Myocarditis means there is inflammation within the heart muscle. Myocarditis in children usually occurs after a viral infection, but rarely can be caused by bacteria, parasites or fungus.  Myocarditis affects the hearts ability to pump and the heart’s electrical system, making the patient at risk for arrhythmias.

With the right medical treatment, most children with myocarditis recover completely within a few months. Some children will need continuing care with a cardiologist.

The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, have the experience and skills to diagnose and provide care for myocarditis in children.

Norton Children’s has a network of outreach diagnostic and treatment services conveniently located throughout Kentucky and Southern Indiana.

Symptoms of Myocarditis in Children

• Fever
• Fast heartbeat or arrhythmia
• Fast breathing
• Trouble feeding or working hard to breathe when feeding
• Failure to thrive
• Restlessness or irritability
• Abnormal sweating
• Little energy or no interest in anything
• Low urine output
• Pale or bluish hands and feet (cyanosis)
• Vomiting

In older children, symptoms also can include cough; nausea; abdominal or chest pain; swelling in the legs, feet and face; and excessive tiredness.

Severe myocarditis can permanently damage the heart muscle. It can cause heart failure where the heart can’t pump blood effectively. In severe cases, people with myocarditis may need a ventricular assist device or a heart transplant because of their severe heart failure.

Since myocarditis-affected hearts are not pumping blood effectively, the blood can pool in the heart, increasing the risk for blood clots. These clots can dislodge and have many life-threatening side effects, including strokes or a pulmonary embolism.

Because myocarditis affects the heart’s electrical system, arrhythmias or very fast heart rates may occur. These rhythms can further worsen the function of the heart making it pump less effectively. Some serious arrhythmias can make a patient’s heart stop beating which can be fatal if not immediately treated.

Diagnosing Myocarditis in Children

At Norton Children’s Heart Institute, your child’s pediatric cardiologist likely will run a number of tests and gather details about your child’s symptoms.

Tests may include:

• Chest X-ray: This shows a picture of the heart and surrounding organs.
• Echocardiogram (echo): This test uses sound waves (ultrasound) to produce images of the heart and blood vessels’ structures on a screen. It can show the structure and function of the heart. Norton Children’s Heart Institute has 28 tele-echo locations throughout Kentucky and Southern Indiana.
• Electrocardiogram (ECG or EKG): This test checks the heart’s electrical activity to show damage or irregular rhythms.
• Cardiac MRI (magnetic resonance imaging): This test uses radio waves, magnets and a computer to form 3D pictures of the heart. These pictures can show structural issues (such as an enlarged ventricle) and help diagnose cardiomyopathies or myocarditis.
• Endomyocardial biopsy (EMB): This procedure is performed through one of the large blood vessels in the neck or groin. A tiny piece of the myocardium (heart) is sampled during an EMB. This is done in an attempt to provide a diagnosis to the patient and family.
• Heart catheterization: During this procedure, a thin, long tube called a catheter is inserted into a large blood vessel in the neck or groin and guided into the heart. This invasive procedure studies the structure and function, and provides direct pressure measurements of the heart.
• Blood test: A polymerase chain reaction test can be done to check for a number of different infectious causes.

Treatment of Myocarditis in Children

There is no one cure for myocarditis. Treatment focuses on the underlying cause, if found, and managing symptoms. The inflammation often goes away on its own over time. Treatment typically focuses on helping the heart work better as it heals and may include:

• Antimicrobial medicines to fight infection if an infectious cause is identified
• Steroid and immunoglobulin medicines to reduce inflammation
• Diuretics to help the body release excess fluid, reducing the heart’s workload
• Standard heart failure medications if the heart is particularly weak
• Blood-thinning medicine if the patient is at risk for blood clots
• Medication or a device such as a pacemaker or defibrillator if arrhythmias are especially problematic
• A ventricular assist device or a heart transplant in the most severe cases

Why Choose Norton Children’s Heart Institute

• Norton Children’s Hospital has been a pioneer in pediatric cardiothoracic surgery, performing Kentucky’s first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
• The American Board of Thoracic Surgery has certified our cardiothoracic surgeons in congenital heart surgery.
• The Adult Congenital Heart Association has accredited Norton Children’s Heart Adult Congenital Heart Disease Program as the only comprehensive care center in Kentucky and Indiana treating adults born with a heart defect.
• More than 17,000 children a year visit Norton Children’s Heart Institute for advanced heart care.
• Norton Children’s Heart Institute has offices across Kentucky and Southern Indiana to bring quality pediatric heart care closer to home.
• The Jennifer Lawrence Cardiac Intensive Care Unit (CICU) at Norton Children’s Hospital is the largest dedicated CICU in Kentucky, equipped with 17 private rooms and the newest technology available for heart care.