What Is Pediatric Myocarditis?
Myocarditis is inflammation of the heart muscle (myocardium), usually caused by the body’s immune response to a viral or bacterial infection. When your body fights off the infection, the heart can become inflamed, creating scar tissue. This makes it harder for the heart to pump blood.
Dr. David Bush , a pediatric cardiologist with University Health Cardiovascular Center, says parents should be on the lookout for the signs of myocarditis and shares how our pediatric heart specialists diagnose and treat this rare heart condition.
How Does a Child Get Myocarditis?
“Myocarditis can develop after a child gets sick with an infection like parvovirus, flu, COVID-19 and even the common cold,” said Dr. Bush.
More rarely, myocarditis may also be caused by:
- Bacterial infections
- Parasites
- Fungi and mold
- Chemotherapy
- Exposure to carbon monoxide
What Are the Odds of a Child Getting Myocarditis?
Myocarditis is a rare condition, affecting about 1 in 100,000 children each year, according to the Myocarditis Foundation . One study suggests the risk is higher in children who have had COVID-19, highlighting the importance of getting the COVID-19 vaccine.
What Viruses Are Associated with Myocarditis?
The viruses most often associated with myocarditis are:
- Common cold
- Influenza
- COVID-19
- Enterovirus
- Viruses causing hepatitis B and C
- Herpes simplex
- HIV
- Parvovirus
- Gastrointestinal viruses
- Rubella
- Epstein-Barr virus
Dr. Bush notes that childhood vaccines can reduce your child’s risk for many of these viruses. Learn more about the importance of immunizations in our blog.
What Are the Symptoms of Pediatric Myocarditis?
The symptoms of myocarditis vary on your child’s age and the condition’s severity.
“Myocarditis symptoms are nonspecific and may be mistakenly attributed to other conditions, so evaluation by a medical provider is crucial,” said Dr. Bush.
Myocarditis Symptoms in Infants
- Fever
- Fussiness
- Decreased urination
- Cold hands and feet due to poor circulation
- Fatigue
Myocarditis Symptoms in Older Children
- Heart palpitations
- Heart arrhythmias
- Fever
- Rapid, shallow breathing
- Nausea, vomiting
- Belly pain
- Chest pain
- Shortness of breath
- Fainting
How Is Pediatric Myocarditis Diagnosed?
Your child’s cardiologist will order a number of tests, including:
- Electrocardiogram (ECG or EKG): This is a non-invasive test that measures the heart’s electrical activity.
- Echocardiogram: This is an imaging test that creates a detailed picture of the heart.
- Chest X-ray: This is a painless, non-invasive imaging test that creates an image of your child’s heart and lungs. It can show if the heart muscle looks enlarged or inflamed.
- Cardiac magnetic resonance imaging (MRI): This test uses magnet, radio signals and a computer to create images of your child’s heart. The MRI machine is a closed space and may be uncomfortable for some children.
- Cardiac catheterization: This involves inserting a long, flexible tube into a blood vessel and guiding it to the heart. Your child’s doctor may take a tissue sample (biopsy) from the wall of the heart muscle and send it to the laboratory for further examination.
- Blood tests: These provide your child’s heart team critical information about how their heart and other organs are functioning. Specifically, your doctor will look for elevated troponin, BNP and CK-MB (Creatine Kinase-MB) levels.
Is Diagnosis Different in Children Than Adults?
Diagnosing myocarditis in adults may be easier because they present with more classic symptoms indicative of a heart condition. These include:
- Chest pain
- Shortness of breath
- Fast heartbeat
However, the diagnostic methods used for children and adults with myocarditis are the same (EKG, MRI, blood tests, etc.).
How Is Myocarditis Treated in Children?
“While the inflammation of the heart will subside on its own, the scarring of the heart muscle will not,” said Dr. Bush. “Children with myocarditis should be admitted to the hospital’s intensive care unit for treatment.”
Your child’s treatment in the pediatric ICU may include:
- Bed rest
- Antibiotics to fight the initial infection
- Medications to manage heart arrhythmias
- Anti-inflammatory medicines
Can the Heart Muscle Repair Itself after Myocarditis?
No, the heart muscle will not repair itself after myocarditis. Depending on the amount of scarring on the heart muscle, your child may need to take medications into adulthood.
Outlook and Recovery
“Most children who receive prompt and proper treatment will make a full recovery,” said Dr. Bush. He also notes that children will need ongoing medical care after treatment to support their heart’s function as they get older.
If untreated, myocarditis can lead to severe complications in adulthood, including:
- Heart failure
- Stroke
- Heart attack
- Heart arrhythmias
Very rarely, do some babies and children with severe myocarditis will need a heart transplant. This is a rare occurrence and is reserved for those cases when other treatment methods fail.
Pediatric Cardiology at University Health
Trust the pediatric heart doctors at University Health to manage your child’s heart condition. Our pediatric heart team includes board-certified cardiologists, interventional cardiologists, heart surgeons and a comprehensive support team. We are dedicated to your child’s care and recovery.
