Frey Teresa, Arain Nofil
University of South Dakota.
Sanford Children's Hospital, Sioux Falls, South Dakota.
S D Med. 2018 Jan;71(1):29-34.
Pediatric myocarditis is a common pediatric illness most commonly secondary to a preceding viral infection. It is a leading cause of acquired heart failure, cardiomyopathy, and cardiac transplantation in pediatrics. Due to the variability in presentation, the diagnosis is often unrecognized until later in the disease course. It should be considered in the differential diagnosis of all children presenting with respiratory distress, since this is the most common presentation. Imagining modalities, such as cardiac magnetic resonance imaging have become a useful diagnostic tool in recent years; however, endomyocardial biopsy remains the gold standard diagnostic test. Treatment of viral myocarditis is mainly supportive, with debatable role of anti-inflammatory, immunosuppressing immunomodulators and anti-viral therapy. Although, the outcome is generally favorable, delay in supportive care may be associated with a worse prognosis. We focus on the clinical presentation, review diagnostic and treatment options of viral myocarditis.
小儿心肌炎是一种常见的儿科疾病,最常见的是继发于先前的病毒感染。它是儿科获得性心力衰竭、心肌病和心脏移植的主要原因。由于临床表现的变异性,在疾病进程后期之前,诊断往往未被识别。对于所有出现呼吸窘迫的儿童进行鉴别诊断时都应考虑到这一点,因为这是最常见的表现。近年来,诸如心脏磁共振成像等影像学检查手段已成为一种有用的诊断工具;然而,心内膜心肌活检仍然是金标准诊断测试。病毒性心肌炎的治疗主要是支持性的,抗炎、免疫抑制免疫调节剂和抗病毒治疗的作用存在争议。尽管总体预后通常良好,但支持治疗的延迟可能与预后较差有关。我们重点关注病毒性心肌炎的临床表现,回顾其诊断和治疗选择。