chest pain, but 27% were too young to complain,
72,7% had heart rhythm disorders, all 11 patients had elevated
troponin I (3,6 ± 2,7ng/L), 45,5% of patients were in need of
inotropic support, 3- ventilation. Causative agents found in 5 cases
(1- Coxacie B, 1- rheumatic fever, 1-EBV, 1-Dyphteria,
1-Rotavirus). There were 3 cases of death (27,3%): 7 months old
girl with large VSD, pneumonia (cause unrecognized, moderate
myocardial intersticial lymphoid cell infiltration on autopsy),10
year old girl with severe heart rhythm disorders (atrial fibrillation,
undulation), cause of myocarditis unclear, autopsy revealed large
regions of myolysis, severe lymphocytic and moderate leucocytar
interstitial infiltrations, 4 months old girl with atypical haemolyticuremic syndrome and myocarditis with poor cardiac function (EF
30%) (only Rotavirus positive found).
There were 10 cases where myocarditis as a part of diagnosis was
revealed only during autopsy, 6 boys (60%), 4 girls, mean age
1,17± 2,5years (5 days to 8 years), causative agent recognized
in 90%(8 patients with severe septicaemia (2-Acinetobacter
Baumani, 1-Micrococcus lutheus, 1- Pseudomona aeruginosa,
1-Serratia marcescens, 1- Salmonella enteritidis, 1- Clebsiella
oxytoca, 1- Staphylococcus epidermidis (two cases in combination
with RSV),1 -Influenza AH1N1. 4 of the patients were newborn
(3 premature).
Conclusions: AM remains serious disease with high mortality rates
and diagnosis is still often recognized only post mortem. Miocardial damage should be evaluated in patients with severe disease
with a rapid, progressive, downhill course.
Original language | English |
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Pages (from-to) | S131-S132 |
Journal | Cardiology in the Young |
Volume | 27 |
Issue number | Supplement S2 |
DOIs | |
Publication status | Published - 21 Aug 2017 |
Event | 51st Annual Meeting of the Association for European Pediatric and Congenital Cardiology (AEPC) - Lyon, France Duration: 29 Mar 2017 → 1 Apr 2017 Conference number: 51 https://www.cambridge.org/core/journals/cardiology-in-the-young/article/51st-annual-meeting-of-the-association-for-european-paediatric-and-congenital-cardiology-aepc/74783DD69B8ED428E5CE7752B1904C99 https://ur.booksc.me/book/66003741/0be487 |
Keywords*
- myocarditis
- pediatrics
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)