Clinical observation on 71 cases of fulminant myocarditis

WANG Ying; YUAN Yue; WANG Qin; SHAO Wei; CUI Lang

doi:10.3969/j.1674-4055.2013.06.27

Abstract：Objective To discuss the clinical characteristics of fulminant myocarditis in child patients. Methods The patients (n=71) were chosen hospitalized in the Beijing Children’s Hospital from Jan. 2006 to Aug. 2013. Their medical data was retrospectively analyzed, including sex, age, clinical manifestations, changes of electrocardiogram (ECG) and myocardial enzyme, curative effect and prognosis.Results Among 71 cases, there were 31 male cases and 40 female ones. Their ages were from 3 months old to 14.5 years old [average (6.1±1.8) years old]. The most common clinical manifestations were respiratory tract infection (42.25%) and digestive tract infection (33.80%). There were 85.92% (61/71) cases had increased CK-MB or cTnI, and 90.14% (64/71) had significant ECG changes. All patients were given anti-viral treatment and immune treatment with MPIV and gamma globulin, and different patients were given therapies of anti-shock, correcting heart failure and antiarrhythmia respectively. The patients (n=18) with grade III atrioventricular block were implanted temporary pacemakers. There were 87.3%(62/71) cases abated after treatment, 7 (9.9%) died (3 due to multiple organ failure induced by heart failure, 1 due to frequent ventricular tachycardia complicating pulmonary infection, 2 due to QRD complex low voltage complicating intraventricular block, 1 due to heart failing complicating pulmonary edema and two due to abandoning treatment). Conclusion The clinical manifestations are multiple in the patients with fulminant myocarditis accompanied by abnormal ECG and higher myocardial enzyme. Most of them have good prognosis after treatment.