Advances in the diagnosis of pediatric fulminant myocarditis
Fulminant myocarditis(FM)is a rare and unique form of myocarditis with rapid progression and high early mortality.The incidence of FM in children is significantly higher than that in adults,and FM in children is often first manifested by extracardiac symptoms such as gastrointestinal and respiratory symptoms,so early identification as well as early and timely treatment may be crucial.Both infective and non-infective factors can cause FM in children.After the emergence of non-specific prodromal symptoms and on the basis of excluding differential diagnosis,rapid severe hemodynamic changes,significant increases in related biomarkers(troponin,inflammatory factors,etc.),abnormalities in electrocardiogram(malignant arrhythmia,ST segment changes,etc.),echocardiographic features(decreased left ventricular ejection fraction,wall hypokinesia,etc.),and specific manifestations of cardiac MRI are helpful for clinical diagnosis of FM.In addition,endomyocardial biopsy is still the gold standard for the diagnosis of FM and can guide further treatment.This article mainly reviews the research progress of FM diagnosis in children,in order to provide reference for clinical work.
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