Pediatric Myocarditis

Myocarditis remains a challenging disease in children. Clinicians must be aware of the various disease phenotypes and have a high index of suspicion for timely diagnosis. While the mainstay of treatment remains supportive, there is continued controversy regarding the use of immunomodulatory therapies for acute and chronic diseases. Newer diagnostic tools, such as cardiac MRI, have emerged, while routine endomyocardial biopsy is utilized less frequently. Most patients will survive and recover normal cardiac function, but a substantial portion will either die or undergo heart transplantation. However, some data suggest that patients with myocarditis may have related sequela, including increased risk of fatal rejection, even after heart transplant.