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Children’s heart conditions can’t be prevented, but a lot can be done to improve their hearts at any age. Thanks to advanced technology and the pediatric heart experts at the Nemours Cardiac Center (based at Nemours/Alfred I. duPont Hospital for Children), most children with a heart problem can be quickly diagnosed and treated. At the Cardiac Center, we specialize in the treatment of heart problems, including myocarditis and heart failure.
If your child’s been diagnosed with myocarditis, we’re here to ease your concerns, answer your questions, and give your child the best possible chance for a healthy future.
Myocarditis is an inflammation or infection of the heart muscle. Although we know that infections with certain viruses may be associated with myocarditis, the exact cause of damage to the heart muscle isn’t clear. Usually, we think that it’s an interaction between the immune system, a virus in the heart that results in myocarditis in certain children. Because of this, many children are exposed to viruses known to be associated with myocarditis but they have no damage to the heart muscle at all, whereas others will develop significant myocardial injury.
How Does the Heart Normally Work?
When your child has a congenital heart defect, there’s usually something wrong with the structure of the heart. In order to understand your child’s condition, it can help to know how the heart should work normally.
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Nemours’ experts at KidsHealth.org also offer these helpful resources to help both you and your child understand how the heart works:
Myocarditis can happen at any age. Symptoms can develop rapidly in previously healthy children.
Initial symptoms may include:
- a flu-like illness (muscle pains or “myalgias,” cough, runny nose, fever)
- abdominal complaints (including nausea and vomiting)
Sometimes these symptoms are related to the initial infection with the virus. And some are related to the development of heart failure. The heart function may deteriorate very quickly and cause a child who was doing well at home to need emergency treatment in an intensive care unit (“ICU”).
There are no medicines that clearly improve heart function in children with myocarditis; although, we often use medications that lessen the child’s immune response. Most of the treatment is directed at supporting the child while giving time for the heart muscle to recover. These treatments include medicines that make the heart beat stronger as well as efforts to decrease the amount of work the heart must do.
In many cases, the heart muscle is functioning so poorly that a mechanical pump has to be used to replace the function of the heart. When children come to us extremely ill, they may need extracorporeal membrane oxygenation (or “ECMO,” which is a pump and artificial lung that can replace the function of both the heart and lungs). In other cases, a ventricular assist device (or “VAD”) may be used to replace only the function of the heart. A variety of VADs are available — some can be effective temporarily, and others can last months or years.
At the Nemours Cardiac Center, we’ve had success treating patients with myocarditis with mechanical support (either ECMO or VAD). By resting the heart and taking over its job temporarily, the heart muscle is able to recover over days or weeks. But, in some cases, the muscle is too badly damaged to recover. So these children may have to get a heart transplant.
In some children, the heart muscle will recover completely following an episode of myocarditis, and they should be able to return to their healthy lives. But, in most children, the muscle doesn’t recover completely, and they develop dilated cardiomyopathy. The severity of the cardiomyopathy varies between children — and it may continue to get better or may get worse over time. Children who develop dilated cardiomyopathy will have to take medicines to treat the symptoms of heart failure and to encourage the heart muscle to continue to remodel and improve. Children who need a heart transplant will have to take lifelong medications to prevent rejection.
If your child has myocarditis, know that at the Nemours Cardiac Center we’re here to give your child the very best, most comprehensive and compassionate care. Our goal is to guide your family, from start to finish, through your child’s heart disease journey — and to help your child live the healthiest, most fulfilling life possible.
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Information for Patients
Outpatient Services and Inpatient Units: (302) 651-6660
After 5 p.m. and Weekends:
Cardiac Intensive Care Unit: (302) 651-6644
General Inpatient Unit, 2B: (302) 651-6690