Symptoms in babies

Babies can also develop heart muscle inflammation. As this is a life-threatening clinical picture, it is essential to pay attention to any signs of the disease and to consult a doctor as soon as there is a suspicion of this. Depending on the age of the child, myocarditis can present itself in very different ways.

The baby may show no symptoms at all or may appear to be seriously ill. In general, the younger the baby is, the higher the risk that the heart muscle inflammation will develop into a chronic disease. The later the correct diagnosis is made, the worse the prognosis.

Babies who suffer from myocarditis may show some symptoms that can lead to suspicion of such a disease. For example, they may suddenly appear listless/apathetic, drink less or hardly any fluids and develop a fever. Other possible signs are short-term breathing stops (apnea), increased sweat production and blue lips or a blue tongue (cyanosis).

Cyanosis is a sign of an already advanced impairment of the heart muscle, as it indicates a lack of oxygen in the tissue. If the baby also has symptoms such as a very fast heartbeat or newly occurring cardiac arrhythmia, it is essential that he or she be presented to a doctor. Any indication of a possible heart muscle inflammation must be taken seriously.

The earlier the disease is diagnosed, the earlier an adequate therapy can be started and the lower the risk of subsequent damage to the little patient’s heart. In the case of myocarditis, the doctor’s medical history is also of primary importance for the diagnosis. It is important for the doctor to find out whether infections have occurred in the near past.

If a patient affirms this, heart disease must also be considered. In most cases, the physical examination by the doctor will not reveal any conspicuous findings. Only the listening (auscultation) of the heart sounds may, under certain circumstances, reveal tachycardia (resting pulse of more than 100 beats/minute) and an irregular heartbeat (arrythmia).

It is important to record an ECG for every patient suspected of having myocarditis. As one of the most important diagnostic criteria, the evaluation of the excitation formation of the heart muscle can provide important indications of myocarditis. A long-term ECG should also be considered.

The blood test of the patient is also important. The following parameters are usually examined: Furthermore, inflammation parameters in the blood are also checked to detect an infection (blood sedimentation rate/BSG and C-reactive protein/CRP value). Bacteriological and virological examinations can also be helpful.

In this case, either a stool sample from the patient is examined for bacteria or a blood sample is taken and incubated in the laboratory in an incubator.The hormone BNP indicates progressive heart failure, which, as already described, can result from myocarditis (inflammation of the heart muscle). As imaging procedures, the doctor may order an ultrasound of the heart, an X-ray of the chest or a magnetic resonance imaging. In the case of myocarditis (inflammation of the heart muscle), the ultrasound often provides an unobtrusive image.

Occasionally, however, an effusion of the pericardium and movement disorders of the heart muscle can be seen. In the case of heart failure, the X-ray image would show a corresponding enlargement of the heart shadow and congestion in the lungs. Magnetic resonance imaging (MRI) of the heart may, under certain circumstances, reveal delayed contrast medium enrichment as a sign of myocarditis.

In this case, a signal increase in the heart MRI would indicate edema in the area of the heart muscle. MRI of the heart also offers the possibility of taking a specific sample biopsy from the heart muscle in order to view it from a histological perspective. In extreme cases, the myocardial sample biopsy may be necessary due to a cardiac catheterization.

CK/CK-MB
Troponin (the increase in these values actually indicate a heart attack, but can also be elevated in myocarditis).