Hanaa Ibrahim Rady
Cairo University
Egypt
Title: Prevalence of myocarditis in pediatric intensive care unit cases presenting with other system involvement
Biography
Biography: Hanaa Ibrahim Rady
Abstract
Myocarditis is a challenging diagnosis to make. It is the most common cause of heart failure in otherwise healthy children. We aimed to determine children with myocarditis, the frequency of various presenting symptoms and the accuracy of different investigations in the diagnosis. We performed an observational study of 63 patients admitted to PICU with non-cardiac diagnosis. Cardiac enzymes, chest-X ray, echo and ECG were performed to diagnose myocarditis among those patients.
RESULTS: There were 16 cases of definite myocarditis. The age distribution was non-normal, with median 5.5 mo (3.25-21). Of the 16 patients who were diagnosed with myocarditis, 62.5% were originally diagnosed as having respiratory problems and females were more than males.
Among our cases, the accuracy of cardiac enzymes (cTn and CKMB) in the diagnosis of myocarditis was only 63.5%, while the accuracy of low FS and of CXR cardiomegaly was 85.7% and 80.9%; respectively. Cardiac Troponin folds 2.02 had predictive value of positive = 100%, predictive value of negative = 88.7%, specificity = 100%, sensitivity = 62.5% and accuracy =90.5%. Children with myocarditis present with symptoms that can be mistaken for other types of illnesses. When clinical suspicion of myocarditis exists, CXR and echocardiography are sufficient screening test. Cardiac Troponins confirm the diagnosis in screened cases, with specificity 100%.