Myocarditis in Children: Recognizing the Symptoms
Myocarditis is a condition characterized by inflammation of the heart muscle, often resulting from infections or other systemic causes. This inflammation can lead to damage or degeneration of heart muscle fibers, causing various degrees of heart dysfunction and affecting other organ systems. While viral infections are the most common cause, bacterial infections, mycoplasma, parasites, fungi, and even toxic or allergic reactions can also trigger myocarditis.In many cases, especially those caused by viruses, children may show no symptoms at all. However, in rare and severe instances, myocarditis can progress rapidly, leading to life-threatening complications such as fulminant myocarditis. Most children diagnosed with acute viral myocarditis have no prior history of heart disease and show normal heart structure upon examination.
Common Symptoms of Myocarditis in Children
The clinical presentation of myocarditis can vary significantly depending on the severity of the condition. In mild cases, symptoms may be absent or very subtle. More commonly, children may experience non-specific symptoms such as fatigue, excessive sweating, palpitations, shortness of breath, dizziness, chest tightness, and pallor.
In more severe cases, symptoms can escalate quickly. These may include signs of heart failure, such as difficulty breathing and fluid retention. Some children may develop Arrhythmias that can lead to fainting spells (syncope), known as Adams-Stokes syndrome. In the most critical situations, myocarditis can result in cardiogenic shock or even sudden cardiac death.
Physical Signs of Myocarditis
During a physical examination, doctors may detect several key signs. These include a diminished or split first heart sound, the presence of an extra heart sound known as a gallop rhythm, and abnormal heart rates—either too fast (tachycardia) or too slow (bradycardia). Irregular heartbeats or arrhythmias may also be present, along with low blood pressure and reduced pulse pressure.
In mild cases, there may be no noticeable enlargement of the heart. However, in more severe cases, the heart may become mildly to moderately enlarged. If the pericardium (the sac around the heart) is also affected, a pericardial friction rub may be heard. When heart failure develops, signs such as crackles in the lungs, jugular venous distention, liver enlargement, and swelling in the lower extremities can occur. In the most severe forms, symptoms of cardiogenic shock may become evident, including cold extremities, altered mental status, and severely reduced urine output.