Farinha Inês Teixeira, Miranda Joana Oliveira
Faculty of Medicine of Porto University, Porto 4200-319, Portugal.
Department of Paediatric Cardiology, Centro Hospitalar São João, Porto 4200-319, Portugal.
J Cardiovasc Dev Dis. 2016 Nov 8;3(4):31. doi: 10.3390/jcdd3040031.
Myocarditis is a challenging and potentially life-threatening disease associated with high morbidity in some paediatric patients, due to its ability to present as an acute and fulminant disease and to ultimately progress to dilated cardiomyopathy. It has been described as an inflammatory disease of the myocardium caused by diverse aetiologies. Viral infection is the most frequent cause of myocarditis in developed countries, but bacterial and protozoal infections or drug hypersensitivity may also be causative agents. The prompt diagnosis in paediatric patients is difficult, as the spectrum of clinical manifestation can range from no myocardial dysfunction to sudden cardiac death. Recent studies on myocarditis pathogenesis have revealed a triphasic nature of this disease, which influences the diagnostic and therapeutic strategies to adopt in each patient. Endomyocardial biopsy remains the gold standard for diagnosing myocarditis, and several non-invasive diagnostic tools can be used to support the diagnosis. Intravenous immunoglobulin has become part of routine practice in the treatment of myocarditis in paediatric patients at many centres, but its true effect on the cardiac function has been the target of many studies. The aim of this review is to approach the recently discovered facets of paediatric myocarditis regarding its progression to dilated cardiomyopathy.
心肌炎是一种具有挑战性且可能危及生命的疾病，在一些儿科患者中发病率较高，因为它可能表现为急性和暴发性疾病，并最终发展为扩张型心肌病。它被描述为由多种病因引起的心肌炎症性疾病。在发达国家，病毒感染是心肌炎最常见的病因，但细菌和原生动物感染或药物过敏也可能是致病因素。儿科患者的及时诊断很困难，因为临床表现范围可从无心肌功能障碍到心源性猝死。最近关于心肌炎发病机制的研究揭示了这种疾病的三相性质，这影响了针对每个患者应采取的诊断和治疗策略。心内膜心肌活检仍然是诊断心肌炎的金标准，并且可以使用几种非侵入性诊断工具来辅助诊断。静脉注射免疫球蛋白已成为许多中心治疗儿科心肌炎患者的常规治疗方法的一部分，但其对心脏功能的真正影响一直是许多研究的目标。本综述的目的是探讨小儿心肌炎在发展为扩张型心肌病方面最近发现的一些情况。
