یک بررسی در مورد میوکاردیت در جمعیت کودکان
Abstract
1- INTRODUCTION
2- DIAGNOSIS
3- TREATMENT
4- FOLLOW‐UP AND RESTRICTIONS
5- CONCLUSION
REFERENCES
Abstract
Myocarditis has a variable clinical presentation and there is still debate regarding accurate diagnostic criteria. Adding to the controversy surrounding this diagnosis, there is no clear consensus for the treatment or ongoing follow‐up of patients with myocarditis. All of this makes the diagnosis and management of myocarditis a par‐ ticular challenge in the pediatric population. Furthermore, the literature with respect to this topic is dynamic and ever‐changing. In this review article, we aim to review and summarize the common clinical presentations of myocarditis, along with the latest recommendations for diagnostic criteria, treatment, and follow‐up of patients with myocarditis.
INTRODUCTION
Myocarditis has been defined as an “inflammatory disease of the heart muscle which is diagnosed by established histological, immu‐ nologic, and immune‐histological criteria.”1 It has a variable clinical presentation and there is still debate regarding accurate diagnos‐ tic criteria.2-4 The true incidence of myocarditis is difficult to as‐ certain because of its frequent sub‐clinical presentation, though autopsy studies have reported the incidence to be approximately 0.12%‐12%.5,6 Most studies of acute myocarditis report male pre‐ dominance, primarily young adults.7,8 In the pediatric population, it is more common and has a poorer prognosis in children less than two years of age as compared to older children. Myocarditis is commonly associated with abnormalities in electrocardiograms (ECG), noninvasive cardiac imaging, and car‐ diac biomarkers. However, these abnormalities may not always be present in a patient diagnosed with myocarditis. Adding to the controversy surrounding this diagnosis, there is no clear consensus for the treatment or ongoing follow‐up of patients with myocardi‐ tis. All of this makes the diagnosis and management of myocarditis a particular challenge in the pediatric population. In this review, we aim to review and summarize the latest recommendations for diagnostic criteria, treatment, and follow‐up of patients with myocarditis.