Symptoms may be mild at first and difficult to detect.
In newborns and infants, symptoms may sometimes appear suddenly and may include:
Symptoms in children over age 2 may also include:
Pediatric myocarditis can be difficult to diagnose because the signs and symptoms often mimic those associated with other heart and lung diseases.
The doctor may hear a rapid heartbeat or abnormal heart sounds while listening to the child' s chest with a stethoscope. A physical examination may detect fluid in the lungs and swelling in the legs in older children.
There may be signs of infection, including fever, rashes, red throat, itchy eyes, and swollen joints.
A chest x-ray can show enlargement (swelling) of the heart. An electrocardiogram and echocardiogram should also be done.
Further tests may include:
Freedman SB, Haladyn JK, Floh A, Kirsh JA, Taylor G, Thull-Freedman J. Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation. Pediatrics. 2007 Dec;120(6):1278-85.
Behrman RE. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: WB Saunders; 2007.
Park MK, Troxler RG. Pediatric Cardiology for Practitioners. 5th ed. St. Louis, Mo: Mosby, Inc; 2008.
Schwartz SM, Wessel DL. Medical cardiovascular support in acute viral myocarditis in children. Guidelines for the Treatment of Myocarditis in Infants and Children and Proceedings of the 2005 Pediatric Cardiac Intensive Care Symposium. Pediatr Crit Care Med. 7(6) Supplement:S12-S16, November 2006.
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