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The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature

Myocarditis is an inflammatory disease of the myocardium with a broad spectrum of clinical presentations, ranging from mild symptoms to severe heart failure. The course of patients with myocarditis is heterogeneous, varying from partial or full clinical recovery in a few days to advanced low cardiac...

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Autores principales: Bejiqi, Ramush, Retkoceri, Ragip, Maloku, Arlinda, Mustafa, Aferdita, Bejiqi, Hana, Bejiqi, Rinor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Republic of Macedonia 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352488/
https://www.ncbi.nlm.nih.gov/pubmed/30740183
http://dx.doi.org/10.3889/oamjms.2019.010
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author Bejiqi, Ramush
Retkoceri, Ragip
Maloku, Arlinda
Mustafa, Aferdita
Bejiqi, Hana
Bejiqi, Rinor
author_facet Bejiqi, Ramush
Retkoceri, Ragip
Maloku, Arlinda
Mustafa, Aferdita
Bejiqi, Hana
Bejiqi, Rinor
author_sort Bejiqi, Ramush
collection PubMed
description Myocarditis is an inflammatory disease of the myocardium with a broad spectrum of clinical presentations, ranging from mild symptoms to severe heart failure. The course of patients with myocarditis is heterogeneous, varying from partial or full clinical recovery in a few days to advanced low cardiac output syndrome requiring mechanical circulatory support or heart transplantation. Myocarditis is a very heterogeneous disease, especially in the pediatric age group as worldwide disease myocarditis has been defined by the World Health Organization/International Society and Federation of Cardiology as an inflammatory disease of the heart muscle diagnosed by established histological, immunologic, and immunohistological criteria. Pediatric myocarditis remains challenging from the perspectives of diagnosis and management. Multiple etiologies exist, and the majority of cases appear to be related to viral illnesses. Enteroviruses are believed to be the most common cause, although cases related to adenovirus may be more frequent than suspected. The clinical presentation is extremely varied, ranging from asymptomatic to sudden unexpected death. A high index of suspicion is crucial. There is emerging evidence to support investigations such as serum N-terminal B-type natriuretic peptide levels, as well as cardiac magnetic resonance imaging as adjuncts to the clinical diagnosis. In the future, these may reduce the necessity for invasive methods, such as endomyocardial biopsy, which remain the gold standard. Management generally includes supportive care, consisting of cardiac failure medical management, with the potential for mechanical support and cardiac transplantation. Treatments aimed at immunosuppression remain controversial. The paediatrics literature is extremely limited with no conclusive evidence to support or refute these strategies. All these summarised in this article and the listed current literature showed that there is no consensus regarding aetiology, clinical presentation, diagnosis, and management of myocarditis in pediatric patients.
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spelling pubmed-63524882019-02-08 The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature Bejiqi, Ramush Retkoceri, Ragip Maloku, Arlinda Mustafa, Aferdita Bejiqi, Hana Bejiqi, Rinor Open Access Maced J Med Sci Review Article Myocarditis is an inflammatory disease of the myocardium with a broad spectrum of clinical presentations, ranging from mild symptoms to severe heart failure. The course of patients with myocarditis is heterogeneous, varying from partial or full clinical recovery in a few days to advanced low cardiac output syndrome requiring mechanical circulatory support or heart transplantation. Myocarditis is a very heterogeneous disease, especially in the pediatric age group as worldwide disease myocarditis has been defined by the World Health Organization/International Society and Federation of Cardiology as an inflammatory disease of the heart muscle diagnosed by established histological, immunologic, and immunohistological criteria. Pediatric myocarditis remains challenging from the perspectives of diagnosis and management. Multiple etiologies exist, and the majority of cases appear to be related to viral illnesses. Enteroviruses are believed to be the most common cause, although cases related to adenovirus may be more frequent than suspected. The clinical presentation is extremely varied, ranging from asymptomatic to sudden unexpected death. A high index of suspicion is crucial. There is emerging evidence to support investigations such as serum N-terminal B-type natriuretic peptide levels, as well as cardiac magnetic resonance imaging as adjuncts to the clinical diagnosis. In the future, these may reduce the necessity for invasive methods, such as endomyocardial biopsy, which remain the gold standard. Management generally includes supportive care, consisting of cardiac failure medical management, with the potential for mechanical support and cardiac transplantation. Treatments aimed at immunosuppression remain controversial. The paediatrics literature is extremely limited with no conclusive evidence to support or refute these strategies. All these summarised in this article and the listed current literature showed that there is no consensus regarding aetiology, clinical presentation, diagnosis, and management of myocarditis in pediatric patients. Republic of Macedonia 2019-01-04 /pmc/articles/PMC6352488/ /pubmed/30740183 http://dx.doi.org/10.3889/oamjms.2019.010 Text en Copyright: © 2019 Ramush Bejiqi, Ragip Retkoceri, Arlinda Maloku, Aferdita Mustafa, Hana Bejiqi, Rinor Bejiqi. http://creativecommons.org/licenses/CC BY-NC/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
spellingShingle Review Article
Bejiqi, Ramush
Retkoceri, Ragip
Maloku, Arlinda
Mustafa, Aferdita
Bejiqi, Hana
Bejiqi, Rinor
The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature
title The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature
title_full The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature
title_fullStr The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature
title_full_unstemmed The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature
title_short The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature
title_sort diagnostic and clinical approach to pediatric myocarditis: a review of the current literature
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352488/
https://www.ncbi.nlm.nih.gov/pubmed/30740183
http://dx.doi.org/10.3889/oamjms.2019.010
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