The outcome of idiopathic dilated cardiomyopathy and myocarditis in children from the west of Scotland

We analysed retrospectively all infants and children with idiopathic dilate d cardiomyopathy (IDC) and myocarditis at the Regional Cardiac Centre of th e Royal Hospital for Sick Children, Glasgow, during 1980-1997. Among the 39 patients with IDC, 25 (64%) were infants aged <1 year, sight (20.5%) had w heezing as the presenting symptom. and only six (15%) had a significant car diac murmur. Thirty-eight of thirty-nine patients diagnosed in life were fo llowed-up for 1 day to 15 years (median 3 years). Twelve of the thirty-nine (31%) died, six deaths were within a week of presentation and the rest wit hin a year. The survival at 1 year and at 12 years was 0.69 (95% CI 0.54 to 0.84). Fourteen patients had histologically proven myocarditis, and all 9/ 14 (64%) detected at post-mortem and one of the five diagnosed in life died . Patients with myocarditis exhibited an actuarial survival of 0.29 (95% CI 0.04 to 0.53) at 1 year and at 9 years, significantly lower than IDC patie nts (log rank 9.8, P<less than>0.01). There was no difference in the outcom e for patients with positive or negative Coxsackie titres or who presented in the 1980s and in the 1990s. No risk factor that independently influenced the outcome or survival could be identified in either group. Thus our stud y from a relatively well-defined population of the west of Scotland showed that a significant proportion of children with IDC and myocarditis died in the first week of illness and that patients with myocarditis had shorter su rvival. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.