Vol. 6, Issue 1, Part B (2024)

Acute myocarditis is a rare but significant inflammatory condition of the heart muscle, particularly impacting the paediatric population. Despite advancements in diagnostic tools and therapeutic approaches, the understanding and management of paediatric acute myocarditis remain challenging. This review aims to synthesize current knowledge, focusing on the epidemiology, pathophysiology, clinical presentation, diagnostic strategies, and treatment modalities. Furthermore, we will explore emerging perspectives, including the role of novel biomarkers, advanced imaging techniques, and evolving therapeutic interventions. Acute myocarditis (AM) is a condition caused by inflammation that impacts the heart muscle. It is distinguished by its sudden onset and wide range of clinical presentations. This condition has a significant global impact, particularly on children and young adults. The lack of discernible onset patterns or predictable progression presents a substantial risk to survival, as it may result in the development of severe heart failure and malignant arrhythmias.
A characteristic of myocardial remodeling, myocardial fibrosis is becoming an increasingly acknowledged factor to negative results in cases of acute myocarditis. The complex relationship between viral infections, dysregulated immune reactions, and genetic susceptibility has been brought to light by developments in molecular and immunological techniques. At present, a definitive consensus regarding the diagnosis or continuous follow-up of pediatric patients is lacking. Endomyocardial biopsy (EMB), which was previously regarded as the benchmark diagnostic method, has been enhanced by the efficacy of cardiac magnetic resonance imaging (CMRI) techniques. In light of the intricate procedural intricacies and consequential complications, it is imperative to consider non-invasive alternatives without delay. Within this framework, biomarkers arise as auspicious candidates due to their ability to assess cardiac remodeling and inflammatory processes, thereby furnishing insightful observations regarding the severity, progression, and efficacy of treatments. Therapeutic approaches that target the particular immune pathways or components linked to the underlying causes have demonstrated potential for improved results in these instances. Acute myocarditis in pediatric patients continues to present a complex clinical dilemma, requiring a thorough comprehension of its pathophysiology, assessment, and treatment. The objective of this review is to examine recent developments in knowledge regarding the pathophysiology, diagnosis, and treatment of acute myocarditis in pediatric patients.