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Zhongguo Dang Dai Er Ke Za Zhi. 2015 Nov;17(11):1232-6.

[Clinical features and prognostic factors in children with fulminant myocarditis].

[Article in Chinese]

Author information

1
Department of Pediatric Intensive Care Unit, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, China. liucf@sj-hospital.org.

Abstract

OBJECTIVE:

To investigate the clinical features and prognostic factors in children with fulminant myocarditis.

METHODS:

The clinical data of 24 children with fulminant myocarditis were retrospectively analyzed. According to the prognosis, these children were classified into two groups: survival (n=12) and death (n=12). The risk factors influencing prognosis in children with fulminant myocarditis were identified by logistic regression analysis.

RESULTS:

Among the 24 cases of fulminant myocarditis, gastrointestinal symptoms were found as initial symptoms in 14 cases, neurological symptoms in 12 cases, respiratory symptoms in 1 case, and cardiac symptoms in 2 cases. On admission, serum levels of creatine kinase MB, troponin I, and brain natriuretic peptide (BNP) were all increased. Besides, left ventricular ejection fraction (LVEF) decreased in 22 cases (92%), cardiothoracic ratio increased in 10 cases, third-degree atrioventricular block was observed in 8 cases, ST-segment changes were found in 11 cases and ventricular tachycardia was identified in 2 cases. LVEF in the death group was lower than in the survival group (P<0.05), while the peak level of serum BNP during hospitalization in the death group was higher than in the survival group (P<0.05). The multivariate logistic regression analysis revealed that LVEF was the risk factor influencing prognosis (OR=7.418; P<0.05).

CONCLUSIONS:

Fulminant myocarditis has no specific clinical features in children. A decreased LVEF is a risk factor for poor prognosis in children with fulminant myocarditis.

PMID:
26575884
[Indexed for MEDLINE]
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