Infection and inflammation of heart muscle, usually due to viruses such as Parvovirus B19, or to bacteria like Borrelial Burgdorferi, or parasites like Trypanosoma Cruzi.Encyclopedia Entry for Myocarditis :Myocarditis - pediatric. Myocarditis is rare in young children. It is slightly more common in older children and adults. It is often worse in newborns and young infants than in children over age 2. Most cases in children are caused by a virus that reaches the heart. These can include the influenza (flu) virus, Coxsackie virus, parovirus, and adenovirus. It may also be caused by bacterial infections such as Lyme disease. Other causes of pediatric myocarditis include: Allergic reactions to certain medicines Exposure to chemicals in the environment Infections due to fungus or parasites Radiation Some diseases (autoimmune disorders) that cause inflammation throughout the body Some drugs The heart muscle may be directly damaged by the virus or the bacteria that infect it. The body's immune response can also damage the heart muscle (called the myocardium) in the process of fighting the infection. This can lead to symptoms of heart failure.Symptoms may be mild at first and hard to detect. However, in newborns and infants, symptoms may sometimes appear suddenly. Symptoms may include: Anxiousness Failure to thrive or poor weight gain Feeding difficulties Fever and other symptoms of infection Listlessness Low urine output (a sign of decreasing kidney function) Pale, cool hands and feet (a sign of poor circulation) Rapid breathing Rapid heart rate Symptoms in children over age 2 may also include: Belly area pain and nausea Chest pain Cough Fatigue Swelling (edema) in the legs, feet, and face.Pediatric myocarditis can be hard to diagnose because the signs and symptoms often mimic those of other heart and lung diseases, or a bad case of the flu. The health care provider may hear a rapid heartbeat or abnormal heart sounds while listening to the child's chest with a stethoscope. A physical exam may detect fluid in the lungs and swelling in the legs in older children. There may be signs of infection, including fever and rashes. A chest x-ray can show enlargement (swelling) of the heart. If the provider suspects myocarditis based on the exam and chest x-ray, an electrocardiogram may also be done to help make the diagnosis. Other tests that may be needed include: Blood cultures to check for infection Blood tests to look for antibodies against viruses or the heart muscle itself Blood tests to check liver and kidney function Complete blood count Heart biopsy (the most accurate way to confirm the diagnosis, but not always needed) Special tests to check for the presence of viruses in the blood (viral PCR).There is no cure for myocarditis. The heart muscle inflammation will often go away on its own. The goal of treatment is to support heart function until the inflammation goes away. Many children with this condition are admitted to a hospital. Activity often needs to be limited while the heart is inflamed because it can strain the heart. Treatment may include: Antibiotics to fight bacterial infection Anti-inflammatory medicines called steroids to control inflammation Intravenous immunoglobulin (IVIG), a medicine made of substances (called antibodies) that the body produces to fight infection, to control the inflammatory process Mechanical support using a machine to help the heart function (in extreme cases) Medicines to treat symptoms of heart failure Medicines to treat abnormal heart rhythms.Recovery from myocarditis depends on the cause of the problem and the child's overall health. Most children recover completely with proper treatment. However, some may have permanent heart disease. Newborns have the highest risk for serious disease and complications (including death) due to myocarditis. In rare cases, severe damage to the heart muscle requires a heart transplant.Complications may include: Enlargement of the heart that leads to reduced heart function (dilated cardiomyopathy) Heart failure Heart rhythm problems.Call your child's pediatrician if signs or symptoms of this condition occur.There is no known prevention. However, prompt testing and treatment may reduce the disease risk.Myocarditis Myocarditis.McNamara DM. Heart failure as a consequence of viral and nonviral myocarditis.Encyclopedia Entry for Myocarditis :Myocarditis. Myocarditis is an uncommon disorder. Most of the time, it is caused by an infection that reaches the heart. When you have an infection, your immune system produces special cells to fight off disease. If the infection affects your heart, the disease-fighting cells enter the heart. However, the chemicals made by these cells can also damage the heart muscle. As a result, the heart can become thick, swollen, and weak. Many cases are caused by a virus that reaches the heart. These can include the influenza (flu) virus, coxsackievirus, parovirus, cytomegalovirus , adenovirus, and others. It may also be caused by bacterial infections such as Lyme disease, streptococcus, mycoplasma, and chlamydia. Myocarditis Other causes of myocarditis include: Reactions to certain medicines, such as certain chemotherapy drugs Exposure to chemicals in the environment, such as heavy metals Infections due to fungus or parasites Radiation Autoimmune disorders that cause inflammation throughout the body Sometimes the exact cause may not be discovered.There may be no symptoms. Symptoms may be similar to the flu. If symptoms occur, they may include: Chest pain that may resemble a heart attack Fatigue or listlessness Fever and other signs of infection including headache, muscle aches, sore throat, diarrhea, or rashes Joint pain or swelling Leg swelling Pale, cool hands and feet (a sign of poor circulation) Rapid breathing Rapid heart rate Other symptoms that may occur with this disease: Fainting , often related to irregular heart rhythms Low urine output.Myocarditis can be hard to diagnose because the signs and symptoms often mimic those of other heart and lung diseases, or a bad case of the flu. The health care provider may hear a rapid heartbeat or abnormal heart sounds while listening to the child's chest with a stethoscope. A physical exam may detect fluid in the lungs and swelling in the legs in older children. There may be signs of infection, including fever and rashes. A chest x-ray can show enlargement (swelling) of the heart. If the provider suspects myocarditis based on the exam and chest x-ray, an electrocardiogram may also be done to help make the diagnosis. Heart biopsy is the most accurate way to confirm the diagnosis, but it is not always needed, Also, a heart biopsy may not reveal the diagnosis if the small piece of heart tissue that is removed does not contain the suspected organism or other indicators. Other tests that may be needed include: Blood cultures to check for infection Blood tests to look for antibodies against viruses or the heart muscle itself Blood tests to check liver and kidney function Complete blood count Special tests to check for the presence of viruses in the blood (viral PCR).Treatment is aimed at the cause of the problem, and may involve: Antibiotics to fight bacterial infection Medicines called steroids to reduce swelling Intravenous immunoglobulin (IVIG), a medicine made of substances (called antibodies) that the body produces to fight infection, to control the inflammatory process Diuretics to remove excess water from the body Low-salt diet Reduced activity If the heart muscle is weak, your provider will prescribe medicines to treat heart failure. Abnormal heart rhythms may require the use of other medicines. You may also need a device such as a pacemaker, or implantable cardioverter-defibrillator's to correct a dangerous abnormal heartbeat. If a blood clot is in the heart chamber, you will also receive blood thinning medicine. Rarely, a heart transplant may be needed if the heart muscle has become too weak to function.The outcome can vary, depending on the cause of the problem and a person s overall health. Some people may recover completely. Others may have lasting heart failure.Complications may include: Cardiomyopathy Heart failure Pericarditis.Call your provider if you have symptoms of myocarditis, especially after a recent infection. Seek medical help right away if: Your symptoms are severe. You have been myocarditis, and you have increased chest pain , swelling , or breathing problems.Treat conditions that cause myocarditis promptly to reduce the risk.Inflammation - heart muscle.Myocarditis Myocarditis Heart, section through the middle Heart, section through the middle Heart, front view Heart, front view Lymph tissue in the head and neck. Lymph tissue in the head and neck.Cooper LT, Knowlton KU. Myocarditis.