Background. Implementation of mechanical circulatory support and heart transplantation technologies in paediatric clinical practice is changing approaches of diagnostics and treatment of heart failure (HF) in children. The experience of carrying out such operations in Russian Federation is extremely limited until recently due to absence of legal mechanisms of people declaration of intention recording about postmortal use of organs for transplantation.Clinical Case Description. The rare clinical case of drug-refractory (cardiotonic agents and cardioverter defibrillator implantation) chronic cardiac failure caused by post-myocarditis dilated cardiomyopathy (DCM) which demanded heart transplantation. Postoperative course, specific and non-specific complications, diagnostics and correction approaches are described.Conclusion. In the absence of proper analysis of non-specific slight symptoms myocarditis can progress to DCM and be complicated by development of refractory HF. The only method of sustaining child’s life in such case is heart transplantation which is connected with high risk of numerous and life-threatening complications.
The lecture presents modern views on the problem of myocarditis in pediatrics. Current ideas about the definition, prevalence, etiology and pathogenesis of inflammatory myocardial lesions in children are presented. Features of clinical manifestations of the disease in patients of different age groups, difficulties of diagnosis and treatment of myocarditis and its complications are disclosed in accordance with federal clinical recommendations. Special attention is paid to diagnostic approaches adjusted with the European society of cardiologists, including first and second level techniques, determination of indications for their implementation and diagnostic capabilities, as well as differential diagnosis of myocarditis with other cardiological diseases. Issues of heart failure treatment in myocarditis and indications for heart transplantation for patients under 18 years of age were also discussed. The lecture has illustrated clinical examples that clearly demonstrate the diversity of the clinical picture and the ambiguity of myocarditis prognosis in children and teenagers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.