{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T15:11:52Z","timestamp":1776697912197,"version":"3.51.2"},"reference-count":132,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2016,11,8]],"date-time":"2016-11-08T00:00:00Z","timestamp":1478563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Myocarditis is a challenging and potentially life-threatening disease associated with high morbidity in some paediatric patients, due to its ability to present as an acute and fulminant disease and to ultimately progress to dilated cardiomyopathy. It has been described as an inflammatory disease of the myocardium caused by diverse aetiologies. Viral infection is the most frequent cause of myocarditis in developed countries, but bacterial and protozoal infections or drug hypersensitivity may also be causative agents. The prompt diagnosis in paediatric patients is difficult, as the spectrum of clinical manifestation can range from no myocardial dysfunction to sudden cardiac death. Recent studies on myocarditis pathogenesis have revealed a triphasic nature of this disease, which influences the diagnostic and therapeutic strategies to adopt in each patient. Endomyocardial biopsy remains the gold standard for diagnosing myocarditis, and several non-invasive diagnostic tools can be used to support the diagnosis. Intravenous immunoglobulin has become part of routine practice in the treatment of myocarditis in paediatric patients at many centres, but its true effect on the cardiac function has been the target of many studies. The aim of this review is to approach the recently discovered facets of paediatric myocarditis regarding its progression to dilated cardiomyopathy.<\/jats:p>","DOI":"10.3390\/jcdd3040031","type":"journal-article","created":{"date-parts":[[2016,11,8]],"date-time":"2016-11-08T09:58:26Z","timestamp":1478599106000},"page":"31","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Myocarditis in Paediatric Patients: Unveiling the Progression to Dilated Cardiomyopathy and Heart Failure"],"prefix":"10.3390","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6161-8547","authenticated-orcid":false,"given":"In\u00eas","family":"Farinha","sequence":"first","affiliation":[{"name":"Faculty of Medicine of Porto University, Porto 4200-319, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5810-0202","authenticated-orcid":false,"given":"Joana","family":"Miranda","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Centro Hospitalar S\u00e3o Jo\u00e3o, Porto 4200-319, Portugal"},{"name":"Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of Porto University, Porto 4200-319, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2016,11,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1093\/eurheartj\/ehm342","article-title":"Classification of the cardiomyopathies: A position statement from the european society of cardiology working group on myocardial and pericardial diseases","volume":"29","author":"Elliott","year":"2008","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/CRD.0b013e31806450c4","article-title":"Myocarditis: Basic and clinical aspects","volume":"15","author":"Ellis","year":"2007","journal-title":"Cardiol. Rev."},{"key":"ref_3","first-page":"180","article-title":"Acute viral myocarditis: Current concepts in diagnosis and treatment","volume":"15","author":"Shauer","year":"2013","journal-title":"Isr. Med. Assoc. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1016\/j.pcl.2010.09.012","article-title":"Myocarditis and pericarditis in children","volume":"57","author":"Durani","year":"2010","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1161\/01.CIR.93.5.841","article-title":"Report of the 1995 world health organization\/international society and federation of cardiology task force on the definition and classification of cardiomyopathies","volume":"93","author":"Richardson","year":"1996","journal-title":"Circulation"},{"key":"ref_6","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","author":"Stiller","year":"2008","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.hfc.2010.05.009","article-title":"Myocarditis in children","volume":"6","author":"Kuhl","year":"2010","journal-title":"Heart Fail. Clin."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.hfc.2005.06.011","article-title":"Viral genomic detection and outcome in myocarditis","volume":"1","author":"Bowles","year":"2005","journal-title":"Heart Fail. Clin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1161\/01.CIR.90.1.330","article-title":"Acute myocarditis. Rapid diagnosis by PCR in children","volume":"90","author":"Martin","year":"1994","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1161\/CIRCULATIONAHA.113.001372","article-title":"Diagnosis and treatment of myocarditis in children in the current era","volume":"129","author":"Canter","year":"2014","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1078\/0344-0338-00322","article-title":"Coxsackie B3 myocarditis in 4 cases of suspected sudden infant death syndrome: Diagnosis by immunohistochemical and molecular-pathologic investigations","volume":"198","author":"Dettmeyer","year":"2002","journal-title":"Pathol. Res. