Pediatric Myocarditis in a Community Pediatric Emergency Department: A Case Series
Abstract
Acute fulminant myocarditis is rare but life-threatening and requires prompt recognition and intervention. Myocarditis presents variably, from nonspecific symptoms to severe arrhythmias and cardiogenic shock, complicating timely diagnosis. Community pediatric emergency departments (EDs) may be the first point of contact, necessitating high clinical suspicion among providers. This case series describes two cases of pediatric myocarditis within a six-month period at a community pediatric ED. Both cases illustrate the challenge of early recognition and the need for rapid stabilization and transfer to a tertiary care center in order to achieve favorable outcomes for these patients. Case 1 describes a 13-year-old female who presented with nausea, vomiting, and abdominal pain, later developing complete heart block. Immediate interventions, including pharmacologic support and transcutaneous pacing, stabilized her for transfer. She was diagnosed with acute fulminant viral myocarditis, required extracorporeal membrane oxygenation (ECMO), and was ultimately discharged. Case 2 demonstrates a 10-month-old male who presented after a brief unresponsive episode, which was initially suspected to be a seizure. He developed pulseless ventricular tachycardia requiring defibrillation and was transferred after stabilization. He was confirmed to have acute fulminant viral myocarditis requiring ECMO, then ultimate placement of a ventricular assist device and prolonged intensive care…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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