Myocarditis - pediatric

ʻO ka myocarditis Pediatric ka mumū o ka puʻuwai puʻuwai i kahi pēpē a keiki ʻōpio paha.

Kākaʻikahi ka Myocarditis i nā keiki ʻōpio. ʻOi aku ka maʻamau o nā keiki a me nā mākua. ʻOi aku ka maikaʻi ma mua o nā keiki hānau hou a me nā keiki ʻōpio ma mua o nā keiki ma mua o 2 mau makahiki.

ʻO ka hapa nui o nā hihia i nā keiki e hopena ʻia e ka maʻi virus i hiki i ka puʻuwai. Hiki i kēia mau mea ke:

• Huʻi maʻi maʻi maʻi (flu)
• Virus Coxsackie
• Parovirus
• Adenovirus

Hoʻokumu ʻia paha ia e nā maʻi koʻohune e like me ka maʻi Lyme.

ʻO nā kumu ʻē aʻe o myocarditis pediatric me:

• Nā hopena āpau i kekahi mau lāʻau
• Hōʻike i nā kemika i ke kaiapuni
• Nā maʻi ma muli o ka fungus a nā parasites
• Pāhawewe
• ʻO kekahi mau maʻi (nā maʻi autoimmune) e hoʻoulu ai i ke kino
• Kekahi lāʻau

Hiki ke hōʻino pololei ʻia ka puʻuwai puʻuwai e ka maʻi hoʻomaʻamaʻa a i ʻole ka maʻi bacteria e hoʻopili iā ia. Hiki i ka pane pale o ke kino ke hōʻino i ka puʻuwai puʻuwai (i kapa ʻia ʻo myocardium) i ke kaʻina hakakā me ka maʻi. Hiki i kēia ke alakaʻi i nā hōʻailona o ka puʻuwai puʻuwai.

Māmā paha nā ʻōuli i ka mua a paʻakikī e ʻike. I kekahi manawa i nā keiki hānau hou a me nā pēpē, ʻike koke ʻia nā ʻōuli.

Pākuʻi ʻia paha nā ʻōuli:

• Ka pīhoihoi
• ʻO ka holomua ʻole a i ʻole ka loaʻa o ke kaumaha maikaʻi ʻole
• Pilikia hānai
• ʻO ka fiva a me nā ʻōuli ʻē aʻe o ka maʻi
• Palapala ʻole
• Low mimi auaiaea (he hoailona o ka hōʻemiʻana hakuʻala kuleana pili i)
• ʻO Pale, nā lima a me nā wāwae anuanu (kahi hōʻailona o ka holo maikaʻi ʻole)
• Hanu wikiwiki
• Helu puʻuwai wikiwiki

ʻO nā ʻōuli i nā keiki ma mua o 2 mau makahiki e hoʻopili pū ʻia:

• ʻO ka ʻeha a me ka nausea o ka ʻōpū
• ʻEha ʻeha
• Cough
• Ka luhi
• ʻO ka pehu (edema) i nā wāwae, nā wāwae, a me ke alo

Hiki i ka myocarditis pēpē ke paʻakikī e kuhi no ka mea pinepine nā hōʻailona a me nā ʻōuli i nā maʻi o ka puʻuwai a me nā maʻi o ka maʻi, a i ʻole kahi hihia maikaʻi ʻole o ka maʻi flu.

Lohe paha ka mea lawelawe olakino i ke kani o ka puʻuwai wikiwiki a i ʻole kani hewa ka puʻuwai ʻoiai e hoʻolohe ana i ka umauma o ke keiki me kahi stethoscope.

E hōʻike paha kahi hōʻike kino:

• Fluid i loko o ka akemāmā a me ka pehu i nā wāwae i nā keiki nui.
• Nā hōʻailona o ka maʻi, e laʻa me ke kuni a me nā ʻino.

Hiki i kahi x-ray umauma ke hōʻike i ka hoʻonui ʻana (pehu) o ka puʻuwai. Inā kānalua ka mea hāʻawi i ka myocarditis e pili ana i ka hoʻokolohua a me ka x-ray umauma, hana ʻia paha kahi electrocardiogram e kōkua i ka ʻike ʻana i ka ʻike.

