المظاهر السريرية و النتائج قصيرة الأمد لتدبير التهاب العضلة القلبية الحاد عند الأطفال

Abstract EN

Title: Clinical Features and Short-Term Outcomes of Managing Acute Myocarditis in Children.

Background & Objective: conducts the diagnosis of acute myocarditis can be challenging due to its subtle clinical signs and symptoms as it involves a wide spectrum of clinical features.

Acute Myocarditis is considered to be a significant cause of morbidity and mortality among infants and children.

This study aimed at highlighting clinical features and echocardiographic findings and their relations to prognosis and knowing the short-term outcomes of managing this dangerous disease, especially the fulminant type (AFM).

Materials and Methods: A descriptive prospective study has been conducded involving 23 cases with Acute Myocarditis fulfilling the inclusive diagnostic criteria admitted to pediatric intensive care unit over a period of two from 1/1/2012/ to 31/12/2013.

Comparison between survivors and non survivors was utilized regarding prognosis predictors.

Results:23 cases were included in this study, of whom 11 patients (47.8%) were fulminant type (AFM).

Median age was 2.7 years.

Infants percentage was 65.2%.

12 cases (52%) required mechanical ventilation.

The most important clinical features at admission were dyspnea (91.3%) , agitation and fever (82.6 %) ، and tachycardia (87%) .

Median duration of symptoms before admission was longer in non-survivors (6 days) than survivors (2.5 days) .

Sinus tachycardia with generalized low QRS voltage were noted in 87% on ECG.

Measured cardiac enzymes increased in 87% - 100% of cases.

Mean Left Ventricular Ejection Fraction (LVEF) value was 23%, and the mean Left Ventricular Fractional Shortening (LVFS) was 13% with a statistically significant difference between the survivors and non-survivors (P=0.04) .

Mortality rate was (39.1%).

Conclusion: Mortality rate in Acute Myocarditis is still high in our center due to the high percentage of fulminant type.

Evaluation of myocardial function with echocardiography renders significant prognostic indicators