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Myocarditis in children
Myocarditis (myo·car·di·tis) in children is inflammation of the heart muscle that causes swelling. This swelling can weaken the heart and affect how it works.
Myocarditis is usually caused by a viral infection. Most cases of myocarditis are mild and short. But some viral infections can lead to severe myocarditis that damages the heart.
At Children's Health℠, our pediatric cardiologists have a great deal of experience diagnosing and treating myocarditis. Our team has the expertise and the advanced equipment needed to identify and treat myocarditis early in children of all ages. This helps your child get the care they need so they can recover as quickly and thoroughly as possible.
What is myocarditis in children?
Myocarditis is rare. It is usually seen in babies who are one or two years old. It can also be seen in teenagers. It is usually caused by a viral infection that triggers inflammation, but can be caused by other types of infections.
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 myocarditis in children?
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 is more common in teenagers than young children.
What are the signs and symptoms of myocarditis in children?
Myocarditis may cause these signs and symptoms:
- Chest pain
- Shortness of breath
- Nausea, which is less common but can happen occasionally
How is myocarditis in children diagnosed?
Methods for diagnosing myocarditis can include:
- A medical history
- Physical exam
- Blood samples for laboratory work to test for certain signs (inflammatory markers) of specific infections
- Chest x-rays
- An electrocardiogram (ECG)
- Echocardiogram
- An MRI of the heart, typically used to make a final diagnosis
What causes myocarditis in childrens?
Myocarditis usually is caused by a viral infection, including flu viruses, cold viruses, parvoviruses (called fifth disease) and 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
Occasionally, myocarditis isn’t caused by any of these issues and there is no clear reason why a child has the condition.
How is myocarditis in children 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.
- For more severe myocarditis, the heart can take a while to heal. We may use heart medicines like 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 can provide complete care, from early diagnosis to the most advanced treatments.
Frequently Asked Questions
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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.
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What are the risks of myocarditis with COVID-19?
Some children who get COVID-19 develop myocarditis. This myocarditis seems to be caused by how the 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.
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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.
When the vaccine does trigger myocarditis, it is 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.