Most patients with acute myocarditis are diagnosed weeks after viral infection, making it questionable whether the therapy could be given early enough to be beneficial. They identified MLC-1 as a prominent culprit of severe myocardial dam - age in FM and demonstrated substantial elimination of this molecule by CRRT. In addition, although studies have shown that CMR has a high sensitivity for the diagnosis of AFM, it is necessary to conduct a randomized prospective trial to demonstrate its specificity in the diagnosis of these patients.AFM has a rapid onset and can progress to heart failure and cardiogenic shock in a short period of time. The contrast agent used in LGE was gadolinium-diethylenetriaminepentacetate (Gd-DTPA).The diagnosis is established when the CMR performance meets two or more of the following three criteria: ① Regional or global myocardial signal intensity increases in T2-weighted images (T2WI); ② Increased global myocardial early enhancement ratio between the myocardium and skeletal muscle in gadolinium-enhanced T1-weighted images (T1WI); There is at least 1 focal lesion with nonischemic regional distribution in inversion recovery-prepared late gadolinium-enhanced T1WI (LGE).SPSS 25.0 statistical software was used, and the measured data are expressed as the range (mean ± standard deviation). A small case studyOn the basis of its known antiviral, anti-inflammatory, and immunomodulating effectsImmunosuppressive therapy has a clear place in the management of giant cellImmunosuppressive therapy has been revisited recently, focusing on patients thought to have an inflammatory dilated cardiomyopathy characterized by symptoms that were unresponsive to time and conventional therapy for a number of months and myocardial inflammation defined by immunohistochemistry and histology.Concordant with the initial use of immunosuppression in adult myocarditis, a number of small case series, retrospective reviews, and mostly uncontrolled clinical trialsDespite this controversy, prednisone is currently used in 25% to 30% of the cases of acute myocarditis in the United States,In 1990, Boston Children’s Hospital and Children’s Hospital of Los Angeles combined to include a 2-mg/kg dose of IVIG in the routine management of children presenting with presumed acute myocarditis on the basis of an observed improvement in left ventricular function after IVIG treatment in myocarditis associated with Kawasaki diseaseUse of IVIG for the treatment of pediatric acute myocarditis has become widespread. By continuing to browse this site you are agreeing to our use of cookies.Myocarditis has been defined by the World Health Organization/International Society and Federation of Cardiology as an inflammatory disease of the heart muscle diagnosed by established histological, immunologic, and immunohistological criteria.In a somewhat confusing fashion, the American Heart Association’s contemporary definitions of cardiomyopathies classify myocarditis as an inflammatory cardiomyopathy but also lists the same infectious causes of dilated cardiomyopathy as those found with myocarditis.Tachypnea and an abnormal respiratory examination were the most frequently described presenting symptoms in emergency department patients ultimately diagnosed with myocarditis.ECGs are virtually always abnormal in children with myocarditis, but a normal ECG does not rule out the possibility of the disease.Nonspecific markers of inflammation (white blood cell count, C-reactive protein, and erythrocyte sedimentation rate) are often elevated in myocarditis, but normal studies do not exclude a myocardial inflammatory process.Although determining acute and convalescent viral serologies is the traditional way to diagnose viral infections, it is likely of limited, if any, use in the determining viral origin in myocarditis.Echocardiography remains the most common tool to assess left ventricular structure and function in pediatrics. There were 5 cases of pericardial effusion, all of which were light.Eight patients in group A underwent CMR follow-up, of whom 6 returned to normal after 25–63 days of onset, and 2 patients still had mild LGE at 33 and 46 days of onset, respectively, although the lesion range was smaller than before.Six of the 8 patients in group B who underwent CMR during the recovery period had abnormal results. View all
Although the most common echocardiographic finding associated with myocarditis is a dilated cardiomyopathy phenotype of left ventricular dilatation and reduced ejection fraction, hypertrophic and restrictive phenotypes have been described in histologically proven myocarditis.Currently, cardiac MRI (cMRI) may be the most helpful imaging tool for the diagnosis of myocarditis. It can show not only the location of myocardial injury but also the degree and extent of myocardial inflammation, as well as the repair of fibrosis after inflammation, which is helpful for the early identification of children with AFM. In a study of pediatric acute myocarditis admissions in 42 American tertiary care hospitals from 2006 to 2011Acute pediatric myocarditis is commonly associated with severe, progressive heart failure.
CMR is highly sensitive for the diagnosis of AFM, especially within 14 days of onset.
Supplementary One of the patients had no abnormalities in the initial examination and follow-up examination.
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