Volume 15, Issue 4 (4-2026)
Clin Exc 2026, 15(4): 1-10 |
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Ershad A. Diagnosis, Evaluation, and Treatment of Myocarditis in Children: A Systematic Narrative Review. Clin Exc 2026; 15 (4) :1-10
URL: http://ce.mazums.ac.ir/article-1-952-en.html
URL: http://ce.mazums.ac.ir/article-1-952-en.html
Abstract: (36 Views)
Background: Pediatric myocarditis, due to its heterogeneous etiology and wide range of clinical manifestations, is one of the complex challenges in pediatric cardiology. This review study aimed to summarize recent advances in the diagnosis, evaluation, and treatment of myocarditis in the pediatric population from 2019 to 2025.
Methods: A systematic narrative review was conducted on articles published between 2019 and 2025 in reputable databases (PubMed, ScienceDirect and ProQuest, etc.). In total, 50 studies that met the inclusion criteria were included in this review.
Results: The findings indicate a diagnostic paradigm shift towards non-invasive methods. Cardiac magnetic resonance imaging (CMR) with the updated Lake Louise 2018 criteria has been established as the non-invasive gold standard and has increased diagnostic accuracy. Echocardiography with speckle tracking (STE) is useful in detecting subclinical dysfunction. The role of endomyocardial biopsy (EMB) is limited to high-risk and severe cases and is mostly used to guide immunosuppressive therapy. In the field of treatment, supportive care is fundamental, and the use of mechanical circulatory support (MCS) is critical in fulminant myocarditis. Although the role of immune system modulators is controversial, there is evidence of the effectiveness of intravenous immunoglobulin (IVIG) and targeted therapy based on biopsy. The COVID-19 pandemic introduced new entities, including multisystem inflammatory syndrome (MIS-C) and post-vaccine myocarditis, which require different management approaches.
Conclusion: Modern management of pediatric myocarditis requires a multifaceted and personalized approach. Integrating advanced imaging the selective use of EMB and timely use of MCS is key to improving clinical outcomes.
Methods: A systematic narrative review was conducted on articles published between 2019 and 2025 in reputable databases (PubMed, ScienceDirect and ProQuest, etc.). In total, 50 studies that met the inclusion criteria were included in this review.
Results: The findings indicate a diagnostic paradigm shift towards non-invasive methods. Cardiac magnetic resonance imaging (CMR) with the updated Lake Louise 2018 criteria has been established as the non-invasive gold standard and has increased diagnostic accuracy. Echocardiography with speckle tracking (STE) is useful in detecting subclinical dysfunction. The role of endomyocardial biopsy (EMB) is limited to high-risk and severe cases and is mostly used to guide immunosuppressive therapy. In the field of treatment, supportive care is fundamental, and the use of mechanical circulatory support (MCS) is critical in fulminant myocarditis. Although the role of immune system modulators is controversial, there is evidence of the effectiveness of intravenous immunoglobulin (IVIG) and targeted therapy based on biopsy. The COVID-19 pandemic introduced new entities, including multisystem inflammatory syndrome (MIS-C) and post-vaccine myocarditis, which require different management approaches.
Conclusion: Modern management of pediatric myocarditis requires a multifaceted and personalized approach. Integrating advanced imaging the selective use of EMB and timely use of MCS is key to improving clinical outcomes.
Keywords: Diagnosis, Evaluation, and Treatment of Myocarditis in Children: A Systematic Narrative Review
Type of Study: Review |
Subject:
قلب کودکان
Received: 2026/01/10 | Accepted: 2026/04/30 | Published: 2026/04/30
Received: 2026/01/10 | Accepted: 2026/04/30 | Published: 2026/04/30
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