Key result
Medical therapy and ICD fail in pediatric subacute myocarditis progressing to DCM, necessitating heart transplantation.
Case Report (n=1)
This case highlights the potential for subacute myocarditis in children to rapidly progress to refractory dilated cardiomyopathy requiring heart transplantation despite medical and device therapy.
May warrant early transplant evaluation in refractory pediatric myocarditis-DCM; leaves open predictors of progression and optimal timing.
The article describes the clinical case of subacute myocarditis in a child with an outcome in dilated cardiomyopathy, complicated with congestive heart failure. Difficulties in diagnosing the disease that manifested with cardiac arrhythmia are discussed. The main signs suggesting postmiocardic cardiomyopathy included a reduced deflection voltage and frequent ventricular extrasystoles with episodes of the ventricular tachycardia in the onset of the disease, left ventricular dilatation, a significant decrease in ejection fraction, increased activity of natriuretic peptide, findings of perfusion scintigraphy and magnetic resonance imaging. Medical therapy and implantation of a cardioverter defibrillator were ineffective. The child repeatedly suffered from syncopal conditions with circulatory arrest, which required resuscitation. Due to the ineffectiveness of drug therapy conducted in the leading federal centres, considering cardiac transplantation abroad was recommended.
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Балыкова et al. (2018) conducted a case report in Subacute myocarditis progressing to dilated cardiomyopathy and refractory heart failure (n=1). Medical therapy and cardioverter defibrillator implantation was evaluated. Medical therapy and ICD implantation were ineffective in a child with subacute myocarditis progressing to dilated cardiomyopathy, necessitating recommendation for heart transplantation.
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