Myokarditis

Fazit

Die Myokarditis ist eine seltene Erkrankung bei Kindern und Jugendlichen. Sie stellt aber eine wichtige Differenzialdiagnose dar bei Patientinnen/-en 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 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.

Die angeborene Kardiomyopathie ist eine wichtige Differenzialdiagnose und wird zunehmend als Ursache der akuten Herzinsuffizienz diagnostizierbar. 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].

• Literatur

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