Point-of-care Ultrasound in Early Diagnosis of Cardiomyopathy in a Child with Viral Myocarditis: A Case Report

Abstract

Introduction: Pediatric myocarditis is a commonly missed diagnosis in the pediatric emergency department (ED) with high morbidity and mortality. The presentation of cardiogenic shock secondary to myocarditis and septic shock can be difficult to differentiate during initial resuscitation, and incorrect treatment can lead to poor prognosis. Early diagnosis may provide a better prognosis for this life-threatening condition. Case Report: We report a case of a five-year-old female who presented to the ED with non-specific symptoms of myocarditis. Rapid point-of-care ultrasound led to early diagnosis, correct management, and great prognosis for the patient. Conclusion: Providers must maintain a high index of suspicion for cardiogenic shock in patients with nonspecific symptoms and fluid unresponsiveness. Point-of-care ultrasound can help in the identification of cardiac disorders and guide practitioners in their management plans.

Focused Cardiac Ultrasound Diagnosis of Dilated Cardiomyopathy

“…10 It has also been shown to correctly identify pediatric dilated cardiomyopathy secondary to myocarditis. 11 Although recommended as part of the FOCUS, the evidence for IVC evaluation in volume status determination remains evolving.…”

“…In adult patients, FOCUS performed by noncardiologists has been shown to be comparable to cardiology echocardiography when assessing LV function and LV dilation 10 . It has also been shown to correctly identify pediatric dilated cardiomyopathy secondary to myocarditis 11 . Although recommended as part of the FOCUS, the evidence for IVC evaluation in volume status determination remains evolving 2,6 …”

Updates on the clinical integration of point-of-care ultrasound in pediatric emergency medicine

“…In pediatric patients, one of the greatest utilities of POCUS is to distinguish cardiogenic shock from hypovolemic shock [6]. POCUS can help identify challenging diagnoses such as myocarditis in patients presenting with nonspecific symptoms, and guide treatment in terms of judicious fluid administration and timing of initiating inotropic support [7]. Early recognition of acute heart failure (Fig.…”