Myocarditis in childhood report of 67 patients
Myocarditis in childhood report of 67 patients
Aim: The aim of this study is to evaluate the clinical findings, sociodemographic characteristics and follow -up of the myocarditis cases and to investigate factors affecting the mortality. Materials and Methods: Patients who diagnosed myocarditis from January 2009 to December 2017 were included in this study. Sex, date of admission, age at the time of admission, presence of previous infection, physical examination findings, serum cardiac biomarkers, whole blood count, C reactive protein and viral serology results, electrocardiographic findings, telecardiography and echocardiographical findings and the medical records about complications and mortality during follow-up were analysed. Statistical analyzes performed with IBM SPSS 22.0. Pearson chi-square and continuity corrected chi-square tests were used. Numerical data were summarized with median, minimum and maximum values. Univariate Kaplan - Meier and Cox regression analyzes were used in comparisons. The significance level was accepted as 0.05 in all tests. Results: From January 2007 to December 2017, 67 patients with myocarditis were retrospectively analyzed. 31 (46.2%) patients were recovered. 21 patients (31.3%) developed dilate cardiomyopathy. Six patients were died in acute phase. 7 of 21 patients with dilate cardiomyopathy were died at follow-up period. Nine patients were referred to a cardiovascular surgery center for VAD, ECMO or cardiac transplantation. Among them seven patients were died under ECMO. 2 patients were implanted VAD. Conclusion: Myocarditis is an inflammatory disease of the myocardium. Diagnosis of myocarditis may be difficult to subtle clinical findings. The clinical picture may be varying from a mild subclinical period to congestive heart failure. The prognosis varies from recovery to complicated chronic disease and death. In our study, increased cardiothoracic index and pulmonary congestion findings in telecardography, increased serum myoglobin level and decreased echocardiographic shortening fraction were factors associated with increased mortality. The using the cardiac support devices in patients with myocarditis may decrease mortality.
___
- 1. Villablanca P, Mohananey D, Meier G, et al. Salmonella Berta myocarditis: Case report and systematic review of non-typhoid Salmonella myocarditis. World J Cardiol 2015;7:931-7.
- 2. Levine MC, Klugman D, Teach SJ. Update on myocarditis in children. Curr Opin Pediatr 2010;22:278-83.
- 3. Dominguez F, Kuhl U, Pieske B, et al. Update on Myocarditis and Inflammatory Cardiomyopathy: Reemergence of Endomyocardial Biopsy. Rev Esp Cardiol (Engl Ed) 2016;69:178-87.
- 4. Ghelani SJ, Spaeder MC, Pastor W, et al. Demographics, trends, and outcomes in pediatric acute myocarditis in the United States, 2006 to 2011. Circ Cardiovasc Qual Outcomes 2012;5:622-7.
- 5. Kearney MT, Cotton JM, Richardson PJ, et al. Viral myocarditis and dilated cardiomyopathy: mechanisms, manifestations, and management. Postgrad Med J 2001;77:4-10.
- 6. Haider N, Shaikh AS, Wazir R, et al. Clinicodemographic features and outcome of acute myocarditis in children admitted at tertiary care hospital. Int J Cardiol 2016;221:42-5.
- 7. Doolan A, Langlois N, Semsarian C. Causes of sudden cardiac death in young Australians. Med J Aust. 2004;180:110-2.
- 8. Durani Y, Egan M, Baffa J, et al. Pediatric myocarditis: presenting clinical characteristics. Am J Emerg Med. 2009;27:942-7.
- 9. Freedman SB, Haladyn JK, Floh A, et al. Thull-Freedman J. Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation. Pediatrics 2007;120:1278-85.
- 10. Butts RJ, Boyle GJ, Deshpande SR, et al. Characteristics of Clinically Diagnosed Pediatric Myocarditis in a Contemporary Multi-Center Cohort. Pediatr Cardiol 2017;38:1175-82.
- 11. Mogyorosy G, Felszeghy E, Kovacs T, et al. Pediatric myocarditis: A sentinel of non-cardiac chronic diseases? Interv Med Appl Sci 2014;6:154-9.
- 12. Molina KM, Garcia X, Denfield SW, et al. Parvovirus B19 myocarditis causes significant morbidity and mortality in children. Pediatr Cardiol. 2013;34:390.
- 13. Wu HP, Lin MJ, Yang WC, et al. Predictors of Extracorporeal Membrane Oxygenation Support for Children with Acute Myocarditis. BioMed Research International Volume 2017;8:1-8.
- 14. Odemis E, Turkay S, Koca C, et al. Effects of zileuton on the development of autoimmune myocarditis in an experimental rat model. Curr Ther Res Clin Exp. 2007;68:262-70.
- 15. Pinamonti B, Alberti E, Cigalloto A, et al. Echocardiographic findings in myocarditis. Am J Cardiol 1988;62:285-91.
- 16. Singh R, Yeh J, Price JF. Diagnosis and treatment strategies for children with myocarditis. Progress in Pediatric Cardiology 2016;43:23-30.