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Master Thesis

Facteurs pronostiques précoces des myocardites aigües virales de l'enfant

Abstract : Objectives. To assess early predictors for favourable outcome at day 3 and further full recovery for acute viral myocarditis in children. To outline clinical features of hypokinetic cardiomyopathy and check for differences between acute and fulminant myocarditis. Methods. Retrospective inclusion of 23 patients, over a 10 years period, located in 3 cities: Lyon, Clermont-Ferrand and Grenoble. Results. 14 acute myocarditis cases and 9 fulminant myocarditis cases were reported. Digestive clinical signs were the most frequent. Cardiomegaly was detected in 74% of the cases and sinusal tachycardia in 78%. Troponin and NTProBNP were checked for median value at 0,20μg/L and 29430ng/L. Survival rate has been 87%; four patients received ECMO with 75% survival rate. Early MRI was not performed although it is helpful for pertinent diagnosis and prognosis. Positive prognosis for fulminant myocarditis wasn't shown in this study. Recovery predictors conclusion: day 0, less repolarisation troubles and lower rate of metabolic acidosis; day 1, improvement or stabilization in hemodynamic values; day 3, positive outcome issue. Positive outcome predictors at day 3 have been: more time for diagnosis, lower metabolic acidosis, combined criteria bicarbonate<20+troponin≥0,10 less frequent, higher FEVG. Conclusion. This study has shown positive outcome predictors at day 3; predictors for a full recovery at day 1 and 3, confirm the need for a quick medical care in order to recover hemodynamic status of patients together with the diagnosis.
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Master Thesis
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Submitted on : Thursday, October 17, 2013 - 4:17:07 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
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  • HAL Id : dumas-00874364, version 1

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Cécile Boulet. Facteurs pronostiques précoces des myocardites aigües virales de l'enfant. Médecine humaine et pathologie. 2013. ⟨dumas-00874364⟩

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