Vol 15, No 4 (2020)
Review paper
Published online: 2020-11-25
Myocarditis in children and adolescents: a literature review
DOI: 10.5603/FC.2020.0042
Folia Cardiologica 2020;15(4):293-302.
Abstract
Myocarditis is defined by the World Health Organization as an inflammatory disease involving cardiomyocytes, interstitial tissue, vessels and occasionally the pericardium. In this article, literature from the past 5 years regarding epidemiology, diagnostic tests, treatment and prognosis in myocarditis in young children and adolescents was analyzed. For this purpose the Pubmed database was screened using the key words “myocarditis” and “children”, yielding 117 articles. This list of was narrowed down to those in which the study group consisted of at least 5 people and included information about: symptoms and signs, abnormalities in additional tests, etiology, treatment, length of hospitalization and mortality. Finally, the review included 17 studies, describing 1891 children with a diagnosis of myocarditis. The analysis shows that myocarditis is a rare disease. Two peaks of the disease are observed: the first in newborns and infants, the second one in adolescents. Age less than 2 years is a predictor of severe prognosis. In reported cases the most common symptoms were: fatigue, chest pain, palpitations or irregular heart rhythm. Tachycardia, tachypnoe, hypotension and hepatomegaly dominated among findings in physical examination. The interview, the result of physical examination and additional tests (troponin levels, electrocardiogram, echocardiogram) are helpful in making a diagnosis. Cardiac magnetic resonance imaging is used to confirm the diagnosis. In the analyzed group, 65–90% of children were treated in the Intensive Care Unit. Extracorporeal membrane oxygenation was used in 168 cases, a ventricular assist device was implanted in 35 children and 38 children underwent heart transplantation. The mortality rate in myocarditis remains high (25–35% in analyzed studies). Up to 25% of children may develop chronic heart failure. Due to the unpredictable course of this disease, patients in the acute period of the disease should be hospitalized, and after being discharge from the hospital undergo further cardiological check-up.
Keywords: myocarditisheart failurechildrenadolescents
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