Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2019; 7(5): 548-561
Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.548
Clinical presentation and early predictors for poor outcomes in pediatric myocarditis: A retrospective study
Moises Rodriguez-Gonzalez, Maria Isabel Sanchez-Codez, Manuel Lubian-Gutierrez, Ana Castellano-Martinez
Moises Rodriguez-Gonzalez, Department of Pediatric Cardiology, Puerta del Mar University Hospital, Cadiz 11009, Spain
Maria Isabel Sanchez-Codez, Manuel Lubian-Gutierrez, Department of Pediatrics, Puerta del Mar University Hospital, Cadiz 11009, Spain
Ana Castellano-Martinez, Department of Pediatric Nephrology, Puerta del Mar University Hospital, Cadiz 11009, Spain
Author contributions: All authors helped to perform the research; Rodriguez-Gonzalez M contributed to the conception and design, performing procedures, manuscript writing, and data analysis; Sanchez-Codez MI contributed to the abstracted data, performing procedures, and manuscript writing; Castellano-Martinez A contributed to manuscript writing and data analysis; Lubian-Gutierrez M contributed to manuscript writing.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Puerta del Mar University Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have included all the items included in STROBE statement for retrospective studies.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Moises Rodriguez-Gonzalez, MD, Doctor, Department of Pediatric Cardiology, Puerta del Mar University Hospital, Ana de Viya Avenue 34, Cadiz 11009, Spain.
Telephone: +34-95-6002700
Received: November 22, 2018
Peer-review started: November 23, 2018
First decision: December 15, 2018
Revised: December 29, 2018
Accepted: January 30, 2019
Article in press: January 30, 2019
Published online: March 6, 2019
Core Tip

Core tip: In this retrospective study involving 42 children with myocarditis, we delineated the heterogeneous and unspecific clinical presentation of this condition in order to provide clinical clues to improve its early recognition. We found that the presence of left ventricle ejection fraction < 30% on echocardiography on admission was the major predictor for poor early outcomes. Because echocardiography is not widely available at emergency departments, we found that younger ages (< 2-years-old), a prolonged course of the disease (> 7 d), and increased N-terminal pro-brain natriuretic peptide levels (> 5000 pg/mL) could help to identify these high-risk patients.