title: Clinical presentation of pediatric myocarditis in Taiwan.
abstract: BACKGROUND
  The purposes of this study were to characterize the symptoms and signs of children with myocarditis at the time of presentation to the hospital and to identify the predictors of death.
  
  
  METHODS
  This was a 5-year retrospective study in a tertiary hospital. We collected demographic data and clinical symptoms and signs when children with myocarditis presented at the hospital. The outcome for patient was classified as either survival or death, and the predictors of death were identified.
  
  
  RESULTS
  Over the 5-year period, 27 children (14 boys and 13 girls) met the definition of clinical myocarditis. The mean age of the myocarditis patients was 9.1±5.1 years (range, 0.08-17.9 years), and the maximum age was 10-12 years. The most common presentation was gastrointestinal symptoms. We used extracorporeal membrane oxygenation on nine (33%) children, and pacemaker was implanted in eight (30%). Six (22%) children died in this study, and only one of them was younger than 6 years. The poor prognosis predictors were gastrointestinal symptoms, hepatomegaly, and hypotension.
  
  
  CONCLUSIONS
  Pediatric myocarditis presents primarily with gastrointestinal symptoms in Taiwan. Careful check of heart rhythm may provide a useful objective marker of myocarditis. The predictors of a poor prognosis were gastrointestinal symptoms, hepatomegaly, and hypotension.
authors.affiliation: Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Hsiang-Ju
authors.initials: HJ
authors.lastname: Hsiao
authors.forename: Shao-Hsuan
authors.initials: SH
authors.lastname: Hsia
authors.forename: Chang-Teng
authors.initials: CT
authors.lastname: Wu
authors.forename: Jainn-Jim
authors.initials: JJ
authors.lastname: Lin
authors.forename: Hung-Tao
authors.initials: HT
authors.lastname: Chung
authors.forename: Mao-Sheng
authors.initials: MS
authors.lastname: Hwang
authors.forename: Wu-Jen
authors.initials: WJ
authors.lastname: Su
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006339:Heart Rate; D006529:Hepatomegaly; D006801:Humans; D007223:Infant; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013624:Taiwan