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Kardiologie up2date 2017; 13(03): 275-293
DOI: 10.1055/s-0043-117255
Spezialthemen
Georg Thieme Verlag KG Stuttgart · New York

Myokarditis im Kindes- und Jugendalter

Stephan Schubert
,
Daniel Messroghli
,
Sabine Klaassen
,
Felix Berger
Further Information

Publication History

Publication Date:
19 October 2017 (online)

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Die Myokarditis bei Kindern und Jugendlichen ist selten, kann aber zunehmend als Ursache der akuten Herzinsuffizienz diagnostiziert werden. Sie ist eine wichtige Differenzialdiagnose der angeborenen Kardiomyopathien. Die Diagnostik und Therapie der akuten Myokarditis im Kindes- und Jugendalter ist aktuell nicht standardisiert, denn das Patientenalter spielt eine wesentliche Rolle für das Risiko, den Verlauf aber auch die durchgeführte Diagnostik und Therapie.
Kernaussagen

  • Die Myokarditis ist eine seltene Erkrankung bei Kindern und Jugendlichen. Sie stellt aber eine wichtige Differenzialdiagnose dar bei Patienten mit einer akuten oder chronischen Herzinsuffizienz, welche nicht durch einen angeborenen Herzfehler erklärbar ist.

  • Nicht selten folgt der Myokarditis eine dilatative und damit postinflammatorische Kardiomyopathie.

  • Bei unklarer Inzidenz und Verlauf der Myokarditis im Kindes- und Jugendalter in Deutschland sind Diagnostik und Therapie aktuell noch nicht standardisiert. Klinische und auch paraklinische Kriterien sind nicht spezifisch und ebenfalls noch nicht definiert.

  • Durch den Einsatz von Rö-Thorax, EKG, Labor, Echokardiografie, Magnetresonanztomografie und Herzkatheteruntersuchung mit Histologie lässt sich diese Verdachtsdiagnose aktuell besser charakterisieren und häufig bestätigen.

  • Dennoch sind die bisherigen diagnostischen Verfahren und Therapien v. a. im Kindesalter noch nicht umfassend evaluiert und auch nicht spezifisch.

  • „Mykke“ verfolgt als wichtige multizentrische Evaluation die Wertigkeit von Diagnostik und Therapie der pädiatrischen Myokarditis.

  • Patienten mit V. a. auf Myokarditis sollten in einer auf Kinderkardiologie spezialisierten Klinik oder in einem Herzzentrum entsprechend abgeklärt werden.

  • Für weitere Informationen verweisen wir auch auf die aktuelle DGPK-Leitlinie „Myokarditis“ unter www.dgpk.org [55].

 

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