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Pediatric Myocarditis

Myocarditis is inflammation – swelling – of the heart muscle. This swelling can affect how the heart works and weaken it.

At Children’s Health, our pediatric cardiologists have a great deal of experience diagnosing and treating myocarditis. The multidisciplinary team has the expertise and the advanced equipment needed to identify and treat myocarditis early in babies, children and teens. This helps your child get the care they need so they can recover as quickly and thoroughly as possible.

What is Pediatric Myocarditis?

Myocarditis is a rare condition. It is most commonly seen in babies who are one or two years old, or in teenagers. Although it is primarily caused by a viral infection that triggers an inflammatory response, it can also be caused by other types of infections or autoimmune disorders.

Most cases of myocarditis are mild and short. But some viral infections can lead to severe myocarditis that damages the heart.

The inflammation can affect the heart’s muscles and electrical system. In severe cases, this rare condition can make it harder for the heart to pump blood and can disrupt heart rhythms (arrhythmia).

What are the different types of Pediatric Myocarditis?

Inflammation can affect different parts of the heart. When it only affects the muscle of the heart, it is called myocarditis.

When it also affects the lining around the heart (pericardium), it is called myopericarditis. Myopericarditis occurs more in teenagers than young children.

What are the signs and symptoms of Pediatric Myocarditis?

Myocarditis may cause these signs and symptoms:

  • Chest pain
  • Shortness of breath
  • Nausea and vomiting

How is Pediatric Myocarditis diagnosed?

Methods for diagnosing myocarditis can include:

  • A medical history
  • Physical exam
  • Chest X-rays
  • An electrocardiogram (EKG)
  • Echocardiogram
  • A cardiac MRI, typically used to make a final diagnosis
  • Blood samples for laboratory work to test for certain signs (inflammatory markers) of specific infections

What are the causes of Pediatric Myocarditis?

Usually myocarditis is caused by a viral infection, including flu viruses, cold viruses, parvoviruses (called fifth disease) and the novel coronavirus (COVID-19). These viral infections cause an immune response that leads to inflammation in the heart. This may be the same reason that mild myocarditis can be a very rare side effect of some COVID-19 vaccines.

Myocarditis can also be caused by:

  • A bacterial infection, including infections caused by staph bacteria, strep bacteria and the bacterium that causes Lyme disease
  • Fungi, including one found in bird droppings
  • Allergic or toxic reaction to a medication, including some antibiotics and illegal drugs
  • Exposure to radiation or some chemicals, such as carbon monoxide
  • Some diseases, such as lupus
  • Unknown causes

How is Pediatric Myocarditis treated?

Mild myocarditis can get better on its own or with medication. Children may need to rest and avoid sports for three to six months while they recover from the infection that caused the inflammation. It’s important to diagnose and treat myocarditis early. Children with mild myocarditis typically recover completely and quickly.

For more severe myocarditis, the heart can take a while to heal. Children may benefit from heart medications, such as beta blockers or ACE inhibitors. Doctors may also use IVIG (intravenous immune globulin) or steroids. Some children may need to spend time in the ICU and may need help from a mechanical ventilator to temporarily support their heart and lungs. In the most severe cases, a child may need a heart transplant. The pediatric cardiology care team at Children’s Health and The Heart Center can provide complete care, from early diagnosis to the most advanced treatments.

Frequently Asked Questions

  • If my child has myocarditis, how will they do in the long term?

    Most children diagnosed with myocarditis will completely recover. Your child may have follow-up appointments with their doctor to make sure they’re doing well, but most children have no long-term effects and will be able to return to their usual activities.

  • What are the risks of myocarditis with COVID-19?

    Some children who get COVID-19 develop myocarditis. The myocarditis seems to be caused by how the body’s immune system responds to the virus.

    The Children’s Health pediatric cardiology care team strongly recommends COVID-19 vaccinations, even for children with heart failure or heart transplants. This is because the vaccines are very effective at preventing COVID-19. In turn, this reduces the risk of myocarditis and other effects of the virus.

  • What are the risks of myocarditis with the COVID-19 vaccine?

    The risk of your child getting myocarditis from the vaccine is very small – and far less than their risk of getting myocarditis from COVID-19 itself. In fact, a child’s risk of getting hurt in a car accident is much higher than their risk of suffering a severe side effect from the COVID vaccine.

    When the vaccine does trigger myocarditis, it is typically much milder than the myocarditis caused by COVID-19. Early data show that all the children who have developed myocarditis after a COVID-19 vaccine had mild cases and recovered fully.