{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T14:18:15Z","timestamp":1793974695443,"version":"4.8.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Objectives<\/jats:title>\n          <jats:p>Myopericarditis is a newly described entity that is primarily a pericardial syndrome with elevated cardiac enzymes that has been seen with increasing frequency in our pediatric intensive care unit. For this reason, we performed a retrospective cohort analysis with a goal of establishing differences between myopericarditis and myocarditis that could lead to proper diagnosis on emergency department presentation.<\/jats:p>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A database query was performed and identified patients over a 9-year period, and clinical data, laboratory data, and cardiac studies were extracted and analyzed from the electronic health record.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 36 patients were identified with the discharge diagnosis of myopericarditis and 22 with myocarditis. The median age for myopericarditis patients was 16.2 years, and 97% were male. The median initial troponin was 7.1 ng\/mL, the peak was at 16.6 ng\/mL, and 58% had ST changes on electrocardiogram. The median length of stay for myopericarditis patients was 1.7 days, and 50% were discharged home on nonsteroidal anti-inflammatory medication. Compared with myocarditis, myopericarditis patients were older, had a higher incidence of chest pain, and were less likely to have fever, vomiting, abdominal pain, upper respiratory infection symptoms, chest radiograph abnormalities, or T-wave inversion (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05). Myopericarditis patients also had lower Pediatric Risk of Mortality version 3 scores, B-type natriuretic peptide levels, and higher left ventricular ejection fractions on admission (67% vs 41%; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05). A classification model incorporating initial left ventricular ejection fraction, B-type natriuretic peptide, electrocardiogram, and chest radiograph findings distinguished myopericarditis from myocarditis with correct classification in 95% of patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Myopericarditis is a relatively common cause of chest pain for patients admitted to the pediatric intensive care unit, presents differently than true myocarditis, and carries a good prognosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002376","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T08:56:08Z","timestamp":1614243368000},"page":"e761-e765","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Pediatric Myopericarditis Presenting to the Emergency Department as Chest Pain"],"prefix":"10.1097","volume":"38","author":[{"given":"Christopher J.","family":"Babbitt","sequence":"first","affiliation":[{"name":"Pediatric Critical Care, Miller Children\u2019s and Women\u2019s Hospital of Long Beach, Long Beach"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Babbitt","sequence":"additional","affiliation":[{"name":"Chapman University, Orange"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Byrne","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Miller Children's and Women's Hospital of Long Beach, Long Beach, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tricia","family":"Morphew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1542\/peds.2011-0141","article-title":"Management of pediatric chest pain using a standardized assessment and management plan","volume":"128","year":"2011","journal-title":"Pediatrics"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/00006565-199208000-00004","article-title":"Review of 180 episodes of chest pain in 134 children","volume":"8","year":"1992","journal-title":"Pediatr Emerg Care"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1007\/s00246-012-0222-y","article-title":"Myopericarditis in children: elevated troponin I level does not predict outcome","volume":"33","year":"2012","journal-title":"Pediatr Cardiol"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1111\/j.1460-9592.2011.03595.x","article-title":"Are all ICUs the same?","volume":"21","year":"2011","journal-title":"Paediatr Anaesth"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1097\/00003246-198811000-00006","article-title":"Pediatric Risk of Mortality (PRISM) score","volume":"16","year":"1988","journal-title":"Crit Care Med"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s12872-017-0564-8","article-title":"Clinical evaluation of myocardial involvement in acute myopericarditis in young adults","volume":"17","year":"2017","journal-title":"BMC Cardiovasc Disord"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.ijcard.2007.10.053","article-title":"Myopericarditis: etiology, management, and prognosis","volume":"127","year":"2008","journal-title":"Int J Cardiol"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.ehj.2004.02.002","article-title":"Guidelines on the diagnosis and management of pericardial diseases executive summary; the task force on the diagnosis and management of pericardial diseases of the European Society of Cardiology","volume":"25","year":"2004","journal-title":"Eur Heart J"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1161\/CIRCULATIONAHA.113.001531","article-title":"Good prognosis for pericarditis with and without myocardial involvement: results from a multicenter, prospective cohort study","volume":"128","year":"2013","journal-title":"Circulation"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1007\/978-0-387-73960-1_15","article-title":"Management of myocarditis in children: the current situation","volume":"609","year":"2008","journal-title":"Adv Exp Med Biol"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1148\/rg.293085715","article-title":"CT and MR imaging findings in patients with acquired heart disease at risk for sudden cardiac death","volume":"29","year":"2009","journal-title":"Radiographics"},{"key":"bib13-20250504","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1520\/JFS10385J","article-title":"Occurrence of myocarditis in sudden death in children","volume":"22","year":"1977","journal-title":"J Forensic Sci"},{"key":"bib14-20250504","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1053\/euhj.1998.1444","article-title":"Incidence of three presentations of acute myocarditis in young men in military service. A 20-year experience","volume":"20","year":"1999","journal-title":"Eur Heart J"},{"key":"bib15-20250504","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1253\/jcj.50.1288","article-title":"Twenty-year autopsy statistics of myocarditis incidence in Japan","volume":"50","year":"1986","journal-title":"Jpn Circ J"},{"key":"bib16-20250504","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1056\/NEJMoa021737","article-title":"The epidemiology of childhood cardiomyopathy in Australia","volume":"348","year":"2003","journal-title":"N Engl J Med"},{"key":"bib17-20250504","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1056\/NEJMoa021715","article-title":"The incidence of pediatric cardiomyopathy in two regions of the United States","volume":"348","year":"2003","journal-title":"N Engl J Med"},{"key":"bib18-20250504","doi-asserted-by":"crossref","first-page":"e1113","DOI":"10.1542\/peds.2015-0343","article-title":"Point-of-care ultrasonography by pediatric emergency medicine physicians","volume":"135","year":"2015","journal-title":"Pediatrics"},{"key":"bib19-20250504","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/PEC.0000000000000492","article-title":"Point-of-care ultrasonography by pediatric emergency medicine physicians","volume":"31","year":"2015","journal-title":"Pediatr Emerg Care"},{"key":"bib20-20250504","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s13089-016-0049-5","article-title":"Pediatric emergency medicine point-of-care ultrasound: summary of the evidence","volume":"8","year":"2016","journal-title":"Crit Ultrasound J"},{"key":"bib21-20250504","first-page":"3","article-title":"Myocarditis. A histopathologic definition and classification","volume":"1","year":"1987","journal-title":"Am J Cardiovasc Pathol"},{"key":"bib22-20250504","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1016\/S0735-1097(99)00452-0","article-title":"Complications of endomyocardial biopsy in children","volume":"34","year":"1999","journal-title":"J Am Coll Cardiol"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002376","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T19:02:27Z","timestamp":1746385347000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002376"}},"subtitle":["A Comparative Study With Myocarditis"],"short-title":[],"issued":{"date-parts":[[2021,2,12]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000002376","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2021,2,12]]}}}