Andersons pediatric cardiology 1712

Cardiac Manifestations The dominating cardiac manifestation is pericarditis A pericardial friction rub is often present, and, if an effusion is present, the chest radiograph may show an enlarged heart Myocardial involvement may underscore cardiac failure The latter feature may be complicated by valvar dysfunction, either as part of the disease or secondary to the ventricular volume overload The mitral valve is most frequently involved, although significant aortic insufficiency has been described The electrocardiogram will usually show nonspecific changes of the ST segment Disturbances of rhythm and conduction are frequent Treatment The treatment of choice is corticosteroids, which also have a favorable effect on the management of cardiac dysfunction Nonetheless, deleterious effects on the heart from chronic administration of suppressive doses of prednisone have been described Other immunosuppressive agents such as cyclophosphamide have also been used with success Rare case reports mention the use of high doses of intravenous immunoglobulin as well as plasmapheresis Annotated References Baughman KL Diagnosis of myocarditis: death of the dallas criteria Circulation 2006;113:593– 595 Bowles NE, Ni J, Kearney DL, et al Detection of viruses in myocardial tissues by polymerase chain reaction: evidence of adenovirus as a common cause of myocarditis in children and adults J Am Coll Cardiol 2003;42:466–472 The approach to the histologic diagnosis of myocarditis has changed in recent years with realization of the shortcomings of the Dallas criteria Analysis of myocardial samples using the polymerase chain reaction has also changed our views of the common viral etiologies Canter C, Simpson K Diagnosis and treatment of myocarditis in children in the current era Circulation 2014;129:115–128 Singh R, Humlicek T, Jeewa A, et al Pediatric cardiac intensive care society 2014 consensus statement: pharmacotherapies in cardiac critical care immune therapy Pediatr Crit Care Med 2016;63:69–76 Consensus statement on the use of immune therapy in pediatric heart failure of various causes, ... myocarditis in children in the current era Circulation 2014;129:115–128 Singh R, Humlicek T, Jeewa A, et al Pediatric cardiac intensive care society 2014 consensus statement: pharmacotherapies in cardiac critical... care immune therapy Pediatr Crit Care Med 2016;63:69–76 Consensus statement on the use of immune therapy in pediatric heart failure of various causes,