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1161\/CIRCULATIONAHA.105.606509","article-title":"Presentation, patterns of myocardial damage, and clinical course of viral myocarditis","volume":"114","author":"Mahrholdt","year":"2006","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1136\/jcp.2008.059568","article-title":"Human herpes virus 6 in archival cardiac tissues from children with idiopathic dilated cardiomyopathy or congenital heart disease","volume":"62","author":"Comar","year":"2009","journal-title":"J. Clin. Pathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1007\/s00246-012-0468-4","article-title":"Parvovirus B19 myocarditis causes significant morbidity and mortality in children","volume":"34","author":"Molina","year":"2013","journal-title":"Pediatr. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/S0735-1097(03)00648-X","article-title":"Detection of viruses in myocardial tissues by polymerase chain reaction. Evidence of adenovirus as a common cause of myocarditis in children and adults","volume":"42","author":"Bowles","year":"2003","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.ijcard.2009.11.002","article-title":"Myocarditis in children and detection of viruses in myocardial tissue: Implications for immunosuppressive therapy","volume":"148","author":"Camargo","year":"2011","journal-title":"Int. J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.cardfail.2005.11.004","article-title":"Myocarditis and heart failure associated with hepatitis c virus infection","volume":"12","author":"Matsumori","year":"2006","journal-title":"J. Card. Fail."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.jcv.2008.05.012","article-title":"A myocarditis outbreak with fatal cases associated with adenovirus subgenera c among children from havana city in 2005","volume":"43","author":"Savon","year":"2008","journal-title":"J. Clin. Virol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e65","DOI":"10.1542\/peds.109.4.e65","article-title":"A rare presentation of childhood pompe disease: Cardiac involvement provoked by epstein-barr virus infection","volume":"109","author":"Talsma","year":"2002","journal-title":"Pediatrics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.jacc.2010.01.004","article-title":"Fulminant myocarditis associated with pandemic H1N1 influenza a virus in children","volume":"55","author":"Bratincsak","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.pcad.2009.11.006","article-title":"Myocarditis","volume":"52","author":"Blauwet","year":"2010","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1007\/s12098-014-1481-9","article-title":"Cardiac manifestations in hiv infected children","volume":"82","author":"Singh","year":"2015","journal-title":"Indian J. Pediatr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1111\/j.1749-6632.2001.tb03911.x","article-title":"Cardiac manifestations of hiv infection in infants and children","volume":"946","author":"Keesler","year":"2001","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/S0735-1097(99)00264-8","article-title":"The detection of viral genomes by polymerase chain reaction in the myocardium of pediatric patients with advanced hiv disease","volume":"34","author":"Bowles","year":"1999","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1056\/NEJMra0800028","article-title":"Myocarditis","volume":"360","author":"Cooper","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1086\/315533","article-title":"The changing epidemiology of diphtheria in the vaccine era","volume":"181","author":"Galazka","year":"2000","journal-title":"J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.idc.2015.02.011","article-title":"Lyme disease in children","volume":"29","author":"Sood","year":"2015","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e835","DOI":"10.1542\/peds.2008-3058","article-title":"Lyme carditis in children: Presentation, predictive factors, and clinical course","volume":"123","author":"Costello","year":"2009","journal-title":"Pediatrics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.ijcard.2006.03.004","article-title":"Clinical aspects of the chagas\u2019 heart disease","volume":"115","author":"Punukollu","year":"2007","journal-title":"Int. J. Cardiol."},{"key":"ref_30","first-page":"728","article-title":"Dapsone hypersensitivity syndrome with myocarditis","volume":"62","author":"Pereira","year":"2014","journal-title":"J. Assoc. Phys. India"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"833","DOI":"10.47102\/annals-acadmedsg.V35N11p833","article-title":"Presumed dapsone-induced drug hypersensitivity syndrome causing reversible hypersensitivity myocarditis and thyrotoxicosis","volume":"35","author":"Teo","year":"2006","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"236","DOI":"10.3904\/kjim.2014.29.2.236","article-title":"Hypersensitivity myocarditis confirmed by cardiac magnetic resonance imaging and endomyocardial biopsy","volume":"29","author":"Park","year":"2014","journal-title":"Korean J. Int. