Is pediatric myocarditis curable?

Written by Yao Li Qin
Pediatrics
Updated on February 17, 2025
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Myocarditis in children is generally caused by a viral infection, which means viral myocarditis is the most common type. This condition indicates that the virus has damaged the myocardial cells, leading to severe symptoms such as heart failure and cardiogenic shock. Once myocarditis is diagnosed in a child, it is crucial to hospitalize and treat them actively. While treating myocarditis, it is essential to use medications that nourish the myocardium and actively treat the primary disease. Most children with myocarditis have a favorable prognosis, but fulminant myocarditis has a poor prognosis, carrying a certain risk of mortality.

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Written by Chen Si
Pediatrics
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Is pediatric myocarditis serious?

The severity of myocarditis in children needs to be assessed by considering the child's clinical symptoms and corresponding clinical examinations comprehensively. Common clinical symptoms include chest tightness, fatigue, shortness of breath, etc. Most children have a history of upper respiratory tract infection before the symptoms appear. It is necessary to conduct routine blood tests, myocardial enzymes, troponin, myocardial antibodies, viral antibodies, electrocardiograms, and other relevant physicochemical examinations to further clarify the condition. Patients with mild symptoms and roughly normal laboratory results can improve on their own with rest. If there are clinical symptoms such as chest tightness, fatigue, shortness of breath, and related physicochemical examinations show abnormal changes, it is necessary to use medication to nourish the myocardium. During treatment, rest is advised, reduce fatigue, maintain emotional stability, and generally, the symptoms can improve within 10 to 15 days. For more severe cases, the treatment period may need to be extended accordingly.

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Written by Zhou Yan
Geriatrics
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Does myocarditis cause a fever?

Myocarditis is an inflammatory heart disease, commonly caused by viral infections, with the Coxsackievirus being the most common. Other infections, such as bacterial, fungal, and Rickettsia, can also cause myocarditis. These infectious myocarditis cases generally show preliminary symptoms of infection, such as fever, in the 1 to 3 weeks before the onset of the disease. Fever indicates a high body temperature, which means the same as having a fever. However, there are also non-infectious forms of myocarditis, such as those caused by drugs, radiation, or connective tissue diseases, and these non-infectious types of myocarditis do not always involve a fever.

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Written by Zhou Yan
Geriatrics
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Criteria for Diagnosing Myocarditis

The diagnosis of myocarditis is primarily clinical, based on typical precursor symptoms, corresponding clinical manifestations, and physical signs. The precursor symptoms usually occur one to three weeks before the onset, including symptoms of a viral infection such as fever, general fatigue, and muscle soreness, or gastrointestinal symptoms like nausea and vomiting. Subsequently, symptoms such as chest tightness, palpitations, difficulty breathing, and even fainting and sudden death may occur. The physical signs generally include arrhythmias, commonly premature atrial contractions, premature ventricular contractions, or conduction blocks. There may be an increased heart rate which does not correspond to the body temperature, and there could be the presence of second or third heart sounds or gallop rhythm. A minority of patients may show signs of heart failure. Tests can include electrocardiograms, enzymatic studies, or echocardiograms, and magnetic resonance imaging may show symptoms of myocardial injury. To confirm the diagnosis, an endomyocardial biopsy must be performed.

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Written by Zhou Yan
Geriatrics
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Manifestations of myocarditis

Myocarditis is an inflammatory disease of the myocardium. Its manifestations depend on the extent and location of the condition; mild cases may have no symptoms, while severe cases can lead to cardiogenic shock and sudden death. Most patients experience precursor symptoms of viral infection one to three weeks before onset, such as fever, general fatigue, and muscle soreness, or gastrointestinal symptoms like nausea and vomiting. Subsequently, they may experience palpitations, chest tightness, difficulty breathing, and potentially fainting or sudden death. Clinically diagnosed myocarditis is mostly due to arrhythmias as the primary complaint, or patients seek treatment for common symptoms.

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Written by Xiao Chang Jiang
Cardiology
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How is myocarditis treated?

Let's talk about how myocarditis is treated. Myocarditis is actually considered a self-limiting disease with no specific cure. However, treatment generally revolves around symptomatic treatment, combining conventional care and symptom management. For general treatment, bed rest is highly recommended for patients suffering from acute viral myocarditis to reduce the strain on the heart. Patients suffering from severe arrhythmias or heart failure are advised to rest in bed for at least one month and are not allowed to participate in strenuous physical labor for six months. For those without cardiac morphological or functional changes, rest for half a month is recommended, followed by avoiding heavy physical activity for three months. Additional antiviral treatments, such as interferon-alpha and Astragalus membranaceus, may be used; protective cardiac therapies or immunotherapies may also be administered. Symptomatic treatment mainly targets patients with severe heart failure or severe arrhythmias, following conventional treatment protocols for these conditions. For patients with complete atrioventricular block, temporary pacemakers may be used, and permanent pacemakers can be installed depending on the situation if the block cannot be resolved. Depending on the type of arrhythmia, antiarrhythmic medications like beta-blockers, amiodarone, and others may also be used. As each patient's cause of illness, severity, and physical constitution vary, it is essential to undergo personalized treatment under the guidance of a doctor.