EVALUATING THE IMPACT OF MYOCARDITIS IN PEDIATRIC PATIENTS: A CROSS-SECTIONAL STUDY FROM A LOW-RESOURCE SETTING

Abstract

Background: Pediatric myocarditis is a significant cause of heart failure and associated mortality in children, particularly in low-resource settings like Pakistan  where diagnostic and treatment challenges are more pronounced. The purpose of this study is to evaluate pediatric myocarditis prevalence, clinical characteristics, treatment modalities, and results at a Pakistani tertiary care facility.

Objectives: to assess the prevalence, clinical characteristics, treatment approaches, and short-term outcomes of pediatric myocarditis in a low-resource setting at a Pakistani tertiary care hospital.

Study Design: A cross-sectional study

Methods: A cross-sectional study was conducted from August to October 2023 at the Pediatric Cardiology Department, Lady Reading Hospital, Peshawar. In this study a total of 104 children, between the ages of 1 and 16 diagnosed with myocarditis were examined based on echocardiographic and lab criteria. The data collected included information on demographics symptoms upon presentation, diagnostic results, treatment approaches and short term outcomes.

Results: Among the 104 patients studied 65 were male (62%) with an age of 7.9 years (ranging from 1 to 16 years). Most patients (85%) presented symptoms of heart failure such as difficulty breathing, fatigue and swelling in extremities. Echocardiograms indicated left dysfunction in 73 individuals (70%) with a mean ejection fraction of 32% (+/ 12%).IV immunoglobulin (IVIG) therapy was used as one of the management methods for 44% (n=46) of the patients. Just 50% (n=23) of patients receiving IVIG, however, saw appreciable improvements in their cardiac function. Only 8% (n=8) of patients had access to mechanical circulatory support due to resource limitations, which restricted the utilization of advanced heart failure therapy. Cardiogenic shock was the leading cause of death, accounting for 18% of the total mortality rate (n = 19). At the 3-month follow-up, 59% of survivors (n=50) still had left ventricular dysfunction, indicating the long-term effects of the illness.

Conclusion: In conclusion this research underscores the toll of myocarditis in areas with limited resources. The high mortality rate, lack of access to treatments and the prevalence of heart issues underscore the importance of early detection easier access to therapies and preventive measures such as vaccinations, against common viruses.