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/j.jacc.2003.11.053","article-title":"Smallpox vaccination and myopericarditis: A clinical review","volume":"43","author":"Cassimatis","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.4065\/78.11.1431-a","article-title":"Acute myocarditis associated with tetanus vaccination","volume":"78","author":"Dilber","year":"2003","journal-title":"Mayo Clin. Proc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3810\/pgm.2008.11.1940","article-title":"Anthracycline-induced cardiomyopathy","volume":"120","author":"Simmons","year":"2008","journal-title":"Postgrad. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/S0025-6196(12)60870-2","article-title":"Myocarditis related to drug hypersensitivity","volume":"60","author":"Taliercio","year":"1985","journal-title":"Mayo Clin. Proc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1161\/hc3401.095198","article-title":"Advances in the understanding of myocarditis","volume":"104","author":"Liu","year":"2001","journal-title":"Circulation"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S0008-6363(03)00437-1","article-title":"Myocarditis and dilated cardiomyopathy: An inflammatory link","volume":"60","author":"Mason","year":"2003","journal-title":"Cardiovasc. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1017\/S1047951113002369","article-title":"Paediatric dilated cardiomyopathy: Clinical profile and outcome. The experience of a tertiary centre for paediatric cardiology","volume":"25","author":"Miranda","year":"2015","journal-title":"Cardiol. Young"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1161\/01.CIR.99.8.1091","article-title":"From myocarditis to cardiomyopathy: Mechanisms of inflammation and cell death: Learning from the past for the future","volume":"99","author":"Kawai","year":"1999","journal-title":"Circulation"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S0008-6363(03)00475-9","article-title":"Myocarditis and inflammatory cardiomyopathy: Microbiological and molecular biological aspects","volume":"60","author":"Calabrese","year":"2003","journal-title":"Cardiovasc. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/S0006-2952(98)00332-3","article-title":"Receptors mediating adenovirus attachment and internalization","volume":"57","author":"Bergelson","year":"1999","journal-title":"Biochem. Pharmacol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1126\/science.275.5304.1320","article-title":"Isolation of a common receptor for coxsackie b viruses and adenoviruses 2 and 5","volume":"275","author":"Bergelson","year":"1997","journal-title":"Science"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1053\/hupa.2003.48","article-title":"Fatal parvovirus b19-associated myocarditis clinically mimicking ischemic heart disease: An endothelial cell-mediated disease","volume":"34","author":"Bultmann","year":"2003","journal-title":"Hum. Pathol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1097\/INF.0b013e3182425786","article-title":"Fatal parvovirus B19 myocarditis in children and possible dysimmune mechanism","volume":"31","author":"Koehl","year":"2012","journal-title":"Pediatr. Inf. Dis. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1161\/01.CIR.0000085168.02782.2C","article-title":"Parvovirus B19 infection mimicking acute myocardial infarction","volume":"108","author":"Kuhl","year":"2003","journal-title":"Circulation"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/1058-9813(92)90031-G","article-title":"New concepts in myocarditis: Crossroads in the 1990s","volume":"1","author":"Liu","year":"1992","journal-title":"Prog. Pediatr. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1136\/hrt.72.6.561","article-title":"Increased circulating cytokines in patients with myocarditis and cardiomyopathy","volume":"72","author":"Matsumori","year":"1994","journal-title":"Br. Heart J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1006\/jmcc.2002.2056","article-title":"Cytotoxic lymphocytes and cardiac electrophysiology","volume":"34","author":"Binah","year":"2002","journal-title":"J. Mol. Cell. Cardiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1161\/01.RES.86.3.253","article-title":"Viral myocarditis: Receptors that bridge the cardiovascular with the immune system?","volume":"86","author":"Liu","year":"2000","journal-title":"Circ. Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.jacc.2011.09.074","article-title":"Update on myocarditis","volume":"59","author":"Kindermann","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/S1388-9842(02)00010-7","article-title":"Circulating cardiac autoantibodies in dilated cardiomyopathy and myocarditis: Pathogenetic and clinical significance","volume":"4","author":"Caforio","year":"2002","journal-title":"Eur. J. Heart Fail."