Pediatric myocarditis

Viral infections are the most frequent cause of myocarditis in childhood while other infectious agents, cardiotoxic drugs and myocardial inflammation in systemic diseases play a less important role. Although most cases of myocarditis run a mild course, fulminant forms with life-threatening arrhythmias and cardiogenic shock are possible. The nonspecific initial symptoms are the real challenge for a timely diagnosis and facilitate the transition to a cardiomyopathy with permanent cardiac functional impairments. A thorough medical history and physical examination, baseline laboratory tests, electrocardiography (ECG) and a subsequent stepwise cardiologic work-up using echocardiography, magnetic resonance imaging, and endomyocardial biopsy confirm the diagnosis. Knowledge and utilization of the therapeutic options for the staged course of the disease, including advice on resuming physical activity/returning to sports are components of care by pediatricians and pediatric cardiologists.

Automated summary

Viral infections are the leading cause of myocarditis in childhood, while other infectious agents and myocardial inflammation in systemic diseases play a minor role. Fulminant forms of myocarditis can be life-threatening, with severe arrhythmias and cardiogenic shock. The challenge lies in the nonspecific initial symptoms, which can lead to permanent cardiac functional impairments. A thorough medical history, physical examination, and diagnostic tests such as ECG, echocardiography, MRI, and biopsy are necessary for a timely diagnosis. Treatment options and staged care, including guidance on physical activity and sports, are crucial for pediatricians and pediatric cardiologists.