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Symptoms of myocarditis in children
Last reviewed: 04.07.2025
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Myocarditis, as an inflammatory disease of the myocardium, in most pediatric patients occurs without pronounced cardiac symptoms, and often asymptomatically, usually benign or subclinical. On the other hand, in sudden infant death syndrome, acute myocarditis is often diagnosed as the cause of death at autopsy. It should be noted that children rarely actively complain; more often, parents notice the child's health problems.
The first symptoms of myocarditis in children usually appear at the end of the 1st or 2nd week from the onset of the infectious disease, i.e. not at the height of the febrile period, but in the early, less often - late convalescence phase. Against the background of the fading of the acute respiratory process, they are assessed as a complication, and at a certain stage they become dominant and determine the clinical picture of the disease. In this case, the only manifestation of the current myocarditis may be disturbances in the rhythm and conduction of the heart, changes in the repolarization process on the ECG, without any subjective manifestations. For a severe course of acute myocarditis in children, a clinical picture of acute cardiac and vascular insufficiency of varying severity is characteristic.
In young children, difficulty feeding, increased sweating, increasing anxiety, and agitation are noted. In older children, weakness, adynamia, possible abdominal pain accompanied by nausea and vomiting, and often fainting (syncope) due to sudden cerebral hypoxia due to low cardiac output or asystole are detected. Noteworthy are coughing, which intensifies with a change in body position, rapid breathing without deepening in acute left ventricular failure and with difficulty breathing like dyspnea in acute right ventricular or total failure. Signs of hypovolemia (decreased venous pressure, collapsed veins, cold extremities, thickening of the blood) and vascular innervation disorders (marbled skin pattern with a cyanotic tint, changes in blood pressure, weak pulse) are determined.
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