GuidelinesOther guideline
Myocarditis/Cardiomyopathy
Mycocarditis/Cardiomyopathy
Myocarditis is an acute inflammation of the cardiac muscle. Dilated cardiomyopathy refers to a group of conditions of diverse etiology in which both ventricles are dilated with reduced contractility. It is difficult and sometimes impossible to distinguish myocarditis from dilated cardiomyopathy. Watch out for myocarditis. The child will normally present in heart failure, but it frequently masquerades as bronchiolitis. It can occur at any age including newborns and is frequently related to a viral infection.
Clinical features
- Cold, clammy extremities
- Poor perfusion
- Tachycardia
- Poor pulses
- Prolonged capillary refill
- Gallop rhythm
- Hepatomegaly
- Tachypnoea
- Respiratory distress
- Wheezes
- Restlessness
- Irritability or crying
- Poor feeding
- Older children:
- Fatigue
- Malaise
- Exercise intolerance
- Dyspnoea
- Palpitations
- Chest pain
Investigations
- Baseline blood investigations
- CXR: Cardiomegaly / pulmonary congestion
- ECG: Low voltage QRS / ST changes / T wave inversion / Dysrythmia / prolonged QT
- Echocardiogram
Treatment
- Recognise and treat the underlying condition
- 100% Oxygen via rebreather mask
- Lasix and fluid restriction
- Inotropes
- Close monitoring
- Refer and call for help early