Myocarditis is not something that can be prevented with healthy living. Most of those affected are otherwise very healthy and physically active before their experience with myocarditis. We need to help raise awareness about the disease so that you can be aware of it and alert your doctors about it if the symptoms are present.
Early diagnosis is the key to improved outcomes from the disease. While myocarditis is considered a rare disease, it is truly difficult to ascertain its true incidence and prevalence. Many cases are likely subclinical, and unrecognized. Being a rare disease, it has not been taught in medical school to any great scale in the past. It is taught more as of recently, thanks to Dr. Leslie Cooper’s efforts.
Signs and symptoms of Acute Heart Failure from myocarditis vary tremendously.
In children, Acute heart failure statistics:
- 68% are male
- 25% are caused by suspected acute myocarditis
- 27% are caused by Idiopathic Dilated Cardiomyopathy (not sure why, but these could also be caused by myocarditis)
Acute heart failure symptoms are:
- Shortness of breath, inability to lie flat
- Chest pain
- Abdominal discomfort
- Vomiting and diarrhea
- Decreased exercise tolerance
- History of recent viral infection
If your child has any of these symptoms, it is important to take them to a physician and have them evaluated. Many times they are incorrectly diagnosed with:
- Gastroenteritis, and other things that can have similar symptoms.
The key often is a recent viral infection. Viruses are the common cause of myocarditis in children.
In a study referenced by Dr. Jack Price at the Texas Children’s Myocarditis Seminar in March 2017, Dr. Kriti Puri studied 193 consecutive children admitted with Heart Failure. 52% of them had a missed diagnosis by prior doctors. They had an average of 2 encounters with a doctor before they were correctly diagnosed. 50% were evaluated by a Primary Care Physician and 50% were evaluated by ER Staff. At this seminar, pediatricians told us that they would never look at a viral syndrome the same again.
While there is no specific test to diagnose viral myocarditis, BNP is an easy blood test that can be performed. BNP is a hormone that is secreted by cardiomyocytes in the ventricles of the heart in response to stretching caused by increased ventricular blood volume. BNP if elevated, it is a red flag to look further into what is the cause of it.
Other tests that may help diagnose acute heart failure are a chest x-ray…Not only to look at the lung fields, but to observe the size of the heart. No healthy child should have an enlarged heart.
Doctors should also be doing a more in depth physical exam when a child presents with these symptoms of heart failure such as listening for abnormal heart sounds, such as a Gallop Rhythm, and palpating the liver margins feeling for increased size indicating possible fluid congestion. Looking for an elevated JVP in the neck is a simple and easy way to look for increased fluid in the body also.
Since many symptoms of what are considered “normal viral diseases” can mimic myocarditis, if you put the “bug” in the doctors’ ear to look for these things, you are being a better advocate for your child. Once you mention these to them, they will look for them and question their clinical diagnosis. As you can see from the study by Dr. Puri, the children had an average of 2 visits to the doctor before the correct diagnosis was made. Remember, the earlier the diagnosis is made, the better the outcome.
Let’s all raise awareness for correctly diagnosing myocarditis with this years World Heart Day.
Share this with all your family and friends to make a bigger impact.
Please donate to the Myocarditis Foundation today at www.myocarditisfoundation.org to help us continue our mission of education, funding research, supporting emotionally those affected by the disease and our ultimate goal of saving lives from this devastating disease.
We thank you!