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1161\/01.CIR.0000155616.07901.35","article-title":"High prevalence of viral genomes and multiple viral infections in the myocardium of adults with \u201cidiopathic\u201d left ventricular dysfunction","volume":"111","author":"Kuhl","year":"2005","journal-title":"Circulation"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1016\/j.mayocp.2016.05.013","article-title":"Myocarditis in clinical practice","volume":"91","author":"Sinagra","year":"2016","journal-title":"Mayo Clin. Proc."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1136\/heart.84.3.245","article-title":"Myocarditis mimicking acute myocardial infarction: Role of endomyocardial biopsy in the differential diagnosis","volume":"84","author":"Angelini","year":"2000","journal-title":"Heart"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s12519-015-0039-x","article-title":"Cardiac biomarkers in children with congenital heart disease","volume":"11","author":"Sugimoto","year":"2015","journal-title":"World J. Pediatr. WJP"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1097\/01.pec.0000221346.64991.e7","article-title":"Myocarditis presenting as gastritis in children","volume":"22","author":"Chang","year":"2006","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/01.pec.0000133615.35075.98","article-title":"Seizures secondary to a high-grade atrioventricular block as a presentation of acute myocarditis","volume":"20","author":"Chavda","year":"2004","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/j.ajem.2008.07.032","article-title":"Pediatric myocarditis: Presenting clinical characteristics","volume":"27","author":"Durani","year":"2009","journal-title":"Am. J. Emerg. Med."},{"key":"ref_60","first-page":"213","article-title":"Clinical aspects and development of dilated cardiomyopathy in infants and children","volume":"56","year":"1991","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1136\/hrt.2005.078402","article-title":"Outcome of acute fulminant myocarditis in children","volume":"92","author":"Amabile","year":"2006","journal-title":"Heart"},{"key":"ref_62","first-page":"1248","article-title":"Myocarditis in children with dilated cardiomyopathy: Incidence and outcome after dual therapy immunosuppression","volume":"16","author":"Kleinert","year":"1997","journal-title":"J. Heart Lung Transplant."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/pch\/6.8.543","article-title":"Myocarditis in infants and children: A review for the paediatrician","volume":"6","author":"Dancea","year":"2001","journal-title":"Paediatr. Child Health"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1542\/peds.2006-0163","article-title":"Factors associated with establishing a causal diagnosis for children with cardiomyopathy","volume":"118","author":"Cox","year":"2006","journal-title":"Pediatrics"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1111\/jpc.12787","article-title":"Dilated cardiomyopathy in children: Review of all presentations to a children\u2019s hospital over a 5-year period and the impact of family cardiac screening","volume":"51","author":"Herath","year":"2015","journal-title":"J. Paediatr. Child Health"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1001\/jama.296.15.1867","article-title":"Incidence, causes, and outcomes of dilated cardiomyopathy in children","volume":"296","author":"Towbin","year":"2006","journal-title":"JAMA"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1017\/S1047951115000943","article-title":"Lessons learned from the pediatric cardiomyopathy registry (PCMR) study group","volume":"25","author":"Wilkinson","year":"2015","journal-title":"Cardiology Young"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/ACO.0b013e3283462257","article-title":"Cardiomyopathy in childhood","volume":"24","author":"Williams","year":"2011","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_69","first-page":"3","article-title":"Dilated cardiomyopathy in childhood","volume":"2","author":"Franklin","year":"2000","journal-title":"Images Paediatr. Cardiol."},{"key":"ref_70","unstructured":"Pagon, R.A., Adam, M.P., Ardinger, H.H., Wallace, S.E., Amemiya, A., Bean, L.J.H., Bird, T.D., Fong, C.T., Mefford, H.C., and Smith, R.J.H. (2007). GeneReviews(R), University of Washington."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1016\/j.cjca.2013.08.008","article-title":"Presentation, diagnosis, and medical management of heart failure in children: Canadian cardiovascular society guidelines","volume":"29","author":"Kantor","year":"2013","journal-title":"Can. J. Cardiol."},{"key":"ref_72","first-page":"3","article-title":"Myocarditis. A histopathologic definition and classification","volume":"1","author":"Aretz","year":"1987","journal-title":"Am. J. Cardiovasc. Pathol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1542\/peds.2007-1073","article-title":"Pediatric myocarditis: Emergency department clinical findings and diagnostic evaluation","volume":"120","author":"Freedman","year":"2007","journal-title":"Pediatrics"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jpeds.2008.10.018","article-title":"Clinical myocarditis masquerading as acute coronary syndrome","volume":"154","author":"Kern","year":"2009","journal-title":"J. Pediatr."