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Treatment and prognosis of myocarditis in children

Catherine K Allan, MD
David R Fulton, MD
Section Editors
John K Triedman, MD
Sheldon L Kaplan, MD
Deputy Editor
Carrie Armsby, MD, MPH


Myocarditis is a condition resulting from inflammation of the heart muscle. Myocellular damage results in myocardial dysfunction leading to heart failure. In contrast to adults, the majority of children with myocarditis present with acute or fulminant disease usually due to a viral infection. Children with myocarditis are at risk for arrhythmias and hemodynamic compromise, resulting in significant morbidity and mortality.

The natural course, management, and prognosis of myocarditis in children are reviewed here. The causes, incidence, clinical manifestations, and diagnosis of myocarditis in children are discussed separately. (See "Etiology and pathogenesis of myocarditis" and "Clinical manifestations and diagnosis of myocarditis in children".)


Viral myocarditis can be considered a continuum of two or three disease processes, which transition from one to another in a seamless manner [1,2]. (See "Etiology and pathogenesis of myocarditis", section on 'Viral myocarditis and dilated cardiomyopathy'.)

Viral infection phase is often reported as a prodromal presentation of fever, myalgia, and malaise several days prior to the onset of symptoms of heart dysfunction. Respiratory and gastrointestinal symptoms are also common in this phase. Viral infection may result in direct myocyte injury. (See "Clinical manifestations and diagnosis of myocarditis in children", section on 'Presentation'.)

The use of antiviral agents has been proposed; however, their efficacy is unproven in the treatment of myocarditis [3]. (See 'Antiviral therapies' below.)

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Literature review current through: Nov 2017. | This topic last updated: Mar 09, 2017.
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