📍Acute myocarditis in children

📌Myocarditis is an inflammatory disease of the myocardium, due to countless causes and is the result of various myocardial disorders. But this medication does not lead to this disease.
✅The true frequency of myocarditis remains unknown, since the disease can be subclinical and mild and remain unnoticed against the background of a viral disease, especially in cases where the infection proceeds with bright respiratory or gastrointestinal symptoms.
✅ The frequency of myocarditis, according to various sources, ranges from 2 cases per 100 thousand patient-years, with a predominance in males over the age of 6 years. There is no sexual predisposition in children under 6 years of age.

✅In a large study, according to autopsy data (1516 cases, age 10 days – 16 years), histologically confirmed myocarditis was recorded in 2% of cases. Histologically confirmed myocarditis is the cause of death in 2% of infant deaths and 5% in children over 5 years of age. ⠀
✅ Myocarditis was the cause of sudden death in 57% of cases in the study and in 5-6% of young athletes. ⠀
✅ Myocarditis is also the cause of chronic cardiomyopathy, which is the leading cause of heart transplants in pediatric practice in children under 1 year of age.
⠀🔺 Viral myocarditis is thought to be the cause of chronic cardiomyopathy. However, it is difficult to assess reliably what is the true cause of cardiomyopathy, whether it is a viral infection that provoked the development of myocarditis and subsequently cardiomyopathy, or a viral infection that decompensated the subclinical cardiomyopathy.

📝The gold standard for the diagnosis of myocarditis is the histological analysis of the endocardium, but more often, in practice, the diagnosis is based on the data of the clinical picture

Etiology, classification
Myocarditis can be classified according to etiology: infectious, immunological, toxic; histologically, according to myocardial infiltration with cells: eosinophils, lymphocytes, granulomatous cells, neutrophils;
according to clinical data: fulminant, acute, subclinical, including chronic with active persistent inflammation or chronic without persistent inflammation.

Despite the many causes of myocarditis, the cause remains unrecognized in most cases.

Viral etiology is the most commonly identified cause of myocarditis in North America and Eastern Europe; rheumatic carditis, myocarditis as manifestations
Chaga disease and bacterial infection (diphtheria, for example) are the leading causes
myocarditis in developing countries.

Historically, the enterovirus, especially the Coxsackie B serotype, was thought to be the leading cause of viral myocarditis.
However, in recent studies, it has been found that parvovirus B 19, herpes type 6 and adenovirus are much more common. In total, there are about 20 known cardiotropic
Myocarditis due to bacterial infection is much less common.

Myocarditis due to bacterial infection is much less common.
Borrelia burgdorferi, which is the cause of Lyme disease, can cause acute and
chronic myocarditis. In a study of 207 children with Lyme disease, 16% had carditis and 42% had carditis as a cause of heart block.

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