Clinical presentation and early predictors for poor outcomes in pediatric myocarditis: A retrospective study

Table 1 Baseline characteristics at the time of hospital admission

Clinical and demographic data	n = 42
Age	Median (IQR) yr: 8 (1.5-12)
Male:Female gender	2.23
Evolution	Median (IQR) days from initial symptoms: 5 (2-10)
Visits to ED previously before diagnosis of myocarditis	Median (IQR) visits prior to admission: 2 (1-2); 1 visit (41), 2 visits (36), 3 visits (9), more than 3 visits (14)
Presenting symptoms (%)	Previous viral infection (69); Chest pain (40); Respiratory tract symptoms (cough, apnea, rhinorrhea) (38); Shortness of breath (35); Gastrointestinal tract symptoms (vomiting, abdominal pain, diarrhea) (33); Fever (31); Weakness, exercise or feeding intolerance (21); Palpitations (16); Lethargy (12); Syncope (4)
Physical exam (%)	Tachycardia (57); Tachypnea (52); Evidence of respiratory tract infection (44); Respiratory distress (35); Abnormal lung auscultation (31); Murmur (26); Systolic hypotension (24); Poor perfusion or diminished pulses (21); Gallop rhythm (20); Hepatomegaly (20); Edema (7); Cyanosis (2)
Cardiac syndrome (%)	ACS-like (34); Fulminant myocarditis (29); Congestive heart failure (23); Dysrhythmia (14)
Complementary exams
Laboratory (%)	CRP > 60 mg/L (16); Troponin T > 10 ng/L (62); NT-proBNP > 600 pg/mL (40)
Chest X-Ray (%)	Cardiomegaly (35); Pulmonary edema (28); Pulmonary infiltrate (4%); Pleural effusion (2.5%)
ECG (%)	Abnormal ECG (93); Sinus tachycardia (61); Ischemic changes (57); Low voltage (50); SVT (2.5); VT (7); AVB (2.5); prolonged QT interval (2.5%)
Echocardiography (%)	Abnormal echocardiography (88): LV systolic dysfunction (50): severe (14), moderate (16), mild (20); Biventricular systolic dysfunction (10); Segmental wall motion abnormalities (38); LV dilation (43); Mitral regurgitation (69); Pericardial effusion (59)
Cardiac MRI (%)	MRI performed (50); Median days to realization from admission, 5 (3-9); Lake Louis criteria positive (86), equivocal (10), negative (4)
Microbiology (%)	Positive microbiology (47): Coxsakie (30); Parvovirus B19 (20); Adenovirus (15); EBV (15); CMV (10); Mycoplasma (10)
Treatment (%)	Any treatment (71): Diuretics (69); ACEI (69); Beta-blockers (64); Digoxin (14) Spironolactone (14); Antiarrhythmic (5); Inotropic support (35); Mechanical Ventilation (26); ECMO/VAD (2.5); Pacemaker (2.5)
Outcomes (%)	Hospitalization length of stay (d): Median 6 (IQR 3-13); Death (5), transplant (0)
	Poor early outcomes: Death, transplant, or LV systolic dysfunction/dilation at discharge (43)
	Poor late outcomes: Death, transplant or LV systolic dysfunction/dilation after 1 yr of follow-up (16); Spontaneous LV function recovery during first year after diagnosis (69)

IQR: Interquartile range; GI: Gastrointestinal; SCD: Sudden cardiac death; ACS: Acute coronary syndrome; CRP: C-reactive protein; NT-proBNP: N-terminal pro-brain natriuretic peptide; ECG: Electrocardiogram; SVT: Supraventricular tachycardia; VT: Ventricular tachycardia; AVB: Atrioventricular block; LV: Left ventricle; MRI: Magnetic resonance imaging; EBV: Epstein-Barr virus; CMV: cytomegalovirus; ACEI: Angiotensin-converting-enzyme inhibitors; ECMO: Extracorporeal membrane oxygenation; VAD: Ventricular assist device.