Management of Myocarditis in Children: The Current Situation
Acute myocarditis is an important cause of morbidity and mortality in children. It is defined as inflammation of the myocardium in association with non-ischaemic myocellular necrosis (Aretz 1987). Despite its clear-cut definition, the classification, diagnosis and treatment of myocarditis remain the subject of ongoing debate. The use of endomyocardial biopsy, which has become routine, has helped to better define the natural history of human myocarditis and to clarify clinicopathological correlations.
KeywordsDilate Cardiomyopathy Immune Globulin Endomyocardial Biopsy Ventricular Assist Device Mechanical Circulatory Support
Unable to display preview. Download preview PDF.
- Chen JW, Zhou B, Yu QC, Shin SJ, Jiao K, Schneider MD, Baldwin HS, and Bergelson JM. (2006). Cardiomyocyte-specific deletion of the coxsackievirus and adenovirus receptor results in hyperplasia of the embryonic left ventricle and abnormalities of sinuatrial valves. Circ Res, 98:923–930.PubMedCrossRefGoogle Scholar
- Gullestad L, Aass H, Fjeld JG, Wikeby L, Andreassen AK, Ihlen H, Simonsen S, Kjekshus J, Nitter-Hauge S, Ueland T, Lien E, Froland SS, and Aukrust P. (2001). Immunomodulating therapy with intravenous immunoglobulin in patients with chronic heart failure. Circulation, 103:220–225.PubMedGoogle Scholar
- Hetzer R, Alexi-Meskishvili V, Weng Y, Hubler M, Potapov E, Drews T, Hennig E, Kaufmann F, and Stiller B. (2006). Mechanical cardiac support in the young with the Berlin Heart EXCOR pulsatile ventricular assist device: 15 years’ experience. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006:99–108.Google Scholar
- Hoffman TM, Wernovsky G, Atz AM, Kulik TJ, Nelson DP, Chang AC, Bailey JM, Akbary A, Kocsis JF, Kaczmarek R, Spray TL, and Wessel DL. (2003). Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation, 107:996–1002.PubMedCrossRefGoogle Scholar
- Kuhl U, Pauschinger M, Noutsias M, Seeberg B, Bock T, Lassner D, Poller W, Kandolf R, and Schultheiss HP. (2005). High prevalence of viral genomes and multiple viral infections in the myocardium of adults with “idiopathic” left ventricular dysfunction. Circulation, 111:887–893.PubMedCrossRefGoogle Scholar
- Matsumori A, Igata H, Ono K, Iwasaki A, Miyamoto T, Nishio R, and Sasayama S. (1999). High doses of digitalis increase the myocardial production of proinflammatory cytokines and worsen myocardial injury in viral myoc arditis: a possible mechanism of digitalis toxicity. Jpn Circ J, 63:934–940.PubMedCrossRefGoogle Scholar
- Stiller B, Lemmer J, Merkle F, Alexi-Meskishvili V, Weng Y, Hübler M, Koster A, Drews T, Lange P, and Hetzer R. (2004). Consumption of blood products during mechanical circulatory support in children: comparison between ECMO and a pulsatile ventricular assist device. Intensive Care Medicine, 30:1814–1820.PubMedCrossRefGoogle Scholar
- Towbin J. (2001). Myocarditis. In: Allen HD GH, Clarc EB, and Driscoll D, (eds.), Moss and Adams’ Heart Disease in Infants, Children, and Adolescents. Lippincott Williams and Wilkins, Philadelphia, PA.Google Scholar