After a common cold, Xiao Ming had a long period of lethargy, weakness, low fever, and reported tightness in his chest and long sighs. This scared Xiao Ming’s mother, how could a common cold bring about the dreaded pediatric viral myocarditis?
Yes, what is pediatric viral myocarditis?
Pediatric viral myocarditis is a common disease in pediatrics in winter and spring. It is a disease caused by viral invasion of the heart with inflammatory lesions of the myocardium as the main manifestation. Viral myocarditis has a high incidence and is more dangerous in pediatric patients.
What factors can trigger or cause viral myocarditis in children?
There are more than 20 viruses that can cause myocarditis: coxsackieviruses (groups A and B), echoviruses, polioviruses, adenoviruses, infectious hepatitis viruses, influenza and parainfluenza viruses, measles viruses, herpes simplex viruses, mumps viruses, rhinoviruses and herpes viruses, among which coxsackievirus group B (types 1-6) is the most common.
However, there are many opportunities for children to be infected by these viruses, for example, in winter and spring when colds are prevalent, children are easily infected. However, most children have fever, cough, and runny nose, and after treatment and rest, they get better in a few days and do not develop myocarditis. Therefore, children with myocarditis also have their own myocardial susceptibility and some other triggers, i.e., during the infection of the virus and the interference of some unfavorable factors, such as strenuous exercise, excessive fatigue, combined with bacterial infections, nutritional deficiencies, trauma, surgery, etc., the baby’s own immunity is reduced, then, viral myocarditis will take advantage of it.
What are the signs of myocarditis in children?
Viral myocarditis usually develops 1 to 3 weeks after the onset of a cold, and its clinical symptoms vary in severity. Generally speaking, the lighter ones may have dizziness, fatigue, loss of appetite, chest tightness and shortness of breath. With the development of the disease, children may develop nausea and vomiting, precordial pain, tachycardia, arrhythmia (such as frequent premature ventricular contractions, etc.); in severe cases, the disease may manifest as fulminant myocarditis: the condition changes rapidly within a few hours, resulting in respiratory distress, swelling, and even heart failure, shock or syncope. In a very small number of children, the disease may recur as congestive heart failure or progressive heart enlargement, which may become chronic myocarditis, or even irreversible dilated cardiomyopathy in a very small number of cases, thus endangering the child’s life.
Does high cardiac enzymes mean myocarditis?
There are strict pathological criteria for the diagnosis of viral myocarditis abroad. The diagnosis of pathology requires a myocardial biopsy, i.e. the use of instruments to take myocardial tissue directly from the child’s heart for pathological examination, which itself is invasive and has certain limitations in terms of reliability. Therefore, domestic clinical work has developed clinical diagnostic criteria based on the actual situation, which include many signs and examination indicators. The doctor will do the appropriate tests and make a diagnosis based on the child’s condition. Of course, the diagnosis needs to be more rigorous to avoid unnecessary burden on the child and parents, but the treatment should be as broad and aggressive as possible, after all, myocarditis delayed treatment may have consequences.