Myocarditis Symptoms And Manifestations In Children
Myocarditis in children can present with a wide range of symptoms, largely influenced by the severity of the condition and the age of the child. Common signs include palpitations, chest tightness, fatigue, and reduced tolerance for physical activity. In more severe cases, children may develop heart failure, dangerous arrhythmias, cardiogenic shock, or even face life-threatening complications. If not properly managed during the early stages, some cases may progress into dilated cardiomyopathy, a chronic condition characterized by an enlarged and weakened heart.
Newborns with myocarditis often experience the most severe symptoms, including high fever, labored breathing, cyanosis, and respiratory distress. These infants may also develop complications involving the liver, lungs, and nervous system, requiring immediate medical attention.
Physical Examination Findings
During a physical examination, children with myocarditis may show signs such as tachycardia (rapid heart rate), muffled heart sounds, and the presence of a gallop rhythm — an abnormal heart sound indicative of heart stress. Lung examination may reveal crackles or wet rales, especially in cases with associated pulmonary congestion. In advanced cases, symptoms like hypotension (low blood pressure) and weak peripheral pulses may occur. Additionally, some children may exhibit hepatomegaly (enlarged liver) or splenomegaly (enlarged spleen).
Diagnostic Indicators And Tests
Laboratory tests often reveal elevated levels of cardiac biomarkers such as creatine kinase-MB (CK-MB) and cardiac troponins, which indicate damage to heart muscle cells. A chest X-ray may show an enlarged cardiac silhouette, while early-stage disease may be confirmed by detecting specific IgM antibodies at a titer of 1:128 or higher in the blood. Echocardiography can reveal dilatation of the atria and ventricles, along with impaired systolic function in some patients. The definitive diagnosis of myocarditis, however, relies on endomyocardial biopsy — the gold standard for confirming the condition.
Treatment And Management
During the acute phase of myocarditis, strict bed rest is essential to reduce cardiac workload and support recovery. Alongside rest, supportive therapies are often used, including medications that nourish and protect the heart muscle. For example, fructose-1,6-diphosphate can help improve myocardial energy metabolism and repair damaged cells. Intravenous immunoglobulin (IVIG) at high doses may also be administered to modulate the immune response and reduce myocardial injury.
If complications such as arrhythmias or heart failure arise during the course of the illness, targeted symptomatic and supportive treatments are implemented to stabilize the patient's condition and prevent further deterioration.