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Abstract: A 10-year-old child presented to the hospital with transient fainting, which was diagnosed as pediatric myocarditis after ancillary tests and physical examination. Pediatric myocarditis causes inadequate myocardial pumping and ischemia and hypoxia in the brain, resulting in fainting. Astragalus, Radix Angelicae Sinensis and Radix prunus ginseng were given orally to supplement qi and blood, together with coenzyme Q10 capsules. After 1 week of interventional treatment, the child’s condition was significantly relieved and no further fainting occurred.
[Basic information] Female, 10 years old
Disease Type】Pediatric myocarditis
Hospital】Nanjing Hospital of Traditional Chinese Medicine
Date of Consultation】March 2022
Treatment plan】Chinese herbal medicine (Astragalus, Angelica, Prince’s ginseng) + Western medicine oral (Coenzyme Q10 capsule)
Treatment period】Review after 7 days of home treatment
Treatment effect] The child’s condition improved significantly and no more dizziness and fainting occurred
I. Initial consultation
The child was 10 years old and came to the clinic with transient fainting. Blood pressure was within normal range and blood glucose was not high, but the results of myocardial enzyme profile indicated that the child’s phosphocreatine kinase and α-hydroxybutyrate dehydrogenase, especially creatine kinase isoenzyme, were significantly elevated. The elevation of creatine kinase isoenzyme is mainly due to damage to the cardiomyocytes of the child. This indicator is more specific for the presence of myocarditis. In combination with the fact that the child’s complexion is not as red as that of children of the same age, and that he has dizziness and chest tightness, the child’s condition is initially considered to be pediatric myocarditis.
Treatment
In view of the child’s clinical symptoms and signs as well as laboratory tests, the child was initially considered to belong to pediatric myocarditis, so the parents were told that the danger of pediatric myocarditis could potentially cause fulminant myocarditis and even affect the child’s life, so timely intervention and treatment should be given. Treatment was given to Huangqi, Angelica, and prunus ginseng boiled Chinese medicine orally to nourish Qi and blood, together with western medicine to nourish the myocardium (Coenzyme Q10 capsule), and parents were instructed not to let the child exercise strenuously to avoid aggravating the symptoms. After 1 week of treatment, the child’s symptoms were significantly relieved.
Treatment effect
After 1 week of medication, the child’s disease improved significantly, and he did not experience any dizziness, weakness or fainting again, and his mental and appetite conditions were similar to those of his peers. At the same time, myocardial enzyme profile was rechecked and the results indicated that phosphocreatine kinase, ɑ-hydroxybutyrate dehydrogenase and creatine kinase isoenzyme all returned to the normal range.
IV. Precautions
We are glad that the child’s condition has improved significantly after timely treatment, but we suggest that parents should let the child take rest and ensure sufficient sleep for at least 8 hours, and not suitable for strenuous exercise, such as running, jumping rope, kicking soccer, etc., for 1-2 weeks to avoid repeated aggravation of the condition. In addition, parents should pay attention to the child’s diet and try to choose a high-protein, high-vitamin diet, such as eggs, milk, lean meat, fish, fresh fruits and vegetables, etc., and pay attention to nutritional balance to promote disease recovery. If the child is depressed during this period, the parents should also be guided correctly in time.
V. Personal insight
Many pathogens can cause myocardial damage, such as enterovirus and Mycoplasma pneumoniae. These pathogens can directly damage the myocardial cells of children, thus causing the symptoms of myocarditis. The treatment of myocarditis is relatively difficult and requires a high degree of judgment from the physician. If the physician can apply western medicine to nourish the myocardium, together with the identification and treatment of Chinese medicine, using a combination of Chinese and Western medicine treatment plan, it can make the clinical treatment effect more ideal. For example, in this case, the child applied the Chinese medicine of Astragalus, Angelica and Prince’s ginseng to nourish the qi and blood internally, plus the plan of Coenzyme Q10 capsule for For example, in this case, the child was treated with the Chinese herbs of Huangqi, Angelica, and Prince’s ginseng, which tonify the qi and blood, plus Coenzyme Q10 capsules.