Myocarditis In Children: Recognizing The Symptoms

Many cases of viral myocarditis are asymptomatic, especially in mild forms. However, in rare and severe cases, children may experience life-threatening complications such as fulminant myocarditis. Most children affected by viral myocarditis previously had no history of heart disease, and their heart structure typically appears normal upon initial examination.

Common Symptoms Of Myocarditis In Children

In mild cases, children may not show any symptoms at all. When symptoms do appear, they are often non-specific and can include fatigue, excessive sweating, palpitations, shortness of breath, dizziness, chest discomfort, and pallor. These signs can easily be mistaken for other common illnesses, making early diagnosis challenging.

Severe Symptoms And Complications

In more serious cases, myocarditis can lead to severe complications such as heart failure, arrhythmias, and even sudden cardiac arrest. Some children may experience symptoms like fainting due to arrhythmias (known as Adams-Stokes syndrome), signs of shock, or acute heart failure.

Physical Signs Of Myocarditis

During a physical examination, doctors may detect abnormal heart sounds such as a weakened or split first heart sound, or a gallop rhythm, which indicates heart stress. Tachycardia or bradycardia, along with irregular heartbeats, can also be present. Blood pressure may drop, and pulse pressure may be reduced.

In mild cases, the heart may not appear enlarged. However, in more severe instances, the heart may become moderately enlarged. If the pericardium is involved, a heart friction rub may be heard. When heart failure develops, signs such as crackles in the lungs, swollen neck veins, an enlarged liver, and leg swelling may become apparent.

Recognizing Cardiogenic Shock

In the most severe situations, children may exhibit symptoms of cardiogenic shock. These include pale or clammy skin, rapid breathing, weak pulse, confusion, and reduced urine output. Prompt medical attention is critical in these cases to prevent life-threatening outcomes.