Endomyocardial biopsy in infants and children with cardiomyopathy

Abstract

We reviewed our experience of endomyocardial biopsy performed on 21 symptomatic infants and children with cardiomyopathy. Clinical congestive cardiomyopathy was noted in 18 patients, 2 had hypertrophic cardiomyopathy, and 1 a restrictive cardiomyopathy. The biopsy findings led to a diagnosis of hemiochromatosis in one patient, Adriamycin cardiomyopathy in another, and lymphocytic myocarditis in a third. Five patients had features of endocardial fibroelastosis, one endomyocardial fibrosis, and a further one, a mitochrondrial abnormality. In 11 patients normal or nonspecific features were seen. There were 2 myocardial perforations, both patients being successfully resuscitated. Endomyocardial biopsy, although occasionally hazardous, may sometimes provide valuable information which may lead to a diagnosis, facilitate treatment, and be of prognostic value. Despite the low positive yield, it may still be indicated in selected patients, in view of the seriousness and often poor prognosis of this disorder: 5 of our study group subsequently died.

Myocarditis in children and detection of viruses in myocardial tissue: Implications for immunosuppressive therapy

“…In pediatric patients with initial diagnosis of dilated cardiomyopathy who are subjected to endomyocardial biopsy, the prevalence of myocarditis is quite variable, ranging from less than 5% up to 63% [6,[22][23][24]. In the majority of reports, the prevalence is 20% or higher.…”

Symptomatik der primären Endokardfibroelastose im Erwachsenenalter

“…Der Einsatz der transvaskulären Endokardbiopsie erlaubt eine intravitale Differenzierung der Endokardfibroelastose von einer dilatativen Kardiomyopathie im Kindesalter (10,11,15). Bei der durch rechtsventrikuläre Biopsie gesicherten Myokardhypertrophie unserer Patientin handelte es sich um reaktive Veränderungen infolge der langjährigen schweren pulmonalen Hypertonie.…”