Challenges of Diagnosing Viral Myocarditis in Adolescents in the Era of COVID-19 and MIS-C

• Main Authors: Hemali P. Shah (Author), Richard Frye (Author), Sunny Chang (Author), Erin Faherty (Author), Jeremy Steele (Author), Ruchika Karnik (Author)
• Format: Book
• Published: Hindawi Limited, 2021-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2090-6803; 2090-6811; 10.1155/2021/4797498
• Keywords: Pediatrics; RJ1-570
• Source: Case Reports in Pediatrics, Vol 2021 (2021)

Myocarditis has a wide array of clinical presentations ranging from asymptomatic to sudden cardiac death. Pediatric myocarditis is a rare disease, with an estimated annual incidence of 1 to 2 per 100,000 children though its true prevalence remains unknown due to its variable and often subclinical presentation. The diagnosis of myocarditis is challenging in the era of COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C), which can have overlapping clinical conundrum. Here, we present a case of a 17-year-old male presenting with chest tightness, shortness of breath, and electrocardiogram (EKG) findings concerning for myocardial injury along with elevated inflammatory markers such as D-dimer, ESR (Erythrocyte Sedimentation Rate), and CRP (C-Reactive Protein). We discuss the key elements of our clinical experience with this case and review the literature for pediatric myocarditis, with a focus on differentiating it from MIS-C in the current COVID-19 pandemic era.