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1136\/hrt.2010.204818","article-title":"Acute myocarditis presenting as acute coronary syndrome: Role of early cardiac magnetic resonance in its diagnosis","volume":"97","author":"Monney","year":"2011","journal-title":"Heart"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1161\/CIRCRESAHA.115.306573","article-title":"Myocarditis","volume":"118","author":"Fung","year":"2016","journal-title":"Circ. Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/0002-8703(92)90613-Z","article-title":"Electrocardiography of myocarditis revisited: Clinical and prognostic significance of electrocardiographic changes","volume":"124","author":"Morgera","year":"1992","journal-title":"Am. Heart J."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1097\/MOP.0b013e32833924d2","article-title":"Update on myocarditis in children","volume":"22","author":"Levine","year":"2010","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.jcmg.2011.11.022","article-title":"Diagnostic performance of cmr imaging compared with emb in patients with suspected myocarditis","volume":"5","author":"Lurz","year":"2012","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1016\/j.jacc.2004.11.069","article-title":"Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: Comparison of different approaches","volume":"45","author":"Boye","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e842","DOI":"10.1161\/CIRCULATIONAHA.104.532481","article-title":"Images in cardiovascular medicine. Cardiac magnetic resonance imaging for myocarditis: Effective use in medical decision making","volume":"113","author":"Fenster","year":"2006","journal-title":"Circulation"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1007\/s00247-015-3526-2","article-title":"Utility of late gadolinium enhancement in pediatric cardiac mri","volume":"46","author":"Etesami","year":"2016","journal-title":"Pediatr. Radiol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/j.jacc.2009.02.007","article-title":"Cardiovascular magnetic resonance in myocarditis: A jacc white paper","volume":"53","author":"Friedrich","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1161\/01.CIR.0000118493.13323.81","article-title":"Cardiovascular magnetic resonance assessment of human myocarditis: A comparison to histology and molecular pathology","volume":"109","author":"Mahrholdt","year":"2004","journal-title":"Circulation"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1093\/ehjci\/jev246","article-title":"Incremental value of quantitative cmr including parametric mapping for the diagnosis of acute myocarditis","volume":"17","author":"Luetkens","year":"2016","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1016\/j.jacc.2016.02.013","article-title":"Comprehensive cardiac magnetic resonance imaging in patients with suspected myocarditis: The myoracer-trial","volume":"67","author":"Lurz","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"254","DOI":"10.2214\/AJR.08.1281","article-title":"Acute myocarditis: Noninvasive evaluation with cardiac mri and transthoracic echocardiography","volume":"192","author":"Goitein","year":"2009","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1586\/14779072.2016.1114884","article-title":"Improving outcomes of acute myocarditis in children","volume":"14","year":"2016","journal-title":"Expert Rev. Cardiovasc. Ther."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1093\/eurheartj\/eht210","article-title":"Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: A position statement of the european society of cardiology working group on myocardial and pericardial diseases","volume":"34","author":"Caforio","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1038\/nrcardio.2015.108","article-title":"Viral myocarditis\u2013diagnosis, treatment options, and current controversies","volume":"12","author":"Pollack","year":"2015","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1056\/NEJM200011093431908","article-title":"Myocarditis","volume":"343","author":"Feldman","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1161\/CIRCULATIONAHA.107.743427","article-title":"Complication rate of right ventricular endomyocardial biopsy via the femoral approach: A retrospective and prospective study analyzing 3048 diagnostic procedures over an 11-year period","volume":"118","author":"Holzmann","year":"2008","journal-title":"Circulation"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1161\/CIRCULATIONAHA.109.924167","article-title":"Comparative evaluation of left and right ventricular endomyocardial biopsy: Differences in complication rate and diagnostic performance","volume":"122","author":"Yilmaz","year":"2010","journal-title":"Circulation"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1007\/s00246-016-1416-5","article-title":"Is endomyocardial biopsy a safe and useful procedure in children with