Pediatric acute myocarditis: current evidence and practical recommendations.

Summary

A narrative review of paediatric acute myocarditis synthesising guidelines, consensus documents and large cohort data on epidemiology, diagnosis, risk stratification and treatment. It describes age-related phenotypes, the burden of fulminant disease, and the overlap with dilated cardiomyopathy and multisystem inflammatory syndrome in children. The authors propose a practical low-, intermediate- and high-risk classification to guide monitoring, imaging, biopsy and therapy, with early referral of high-risk children to centres offering paediatric intensive care, cardiac surgery and temporary mechanical circulatory support. Relevant to PICU teams managing low cardiac output and mechanical support.

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