PT  - JOURNAL ARTICLE
AU  - Matthias W Freund
AU  - Gitta Kleinveld
AU  - Tannette G Krediet
AU  - Anton M van Loon
AU  - Malgorzata A Verboon-Maciolek
TI  - Prognosis for neonates with enterovirus myocarditis
AID  - 10.1136/adc.2009.165183
DP  - 2010 May 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - F206--F212
VI  - 95
IP  - 3
4099  - http://fn.bmj.com/content/95/3/F206.short
4100  - http://fn.bmj.com/content/95/3/F206.full
SO  - Arch Dis Child Fetal Neonatal Ed2010 May 01; 95
AB  - Objective To assess the severity of the disease and the long-term cardiac prognosis for neonates who developed enterovirus (EV) myocarditis within the first weeks of life. Design Clinical presentation, echocardiographic and ECG findings and the outcome of seven infants with EV myocarditis admitted to the intensive care unit are reported. Additionally, 28 previously reported cases are described. Results Seven neonates presented with cardiac failure within 17 days after birth requiring respiratory and circulatory support. Echocardiography showed dilatation and severe dysfunction of the left ventricle in all and mitral regurgitation in six. In six patients the echocardiographic pattern resembled myocardial infarction. ECG showed complete loss of the R-wave and a new Q-wave in the left precordial leads in all. Two infants died and five developed long-term cardiac sequelae requiring medication. In all survivors aneurysm formation in the left ventricular wall was found weeks to months later. One patient is awaiting heart transplantation. Coxsackie virus B was detected in blood, cerebrospinal fluid, nasopharyngeal swab or stool by PCR or culture. The mortality of previously described neonates combined with our seven cases was 31% (11/35). Among the survivors 66% (16/24) developed severe cardiac damage. Only 23% (8/35) of the infants fully recovered. Conclusions EV myocarditis is a rare but severe disease in the neonatal period, which often leads to death or results in serious chronic cardiac sequelae like chronic heart failure, aneurysm formation within the left ventricle and mitral regurgitation. Chronic cardiac drug therapy is necessary in the majority of these patients.