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Titolo:
ACUTE INFECTIOUS MYOCARDITIS IN CHILDHOOD - RESULTS OF 2 SERIES FROM LYON
Autore:
GOUTON M; DIFILIPPO S; SASSOLAS F; STAMM D; BOZIO A; FLORET D;
Indirizzi:
HOP CARDIOVASC & PNEUMOL LOUIS PRADEL ,BP LYON MONTCHAT F-69394 LYON 03 FRANCE HOP EDOUARD HERRIOT F-69003 LYON FRANCE
Titolo Testata:
Archives des maladies du coeur et des vaisseaux
fascicolo: 5, volume: 88, anno: 1995,
pagine: 753 - 759
SICI:
0003-9683(1995)88:5<753:AIMIC->2.0.ZU;2-T
Fonte:
ISI
Lingua:
FRE
Soggetto:
IMMUNOSUPPRESSIVE THERAPY; DILATED CARDIOMYOPATHY; DIAGNOSIS; CHILDREN; BIOPSY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
14
Recensione:
Indirizzi per estratti:
Citazione:
M. Gouton et al., "ACUTE INFECTIOUS MYOCARDITIS IN CHILDHOOD - RESULTS OF 2 SERIES FROM LYON", Archives des maladies du coeur et des vaisseaux, 88(5), 1995, pp. 753-759

Abstract

Acute infectious myocarditis in childhood has a very poor initial outcome, but the long-term outlook is relatively good for the survivors. This retrospective study was based on cases of acute myocarditis admitted to two hospital departments with different modes of recruitment. Firstly, a polyvalent paediatric intensive care unit where 12 children (mean age 12 months) were admitted during the acute phase of myocarditis. The initial symptoms were non-specific and misleading, the diagnosis being established at autopsy in 9 cases. Only 4 children presented with typical cardiac failure. The clinical signs were hepatomegaly, sinus tachycardia, cardiomegaly, ECG ST-T wave changes and biological signs of multiple organ failure. Left ventricular function was very poorwith a fractional shortening of only 17 %. The causal agent was usually viral. The clinical course was marked by a high early mortality (11/26, 42%) within 23 hours of hospital admission. Secondly, a paediatric cardiology unit where 81 children (mean age 15 months) were followedup after acute infectious myocarditis. Thirteen cases were taken fromour first series and were included for long-term follow-up; 76.5% hadpremonitory signs of infection and 71% were in cardiac failure, Classes III or IV, during the hospital admission. The causal agent was identified in 30 cases (37 %) and was usually a virus (22 cases). Treatment was classical (association of digitalis, diuretics, angiotensin converting enzyme inhibitors, anticoagulants and beta-sympathomimetics when necessary). There were 22 deaths (27.2%) of the 59 survivors, 46 were cured after an interval varying from 8 days to 15 years, 3 underwenttransplantation, and 10 have sequellae of cardiac failure. Two predictive criteria for mortality were identified in the two patient groups:premonitory signs of infection (p = 0.006) and the degree of initial cardiac failure (p = 0.016). Acute myocarditis is therefore a pathology with two features: an extremely dangerous initial phase and a relatively favourable long-term outcome with complete cure being observed in78 % of survivors. The link between myocarditis and dilated cardiomyopathy and the value of adjuvant immuno-suppressor therapy in the prevention of long-term cardiomyopathy are discussed but further large scale clinical trials are necessary to resolve these problems.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 16:38:18