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Acute non-fulminant myocarditis has a less distinct onset in contrast to fulminant myocarditis, and evolves over days to months. [16] [17] While the symptoms of acute myocarditis overlap with those of fulminant myocarditis, they do not typically occur at rest, and treatment does not require the use of mechanical circulatory support. [17]
Myocarditis and cardiogenic shock seem to be relatively common. [22] Myocarditis may be more evident in older children and adolescents. [49] Preschool children tend to display more Kawasaki-like characteristics. [49] Features of macrophage activation syndrome appear to be more frequent than in Kawasaki disease.
Cardiomyopathy is a group of primary diseases of the heart muscle. [1] Early on there may be few or no symptoms. [1] As the disease worsens, shortness of breath, feeling tired, and swelling of the legs may occur, due to the onset of heart failure. [1]
Nature, 2024, Myocarditis associated with COVID-19 vaccination. MedrXiv, May 20, OpenSAFELY: Effectiveness of COVID-19 vaccination in children and adolescents. Thank you for supporting our journalism.
Or, it may be the late sequelae of acute viral myocarditis, such as with Coxsackie B virus and other enteroviruses [14] possibly mediated through an immunologic mechanism. [15] Specific autoantibodies are detectable in some cases. [16] Other causes include: Chagas disease, due to Trypanosoma cruzi.
The appearance of myopericarditis is associated with infections such as acute tonsillitis, pneumonia, and gastroenteritis. [2] Smallpox vaccination has been a known risk factor for myocarditis and pericarditis since the 1950s. [3] In 1983, an incidence of myocarditis of 1 per 10 000 was reported among Finnish military personnel. [4]
Eosinophilic myocarditis is often viewed as a disorder that has three progressive stages. The first stage of eosinophilic myocarditis involves acute inflammation and cardiac cell necrosis (i.e. areas of dead cells); it is dominated by symptoms characterized as the acute coronary syndrome such as angina, heart attack and/or congestive heart failure.
Heart complications may be long-term and severe, particularly if valves are involved. In countries in Southeast-Asia, sub-Saharan Africa, and Oceania, the percentage of people with rheumatic heart disease detected by listening to the heart was 2.9 per 1000 children and by echocardiography it was 12.9 per 1000 children.