suspected cardiomyopathy?","volume":"37","author":"Mills","year":"2016","journal-title":"Pediatr. Cardiol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.ejcts.2005.04.023","article-title":"Pneumatic pulsatile ventricular assist devices in children under 1 year of age","volume":"28","author":"Stiller","year":"2005","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1067\/mtc.2001.115243","article-title":"Mechanical circulatory support for the treatment of children with acute fulminant myocarditis","volume":"122","author":"Duncan","year":"2001","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1136\/hrt.82.2.226","article-title":"Clinical outcomes of acute myocarditis in childhood","volume":"82","author":"Lee","year":"1999","journal-title":"Heart"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1097\/00001573-200103000-00001","article-title":"Diagnosis and treatment of pediatric viral myocarditis","volume":"16","author":"Levi","year":"2001","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1097\/CCM.0b013e3181bc8293","article-title":"Extracorporeal membrane oxygenation for the support of infants, children, and young adults with acute myocarditis: A review of the extracorporeal life support organization registry","volume":"38","author":"Rajagopal","year":"2010","journal-title":"Crit. Care Med."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S0163-4453(97)94311-5","article-title":"Successful diagnosis and management of cytomegalovirus carditis","volume":"34","author":"Ng","year":"1997","journal-title":"J. Infect."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.recesp.2015.10.018","article-title":"Update on myocarditis and inflammatory cardiomyopathy: Reemergence of endomyocardial biopsy","volume":"69","author":"Dominguez","year":"2016","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_102","first-page":"25","article-title":"Dilated cardiomyopathy\u2014A chronic myocarditis? New aspects on diagnosis and therapy","volume":"82","author":"Schultheiss","year":"1993","journal-title":"Z. Fur Kardiol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1002\/ejhf.148","article-title":"Presence of perforin in endomyocardial biopsies of patients with inflammatory cardiomyopathy predicts poor outcome","volume":"16","author":"Escher","year":"2014","journal-title":"Eur. J. Heart Fail."},{"key":"ref_104","first-page":"w14010","article-title":"Viral myocarditis","volume":"144","author":"Kuhl","year":"2014","journal-title":"Swiss Med. Wkly."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1161\/CIRCULATIONAHA.105.584532","article-title":"Myocarditis: Current trends in diagnosis and treatment","volume":"113","author":"Magnani","year":"2006","journal-title":"Circulation"},{"key":"ref_106","first-page":"1","article-title":"Myocarditis and pericarditis in the pediatric patient: Validated management strategies","volume":"12","author":"Bergmann","year":"2015","journal-title":"Pediatr. Emerg. Med. Pract."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1017\/S1047951110000594","article-title":"Acute viral myocarditis: Role of immunosuppression: A prospective randomised study","volume":"20","author":"Aziz","year":"2010","journal-title":"Cardiol. Young"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1136\/hrt.2003.026641","article-title":"Long term follow up of children with myocarditis treated by immunosuppression and of children with dilated cardiomyopathy","volume":"90","author":"Gagliardi","year":"2004","journal-title":"Heart"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1136\/adc.2003.034686","article-title":"Immunosuppressive therapy in acute myocarditis: An 18 year systematic review","volume":"89","author":"Hia","year":"2004","journal-title":"Arch. Dis. Child."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Robinson, J., Hartling, L., Vandermeer, B., and Klassen, T.P. (2015). Intravenous immunoglobulin for presumed viral myocarditis in children and adults. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD004370.pub3"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1161\/01.CIR.89.1.252","article-title":"Gamma-globulin treatment of acute myocarditis in the pediatric population","volume":"89","author":"Drucker","year":"1994","journal-title":"Circulation"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1086\/313929","article-title":"Human parvovirus b19 infection in infancy associated with acute and chronic lymphocytic myocarditis and high cytokine levels: Report of 3 cases and review","volume":"31","author":"Nigro","year":"2000","journal-title":"Clin. Inf. Dis."},{"key":"ref_113","first-page":"810","article-title":"Intravenous immune globulin for severe acute myocarditis in children","volume":"46","author":"Haque","year":"2009","journal-title":"Indian Pediatr."