MIOCARDITIS EN LA INFANCIA. PROBLEMAS DIAGNOSTICOS Y SEGUIMIENTO EVOLUTIVO DE UNA SERIE DE 20 PACIENTES

Introduction: In childhood, myocarditis mainfestations can be unspecific and pose diagnostic and therapeutic dilemma. Material and methods: We have reviewed the records of 20 children admitted because of myocarditis between 1980 and 1992. In every case, analitical and clinical data, treatment and evolution were evaluated. Results: The age of patients ranged between one month and ten years (mean 28 months). The major complaint that prompted assistance was dispnea. Thorax radiography showed cardiomegaly in 85%, with lung or interstitial edema signs in 50%. In ECG, left cavities hypertrophy and unspecific repolarization disturbances were the most significant alterations. Echocardiography detected ventricular hypokinesia and cavity dilations. At admission diagnosis was established only in 40% of children. Treatment included digoxin and furosemide. Intensive care was needed in 25% of patients. 10% of children died. 45% improved until be cured. 25% clincally improved but remain treatment dependent and 5% do not improved at all. Conclusion: The lack of specifity of the clinical picture of myocarditis in childhood is evident in our serie. That circumstance can propitiate some diagnostic pitfalls. The evolution is not easy predictable, although in the majority of cases that received standard treatment a favourable prognosis can be expected.