FREQUENCY AND CLINICAL PRESENTATION OF MYOCARDITS IN PAEDIATRIC PATIENTS WITH CARDIAC FAILURE

Objectives: To determine the frequency of myocarditis in paediatric patients presenting with cardiac failure and to
describe the clinical presentation of myocarditis in children.
Material and Methods: This descriptive study was conducted at the Department of Paediatrics (Emergency and
General Wards), Khyber Teaching Hospital, Peshawar from July 2003 to June 2004. A total of 100 consecutive
children presenting with cardiac failure were subjected to detailed history and examination regarding its aetiology;
and clinical manifestations of myocarditis were also documented on a preformed proforma.
Results: Hundred cases of congestive cardiac failure were studied. Myocarditis was found to be one of the common
causes of congestive heart failure in paediatric patients, constituting 20 % of the cases. Other important causes were
dilated cardiomyopath (50%), congenital heart diseases (26%) and rheumatic heart diseases (4%). Regarding
myocarditis sixty percent of cases were male while forty percent were female. Majority of patients were in the age
group 1-5 years constituting 35% of cases. Common presenting complaints were cough, breathlessness and
orthopnoea. Common clinical signs found in all cases were tachypnoea, tachycardia and hepatomegaly.
Conclusion: Myocarditis is an important paeditric emergency leading to congestive heart failure in significant
number of cases and is also an important cause of morbidity and mortality in paediatric age group. The common
clinical presentation is in the form of respiratory, cardiac, gastrointestinal complaints and pallor.
Key Words: Congestive Heart Failure, Myocarditis, Dilated Cardiomyopathy, Rheumatic Heart Disease.