ʻO nā hoʻokolohua ʻē aʻe e pono ai e hoʻopili ʻia:

• ʻO nā moʻomeheu koko e nānā i ka maʻi
• Nānā ke koko e nānā i nā mea ʻino e kūʻē i nā virus a i ʻole ka mākala puʻuwai ponoʻī
• Nā ho'āʻo koko e nānā i ka hana o ke ake a me ka hakuʻala
• Helu piha koko
• ʻO ka biopsy puʻuwai (ke ala pololei loa e hōʻoia ai i ke kuhi, akā ʻaʻole pono mau ʻia)
• Nā hoʻāʻo kūikawā e nānā ai i ka loaʻa ʻana o nā mea ʻino i loko o ke koko (viral PCR)

ʻAʻohe lāʻau no ka myocarditis. E hele pinepine ka mimiki puʻuwai naʻau nona iho.

ʻO ka pahuhopu o ka mālama ʻana ke kākoʻo i ka hana puʻuwai a hiki i ka hala ʻana o ka mumū. ʻAe ʻia nā keiki he nui me kēia maʻi i ka haukapila. Pono e kaupalena ʻia ka hana ʻoiai ke hoʻā ʻia ka puʻuwai no ka mea hiki ke ʻāʻī i ka puʻuwai.

Hiki ke hoʻopili ʻia i ka mālama ʻana:

• Nā Antibiotics e hakakā i ka maʻi bacteria
• ʻO nā lāʻau lapaʻau anti-inflammatory i kapa ʻia ʻo steroid e kāohi i ka wela
• Intravenous immunoglobulin (IVIG), kahi lāʻau i hana ʻia i nā mea (i kapa ʻia he antibodies) e hoʻopuka ai ke kino e hakakā i ka maʻi, e kaohi i ke kaʻina hana hoʻomeamea.
• Kākoʻo mīkini me ka hoʻohana ʻana i kahi mīkini e kōkua i ka hana o ka puʻuwai (i nā kūlana koʻikoʻi)
• Nā lāʻau lapaʻau e mālama i nā hōʻailona o ka puʻuwai puʻuwai
• Nā lāʻau lapaʻau e mālama ai i nā puʻuwai puʻuwai abnormal

ʻO ke ola ʻana mai ka myocarditis ma muli o ke kumu o ka pilikia a me ke olakino olakino o ke keiki. ʻO ka hapa nui o nā keiki e ola hou me ka lāʻau kūpono. Eia nō naʻe, he maʻi puʻuwai mau paha kekahi.

Loaʻa ka makaʻu kiʻekiʻe loa i nā keiki hānau hou no nā maʻi koʻikoʻi a me nā pilikia (me ka make) ma muli o ka myocarditis. I nā hihia maʻamau, koi nui ka hōʻino i ka puʻuwai i kahi transplant puʻuwai.

Komo pū nā pilikia:

• Ka hoʻonui ʻana o ka puʻuwai e alakaʻi i ka hoʻohaʻahaʻa i ka hana puʻuwai (dilated cardiomyopathy)
• Hewa puʻuwai
• Nā pilikia puʻuwai puʻuwai

Kāhea i kāu pediatric o kāu keiki inā loaʻa nā hōʻailona a i ʻole nā ​​hōʻailona o kēia ʻano.

ʻAʻohe pale e ʻike ʻia. Eia nō naʻe, hiki i ka hoʻāʻo wikiwiki ʻana a me ka lāʻau ʻana ke hōʻemi i ka makaʻu o ka maʻi.

• Myocarditis

Knowlton KU, Anderson JL, Savoia MC, Oxman MN. Myocarditis a me pericarditis. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 84.

ʻO McNamara DM. ʻO ka puʻuwai puʻuwai ma ke ʻano he hopena o ka myocarditis viral a me nonviral. I: Felker GM, Mann DL, hoʻoponopono. Hewa Ka Puʻuwai: He Hoa i ka Maʻi Puʻuwai ʻo Braunwald. ʻEhā ed. Piladelapia, PA: Elsevier; 2020: chap 28.

Makua JJ, Ware SM. Nā maʻi o ka myocardium. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 466.