Pediatric Myocarditis

  • Etiology: inflammation of myocardial tissue, myocardial dysfunction leads to pulmonary venous return obstruction, most commonly due to infection – coxsackie virus most common infectious cause in newborn, less commonly due to toxic / ischemic / mechanical injury or drug related inflammation or transplant rejection
  • Imaging: pericardial effusion in 33%-50%, global left ventricular dysfunction in severe cases
  • MRI: edema and fibrosis with T2WI being a biomarker of edema with increased signal intensity of myocardium and T1WI being a biomarker of fibrosis with delayed enhancement of myocardium due to focal fibrosis on post contrast imaging, need abnormalities on both T1WI and T2WI to make the diagnosis
  • Treatment: heart transplant

Radiology Cases of Myocarditis

CXR of viral myocarditis
CXR AP shows cardiomegaly and pulmonary vascular congestion.