By ULY CLINIC staff

 

Acute myocarditis in Children

It is an acute inflammation of the myocardium, caused by viruses (Coxackie, enterovirus, echovirus and adenovirus), bacteria (diphtheria), fungal, parasites or autoimmune diseases (SLE, rheumatoid arthritis, ARF, Kawasaki disease and sarcoidosis).
 

Causes of myocarditis

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• Parvovirus

• Influenza virus

• Adenovirus and coxsackie virus

• Viruses such as rubella, rubeola and HIV

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Diagnostic Criteria

 

• Sudden onset of features of shock and heart failure in a child who has previously been well.

• Accompanying features are abdominal pain, fever, anorexia and cough.
   

Investigations
 

• Chest X- Ray

• ECG

• Echocardiogram

• FBP and ESR
   

Treatment

Non pharmacological treatment

• Oxygen therapy 2 litres /min.

 

Pharmacological treatment

• Treat congestive cardiac failure as above

• If signs of shock are present give Dopamine IV as a continuous infusion

  • ​1month to 18 years: 5 micrograms/kg/minute adjusted according  to response OR

  • Norepinephrine 100 nanograms/kg/minute adjusted according to  response.

 

Note:

Refer to the next level facility with adequate expertise and facilities.

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Last updated on 26.09.2020

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References

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1. ​Tanzanian Standard treatment guideline for children 2017 edition page 106

2. Cincinnat children's. Myocarditis in Children. https://www.cincinnatichildrens.org/health/m/myocarditis. Accessed September 26.2020

3. ​