Myocarditis in Children with Viral Infections: A Clinical and Laboratory Correlation
Keywords:
Viral myocarditis, Children, Cardiac biomarkers, Echocardiography, Pediatric cardiology, Troponin I, CK-MB, Enterovirus,, Adenovirus, Clinical correlationAbstract
Background: Myocarditis is a significant cause of morbidity and mortality in pediatric populations, often following viral infections. The clinical manifestations of myocarditis range from subclinical disease to fulminant heart failure, making early recognition and timely intervention crucial. This study aimed to evaluate the clinical presentation, laboratory parameters, echocardiographic findings, and outcomes of pediatric patients diagnosed with viral myocarditis in a tertiary care center in Telangana over a two-year period.
Methods: A prospective observational study was conducted involving 72 children under 18 years of age admitted with suspected viral myocarditis between January 2023 and December 2024. Diagnosis was based on clinical features suggestive of myocarditis, elevated cardiac biomarkers (troponin I, CK-MB), ECG abnormalities, and echocardiographic findings. Viral etiologies were identified using serological assays and, where available, PCR-based tests. Clinical and laboratory data were systematically recorded and correlated with outcomes.
Results: The most common presenting symptoms included fever (91.7%), tachycardia (84.7%), respiratory distress (72.2%), and gastrointestinal complaints (43.1%). Elevated troponin I and CK-MB levels were observed in 88.9% and 80.6% of patients, respectively. ECG abnormalities were noted in 75% of cases, and echocardiographic evidence of left ventricular dysfunction was found in 65.3% of patients. Enteroviruses (30.6%) and adenoviruses (25%) were the predominant viral agents detected. While 85% of patients recovered with supportive care, 10% required intensive care with inotropic support, and 5% succumbed to fulminant myocarditis.
Conclusion: This study highlights the varied clinical spectrum of viral myocarditis in children and underscores the critical role of cardiac biomarkers and echocardiography in early diagnosis. Timely intervention significantly improves outcomes, although a small proportion may still progress to severe disease. Continued surveillance and research are needed to optimize diagnostic and therapeutic strategies in pediatric viral myocarditis.
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