title: Prevalence of myocarditis in pediatric intensive care unit cases presenting with other system involvement.
abstract: OBJECTIVE
  To assess children with myocarditis, the frequency of various presenting symptoms, and the accuracy of different investigations in the diagnosis.
  
  
  METHODS
  This was an observational study of 63 patients admitted to PICU with non-cardiac diagnosis. Cardiac enzymes, chest-X ray, echocardiography, and electrocardiogram were performed to diagnose myocarditis among those patients.
  
  
  RESULTS
  There were 16 cases of definite myocarditis. The age distribution was non-normal, with median of 5.5 months (3.25-21). Of the 16 patients who were diagnosed with myocarditis, 62.5% were originally diagnosed as having respiratory problems, and there were more females than males. Among the present cases, the accuracy of cardiac enzymes (cardiac troponin T [cTn] and creatine phosphokinase MB [CKMB]) in the diagnosis of myocarditis was only 63.5%, while the accuracy of low fractional shortening and of chest-X ray cardiomegaly was 85.7 and 80.9%; respectively. Cardiac troponin folds 2.02 had positive predictive value of 100%, negative predictive value of 88.7%, specificity of 100%, sensitivity of 62.5%, and accuracy of 90.5%.
  
  
  CONCLUSIONS
  Children with myocarditis present with symptoms that can be mistaken for other types of illnesses. When clinical suspicion of myocarditis exists, chest-X ray and echocardiography are sufficient as screening tests. Cardiac troponins confirm the diagnosis in screened cases, with specificity of 100%.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: hanaaarady@gmail.com.
authors.forename: Hanaa Ibrahim
authors.initials: HI
authors.lastname: Rady
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: dr_ksadek@yahoo.com.
authors.forename: Hanan
authors.initials: H
authors.lastname: Zekri
mesh_terms: D052279:Creatine Kinase, MB Form / Q000097:blood; D003937:Diagnosis, Differential; D004534:Egypt / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000401:mortality; D015995:Prevalence; D012680:Sensitivity and Specificity; D015996:Survival Rate; D020107:Troponin T / Q000097:blood
chemical_list: D020107:Troponin T; D052279:Creatine Kinase, MB Form
keywords: Cardiac enzymes; Children; Crianças; Enzimas cardíacas; Miocardite; Myocarditis; Pediatric intensive care unit; Troponin; Troponina; Unidade de terapia intensiva pediátrica