Diagnosis, Evaluation, and Treatment of Myocarditis in Children

Putschoegl, Adam; Auerbach, Scott R.

doi:10.1016/j.pcl.2020.06.013

Cited by 36 publications

(24 citation statements)

References 86 publications

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“…In this regard, the search for biomarkers for early diagnosis of myocarditis and assessment of prognosis is considered a priority. [57][58][59] Soongswang et al (2005) report a moderate diagnostic value of cardiac troponins in myocarditis in children. For example, serum troponin T levels > 0.052 ng/L have an analytical sensitivity of 71% and a specificity of 86% for the diagnosis of acute myocarditis in pediatric patients.…”

Section: Cardiac Troponins In Inflammatory Heart Diseases (Endo- Peri- and Myocarditis): Mechanisms Of Elevation And Diagnostic Valuementioning

confidence: 99%

The Main Causes and Mechanisms of Increase in Cardiac Troponin Concentrations Other Than Acute Myocardial Infarction (Part 1): Physical Exertion, Inflammatory Heart Disease, Pulmonary Embolism, Renal Failure, Sepsis

Chauin¹

2021

VHRM

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The causes and mechanisms of increased cardiac troponin T and I (cTnT and cTnI) concentrations are numerous and are not limited to acute myocardial infarction (AMI) (ischemic necrosis of cardiac myocytes). Any type of reversible or irreversible cardiomyocyte injury can result in elevated serum cTnT and cTnI levels. Researchers and practitioners involved in the diagnosis and treatment of cardiovascular disease, including AMI, should know the key causes and mechanisms of elevated serum cTnT and cTnI levels. This will allow to reduce or completely avoid diagnostic errors and help to choose the most correct tactics for further patient management. The purpose of this article is to discuss the main causes and mechanisms of increase in cardiac troponins concentrations in frequently occurring physiological (physical exertion, psycho-emotional stress) and pathological conditions (inflammatory heart disease, pulmonary embolism, chronic renal failure and sepsis (systemic inflammatory response)) not related to myocardial infarction.

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Section: Cardiac Troponins In Inflammatory Heart Diseases (Endo- Peri- and Myocarditis): Mechanisms Of Elevation And Diagnostic Valuementioning

confidence: 99%

The Main Causes and Mechanisms of Increase in Cardiac Troponin Concentrations Other Than Acute Myocardial Infarction (Part 1): Physical Exertion, Inflammatory Heart Disease, Pulmonary Embolism, Renal Failure, Sepsis

Chauin¹

2021

VHRM

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“…At the same time, troponin concentrations vary widely. Thus, in several studies, troponins, determined by moderately sensitive methods for the diagnosis of myocarditis, had a sensitivity of 34–71% and a specificity of 86–94% [ 41 , 42 , 43 , 44 , 45 ].…”

Section: Introductionmentioning

confidence: 99%

“…According to accumulated information, endomyocardial biopsy has shortcomings in the detection of viral myocarditis since it does not reflect the presence of the viral genome in cardiomyocytes and, accordingly, will not “see” inflammation in the case of a weak course of chronic viral myocarditis [ 45 ]. The pathogenetic significance of viral persistence in the myocardium is not fully understood.…”

Section: Introductionmentioning

confidence: 99%

Elevation Mechanisms and Diagnostic Consideration of Cardiac Troponins under Conditions Not Associated with Myocardial Infarction. Part 1

Chaulin

2021

Life

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Although cardiac troponins are considered the most specific biomarkers for the diagnosis of acute myocardial infarction (AMI), their diagnostic consideration goes far beyond the detection of this dangerous disease. The mechanisms of cardiac troponin elevation are extremely numerous and not limited to ischemic necrosis of cardiac myocytes. Practitioners should be well aware of the underlying pathological and physiological conditions that can lead to elevated serum levels of cardiac troponins to avoid differential diagnostic errors, which will be greatly increased if clinicians rely on laboratory data alone. This article presents a classification of the main causes of an elevation in cardiac troponins and discusses in detail the mechanisms of such elevation and the diagnostic consideration of cardiac troponins in some conditions not associated with AMI, such as physical exertion, inflammatory heart diseases (myocarditis and endocarditis), pulmonary embolism (PE), renal failure, and systemic inflammation (sepsis).

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“…Despite the fact that endomyocardial biopsy (EMB) is the gold standard to prove the diagnosis of myocarditis [1], it was used only in one case report [7] as part of the autopsy. Low sensitivity due to sampling error, variability in pathologic interpretation, and potential complications such as myocardial perforation and tamponade are reasons for its reduced use [3].…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…Additionally, the CMR findings did not demonstrate any markers of myocardial inflammation and necrosis (Figure 3). The Luise Lake Criteria for acute myocarditis were not fulfilled by that time as no high signal intensity on T2-weighted imaging, increased T2 and T1 times, myocardial thickening, or rapid uptake (early gadolinium enhancement) of contrast were revealed [3]. Subsequently, antiarrythmic medication was discontinued.…”

Section: Case Reportmentioning

confidence: 99%

Myocarditis in a Pediatric Patient with Campylobacter Enteritis: A Case Report and Literature Review

et al. 2021

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Myocarditis represents a potential complication of various infectious and noninfectious agents and a common diagnostic challenge for clinicians. Data regarding Campylobacter-associated myocarditis are limited. Here, a case of a 13-year-old female with Campylobacter jejuni gastroenteritis complicated by myocarditis is presented, followed by a literature review in order to retrieve information about Campylobacter-associated carditis in the pediatric population. A search on MEDLINE/PubMed yielded 7relevant cases in the last 20 years. Most of them (six/seven) were males and the mean age was 16.1 years. All patients presented with gastrointestinal symptoms followed in six/seven cases by chest pain within two to seven days. Campylobacter was isolated from stool cultures in six patients; abnormal electrocardiographic findings were detected in six; and abnormal echocardiographic findings in three of the cases. Five patients were treated with antibiotics. Full recovery was the clinical outcome in six patients, whereas one patient died. Concerning the nonspecific symptoms of patients with myocarditis, high clinical suspicion of this complication is necessary in cases where patients with a recent infection present with chest pain and elevated cardiac biomarkers.

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Diagnosis, Evaluation, and Treatment of Myocarditis in Children

Cited by 36 publications

References 86 publications

The Main Causes and Mechanisms of Increase in Cardiac Troponin Concentrations Other Than Acute Myocardial Infarction (Part 1): Physical Exertion, Inflammatory Heart Disease, Pulmonary Embolism, Renal Failure, Sepsis

The Main Causes and Mechanisms of Increase in Cardiac Troponin Concentrations Other Than Acute Myocardial Infarction (Part 1): Physical Exertion, Inflammatory Heart Disease, Pulmonary Embolism, Renal Failure, Sepsis

Elevation Mechanisms and Diagnostic Consideration of Cardiac Troponins under Conditions Not Associated with Myocardial Infarction. Part 1

Myocarditis in a Pediatric Patient with Campylobacter Enteritis: A Case Report and Literature Review

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