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J. Cardiovasc. Dev. Dis. 2016, 3(4), 31; doi:10.3390/jcdd3040031

Myocarditis in Paediatric Patients: Unveiling the Progression to Dilated Cardiomyopathy and Heart Failure

1
Faculty of Medicine of Porto University, Porto 4200-319, Portugal
2
Department of Paediatric Cardiology, Centro Hospitalar São João, Porto 4200-319, Portugal
3
Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of Porto University, Porto 4200-319, Portugal
*
Author to whom correspondence should be addressed.
Academic Editor: Joel D. Schilling
Received: 29 August 2016 / Revised: 29 October 2016 / Accepted: 3 November 2016 / Published: 8 November 2016
(This article belongs to the Special Issue Heart Failure Pathogenesis and Management)
View Full-Text   |   Download PDF [3271 KB, uploaded 8 November 2016]   |  

Abstract

Myocarditis is a challenging and potentially life-threatening disease associated with high morbidity in some paediatric patients, due to its ability to present as an acute and fulminant disease and to ultimately progress to dilated cardiomyopathy. It has been described as an inflammatory disease of the myocardium caused by diverse aetiologies. Viral infection is the most frequent cause of myocarditis in developed countries, but bacterial and protozoal infections or drug hypersensitivity may also be causative agents. The prompt diagnosis in paediatric patients is difficult, as the spectrum of clinical manifestation can range from no myocardial dysfunction to sudden cardiac death. Recent studies on myocarditis pathogenesis have revealed a triphasic nature of this disease, which influences the diagnostic and therapeutic strategies to adopt in each patient. Endomyocardial biopsy remains the gold standard for diagnosing myocarditis, and several non-invasive diagnostic tools can be used to support the diagnosis. Intravenous immunoglobulin has become part of routine practice in the treatment of myocarditis in paediatric patients at many centres, but its true effect on the cardiac function has been the target of many studies. The aim of this review is to approach the recently discovered facets of paediatric myocarditis regarding its progression to dilated cardiomyopathy. View Full-Text
Keywords: myocarditis; dilated cardiomyopathy; heart failure; inflammation; viral myocarditis myocarditis; dilated cardiomyopathy; heart failure; inflammation; viral myocarditis
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Farinha, I.T.; Miranda, J.O. Myocarditis in Paediatric Patients: Unveiling the Progression to Dilated Cardiomyopathy and Heart Failure. J. Cardiovasc. Dev. Dis. 2016, 3, 31.

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