RT Journal Article
T1 Clinical presentation and early predictors for poor outcomes in pediatric myocarditis: A retrospective study.
A1 Rodriguez-Gonzalez, Moises
A1 Sanchez-Codez, Maria Isabel
A1 Lubian-Gutierrez, Manuel
A1 Castellano-Martinez, Ana
K1 Cardiac magnetic resonance imaging
K1 Children
K1 Dilated cardiomyopathy
K1 Echocardiography
K1 Heart transplantation
K1 Myocardial ischemia
K1 Myocarditis
K1 N-terminal pro-brain natriuretic peptide
AB Myocarditis is an important cause of morbidity and mortality in children, leading to long-term sequelae including chronic congestive heart failure, dilated cardiomyopathy, heart transplantation, and death. The initial diagnosis of myocarditis is usually based on clinical presentation, but this widely ranges from the severe sudden onset of a cardiogenic shock to asymptomatic patients. Early recognition is essential in order to monitor and start supportive treatment prior to the development of severe adverse events. Of note, many cases of fulminant myocarditis are usually misdiagnosed as otherwise minor conditions during the weeks before the unexpected deterioration. To provide diagnostic clues to make an early recognition of pediatric myocarditis. To investigate early predictors for poor outcomes. We conducted a retrospective cross-sectional single-center study from January 2008 to November 2017 at the Pediatric Department of our institution, including children  A total of 42 patients [69% male; median age of 8 (1.5-12) years] met study inclusion criteria. Chest pain (40%) was the most common specific cardiac symptom. Respiratory tract symptoms (cough, apnea, rhinorrhea) (38%), shortness of breath (35%), gastrointestinal tract symptoms (vomiting, abdominal pain, diarrhea) (33%), and fever (31%) were the most common non-cardiac initial complaints. Tachycardia (57%) and tachypnea (52%) were the most common signs on the initial physical exam followed by nonspecific signs of respiratory tract infection (44%) and respiratory distress (35%). Specific abnormal signs of heart failure such as heart murmur (26%), systolic hypotension (24%), gallop rhythm (20%), or hepatomegaly (20%) were less prevalent. Up to 43% of patients presented an early poor outcome, and 16% presented a late poor outcome. In multivariate analysis, an initial left ventricular ejection fraction (LVEF)  The diagnosis of myocarditis in children is challenging due to the heterogeneous and unspecific clinical presentation. The presence of LVEF
SN 2307-8960
YR 2019
FD 2019
LK http://hdl.handle.net/10668/13698
UL http://hdl.handle.net/10668/13698
LA en
DS RISalud
RD Apr 10, 2025