Treatment of myocarditis in children

Children are in a period of rapid growth and their resistance is always relatively low, making them particularly susceptible to colds and other diseases. Especially in the cold winter and when seasons change, myocarditis is a relatively common disease in children. It seriously affects the health of children. Parents must not be careless when such symptoms occur and must pay great attention to them. Let us now learn about the treatments for myocarditis in children.

Treatment of myocarditis in children

1. Treatment

1. Bed rest

Animal experiments have shown that bed rest can prevent the increase of viral replication in the myocardium during the acute phase. Therefore, during the acute phase, you should stay in bed for at least 8 weeks, and then start light activities after the heart shadow returns to normal and the electrocardiogram changes have improved significantly. During the recovery phase, you should stay in bed for at least half a day for 6 months. Those with an enlarged heart should stay in bed for more than half a year until the heart is significantly smaller. Those with heart failure should strictly stay in bed until the heart failure is under stable control and heart examinations have improved significantly, and then start light activities.

2. Treatment for myocardium

High-concentration and large-dose vitamin C is effective in correcting shock and promoting recovery of myocardial disease, and is therefore one of the commonly used therapeutic drugs in clinical practice. Animal experiments in the Department of Internal Medicine at Kyoto University in Japan have shown that ubidecarenone (coenzyme Q10) has a protective effect on myocardial cells infected by myocarditis virus, so it is often used clinically. Inosine is also one of the commonly used auxiliary drugs in clinical practice. When rescuing critically ill children, energy mixture or polarization fluid can also be added and injected intravenously.

3. Adrenal cortex hormones and immunosuppressive drugs

Adrenal cortical hormone is mainly used to rescue cardiogenic shock and third-degree atrioventricular block, and can also be tried for those who do not respond to other treatments. It is generally believed that this is to prevent the spread of viral infection. Try not to use hormones within 10 days of onset. The use of immunosuppressive drugs in patients with suspected and confirmed viral myocarditis remains controversial. A myocarditis treatment trial recently published abroad showed that there was no significant difference in treatment results among the azathioprine plus prednisone (cordnisone) group, the cyclosporine plus prednisone (cordnisone) group, and the conventional treatment group. Although this study was conducted in adults, the results may apply to children.

4. Treatment of combined heart failure and cardiogenic shock

Patients with concurrent heart failure and cardiogenic shock must be treated promptly and actively. The treatment principles are similar to those for general heart failure and cardiogenic shock, including the use of digitalis, vasodilators, phosphodiesterase inhibitors, diuretics, and volume expansion to correct acidosis. However, when using digitalis, it should be noted that in the acute phase of myocarditis, the myocardium is sensitive to digitalis and is prone to toxic reactions. Rapid saturation should be avoided and the dosage should be appropriately reduced.

5. Treatment of arrhythmias

Arrhythmias must be treated aggressively. Supraventricular tachycardia is effectively treated with digitalis, while ventricular tachycardia can be treated with intravenous drip of lidocaine or amiodarone. If ventricular arrhythmia progresses rapidly to ventricular fibrillation despite active treatment (this situation is more likely to occur in young infants), direct current cardioversion should be given immediately. If complete atrioventricular block occurs, an endocardial pacemaker should be implanted. Because arrhythmias can occur a long time after recovery from myocarditis, children with myocarditis require long-term follow-up after recovery.

6. Other treatments

In recent years, there have been reports of intravenous use of human immunoglobulin to treat myocarditis in children. Research by Drucker et al. showed that after the use of human immunoglobulin, the left ventricular function of children improved during the follow-up period and the one-year survival rate was higher. In some cases, left ventricular assist devices and intraaortic balloon pumps can be used to support the cardiovascular system, while in other children, extracorporeal membrane oxygenation therapy can be used. These devices can be life-saving when necessary and may be considered a treatment option in older children. In some severe and intractable cases, heart transplantation can be used as a last resort.

Children are the apple of every parent's eye. No one wants their children to get sick on the road to growth, but there are many things we cannot avoid. By understanding the treatment of children's myocarditis, we know that the treatment of children's myocarditis is one aspect, and the most important thing in daily life is prevention. Try to reduce colds in daily life. In order to effectively enhance children's resistance, take children outdoors for exercise more often.