Diagnosis and treatment of pediatric viral myocarditis

Acute myocarditis is characterized by the rapid development of life-threate ning congestive heart failure and arrhythmias. Although the initial stages of this disorder apparently result from direct cytopathic effects on the at rial and ventricular myocardium, later stages of progressive decompensation may result from immune-mediated myocyte destruction. There has been recent improvement in understanding the role of this immunologic cascade. As a re sult, treatment now begins earlier in the course of the disease and can tar get both the virus and the immune response. Our ability to implement mechan ical support in children as a bridge to transplant or recovery, even in chi ldren presenting in the final stages of their disease, has led to an improv ed outcome regarding morbidity and mortality, Curr Opin Cardiol 2001, 16:77 -83 (C) 2001 Lippincott Williams & Wilkins, Inc.