Ho Chi Minh City 12 year old girl had mild fever, headache for three days, on the 4th day chest pain, vomiting, cold hands and feet, hospitalized doctor diagnosed viral infection with complications of myocarditis.
On September 3, Dr. Nguyen Minh Tien, Deputy Director of the City Children's Hospital, said that the child was admitted to the hospital drowsy, with low blood pressure, irregular heartbeat, difficult to detect pulse, and high cardiac enzymes. An echocardiogram showed that the ejection fraction had decreased to 22-26% (normal 60-80%).
The doctor diagnosed acute myocarditis, cardiogenic shock, and arrhythmia. The baby was intubated to help him breathe, given vasopressors and anti-arrhythmic drugs, and underwent ECMO (extracorporeal membrane oxygenation).
The baby was given many types of medicine, but the progress was still complicated, the heart rate decreased to 30-40 beats/minute, the doctor installed a pacemaker. After 9 days of ECMO, the doctors tried to handle the abnormal changes in heart rate, heart muscle and hemodynamics as well as continuous blood filtration to support the liver and kidney organs, helping the baby's heart to gradually recover. The baby was taken off ECMO and continued supportive treatment in the intensive care unit.
"With erratic weather, cases of viral infections with complications of myocarditis may appear," the doctor analyzed. Myocarditis is a type of inflammation of the heart muscle caused by a virus, damaging heart muscle cells, reducing the force of heart muscle contractions, leading to circulatory collapse, causing the heart to dilate, the heart muscle to contract very weakly, and increasing cardiac enzymes due to the release of damaged heart muscle cells. The disease is difficult to detect when the initial symptoms are very vague, easily confused with other diseases such as colds.
Myocarditis usually occurs in children aged 2-10 years. Children under 24 months of age often have severe illness due to weak resistance. Some cases of mild myocarditis will heal on their own. Some children have no symptoms before, but the disease progresses very quickly, is severe, and has a high risk of death. If they survive, they are likely to develop heart failure or arrhythmia later.
Doctor Tien recommends that children with mild fever, fatigue, headache, vomiting, abdominal pain, pale complexion, pale hands and feet, pale fingernails, fainting, chest pain... should be quickly taken to a medical facility with a pediatric specialist for examination, early diagnosis of myocarditis and appropriate treatment.
Prevent disease by limiting children's contact with adults who have contracted viral diseases. Provide children with adequate vitamins and minerals. Vaccinate children against diphtheria, influenza, rubella, mumps, etc. to increase their resistance to disease. School-age children should practice the habit of washing their hands before eating and after using the toilet.
Le Phuong
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