CLINICODEMOGRAPHIC FEATURES AND OUTCOME OF CHILDREN WITH ACUTE MYOCARDITIS IN TERTIARY CARE PEDIATRIC HOSPITAL IN KASHMIR
Main Article Content
Keywords
Acute myocarditis, children, pediatric cardiology, echocardiography, cardiac troponins, dilated cardiomyopathy, intensive care, IVIG.
Abstract
Background: Acute myocarditis is a potentially life-threatening inflammatory condition of the myocardium that poses significant diagnostic and therapeutic challenges in pediatric patients. Its clinical presentation is highly variable, ranging from mild symptoms to fulminant heart failure or sudden cardiac death. Early diagnosis and appropriate management are critical for improving outcomes.
Aim: To study the clinical profile, demographic characteristics, and outcomes of children with acute myocarditis and to identify prognostic indicators associated with morbidity and mortality.
Methods: This was a prospective observational study conducted over a period of two years (November 2019 to December 2021) at the Department of Pediatrics, G.B. Pant Hospital, GMC Srinagar. Children less than 18 years of age diagnosed with acute myocarditis based on clinical presentation, laboratory findings, and echocardiographic features were included. A total of 58 suspected cases were evaluated, out of which 36 met the inclusion criteria. Detailed clinical history, examination, laboratory investigations, ECG, and echocardiography were recorded. The outcome was assessed as complete recovery, progression to dilated cardiomyopathy (DCM), or mortality. Follow-up was done for six months post-discharge.
Results: Out of 36 confirmed cases, 47.2% were infants under 1 year. Males constituted 52.8% of the cohort. Common symptoms included fever (63.9%), fast breathing (61.1%), poor feeding (52.8%), and irritability (38.9%). ECG abnormalities were present in 92% of cases, with sinus tachycardia being most common. Elevated troponin levels were noted in 66.7% of patients, and echocardiography revealed depressed LV function in the majority, with 27.8% having LVEF <30%. Mechanical ventilation was required in 52.8% of patients and inotropic support in 88.9%. IVIG therapy was administered in 83.3%. The mortality rate was 16.7%, while 25% of survivors showed evidence of progression to DCM.
Conclusion: Acute myocarditis in children predominantly affects infants and can present with non-specific symptoms, making early diagnosis challenging. Echocardiography and cardiac biomarkers are valuable tools in diagnosis and risk stratification. The need for intensive care support is high, and despite treatment, the risks of mortality and long-term morbidity remain significant. Timely recognition and aggressive supportive care are essential for improved outcomes.
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Dr Jafar Ahmad Tantray
Senior Resident, Department of pediatrics , Government Medical College Srinagar, India
Dr Parvaiz Rafieq sohil
Senior Resident, Department of pediatrics , Government Medical College Srinagar, India
Dr Mudasir Akram
Senior Resident, Department of pediatrics , Government Medical College Srinagar, India
Dr Shaista Ahmad
Senior Resident,, Department of pediatrics , Government Medical College Srinagar, India
Dr Shafat Tak
Professor, Department of pediatrics , Government Medical College Srinagar, India