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1017\/S1047951104005049","article-title":"Outcomes for children with acute myocarditis","volume":"14","author":"English","year":"2004","journal-title":"Cardiol. Young"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1007\/s00246-009-9589-9","article-title":"Pediatric patients hospitalized with myocarditis: A multi-institutional analysis","volume":"31","author":"Klugman","year":"2010","journal-title":"Pediatr. Cardiol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1056\/NEJM200211283472220","article-title":"Specific removal of \u03b21-adrenergic autoantibodies from patients with idiopathic dilated cardiomyopathy","volume":"347","author":"Wallukat","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/0167-5273(96)02598-3","article-title":"Removal of autoantibodies in dilated cardiomyopathy by immunoadsorption","volume":"54","author":"Wallukat","year":"1996","journal-title":"Int. J. Cardiol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.pharmthera.2016.03.006","article-title":"Emerging pharmacologic targets and treatments for myocarditis","volume":"161","author":"Jensen","year":"2016","journal-title":"Pharmacol. Ther."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1007\/s00059-012-3679-9","article-title":"Current treatment options in (peri)myocarditis and inflammatory cardiomyopathy","volume":"37","author":"Maisch","year":"2012","journal-title":"Herz"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1161\/01.CIR.101.4.385","article-title":"Immunoglobulin adsorption in patients with idiopathic dilated cardiomyopathy","volume":"101","author":"Muller","year":"2000","journal-title":"Circulation"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1136\/heart.88.2.198","article-title":"Heart failure in the young","volume":"88","author":"Burch","year":"2002","journal-title":"Heart"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1172\/JCI200420149","article-title":"Direct evidence for a \u03b21-adrenergic receptor-directed autoimmune attack as a cause of idiopathic dilated cardiomyopathy","volume":"113","author":"Jahns","year":"2004","journal-title":"J. Clin. Investig."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1161\/01.CIR.99.5.649","article-title":"Autoantibodies activating human \u03b21-adrenergic receptors are associated with reduced cardiac function in chronic heart failure","volume":"99","author":"Jahns","year":"1999","journal-title":"Circulation"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/0002-9149(88)90226-3","article-title":"Echocardiographic findings in myocarditis","volume":"62","author":"Pinamonti","year":"1988","journal-title":"Am. J. Cardiol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1067\/mpd.2001.113045","article-title":"Carvedilol as therapy in pediatric heart failure: An initial multicenter experience","volume":"138","author":"Bruns","year":"2001","journal-title":"J. Pediatr."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1136\/hrt.2004.034082","article-title":"Immune suppressive treatment in paediatric myocarditis: Still awaiting the evidence","volume":"90","author":"Burch","year":"2004","journal-title":"Heart"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"637","DOI":"10.2165\/00128072-200204100-00002","article-title":"An approach to the treatment of pediatric myocarditis","volume":"4","author":"Levi","year":"2002","journal-title":"Paediatr. Drugs"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: The task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)developed with the special contribution of the heart failure association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/MBC.0b013e32835bfd85","article-title":"Thrombosis and embolism in pediatric cardiomyopathy","volume":"24","author":"Chen","year":"2013","journal-title":"Blood Coagul. Fibrinolysis"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s11936-009-0039-z","article-title":"Acute myocarditis in children: Current concepts and management","volume":"11","author":"Vashist","year":"2009","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1161\/CIRCULATIONAHA.113.002767","article-title":"Long-term outcomes of dilated cardiomyopathy diagnosed during childhood: Results from a national population-based study of childhood cardiomyopathy","volume":"128","author":"Alexander","year":"2013","journal-title":"Circulation"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1161\/CIRCHEARTFAILURE.109.902833","article-title":"Ventricular remodeling and survival are more favorable for myocarditis than for idiopathic dilated cardiomyopathy in childhood: An outcomes study from the pediatric cardiomyopathy registry","volume":"3","author":"Foerster","year":"2010","journal-title":"Circ. Heart Fail."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/3\/4\/31\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:35:02Z","timestamp":1760211302000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/3\/4\/31"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,8]]},"references-count":132,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2016,12]]}},"alternative-id":["jcdd3040031"],"URL":"https:\/\/doi.org\/10.3390\/jcdd3040031","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,8]]}}}