A 10-year-old with suspected myocarditis has increasing work of breathing, cool peripheries, lactate 4.8 mmol/L, ventricular ectopy and severe

Question

A 10-year-old with suspected myocarditis has increasing work of breathing, cool peripheries, lactate 4.8 mmol/L, ventricular ectopy and severe left-ventricular dysfunction. Blood pressure remains just within the age-adjusted normal range. Which disposition is most appropriate?

Accepted Answer

Escalate to paediatric intensive care and specialist cardiac support now

Answer

Discharge if a repeat troponin concentration begins to fall

Answer

Give repeated large crystalloid boluses until tachycardia resolves

Answer

Manage on a general ward with unrestricted oral fluid intake

Answer

Schedule outpatient cardiac MRI before choosing a treatment setting

Myocarditis — RACP Paediatrics MCQ

A 10-year-old with suspected myocarditis has increasing work of breathing, cool peripheries, lactate 4.8 mmol/L, ventricular ectopy and severe left-ventricular dysfunction. Blood pressure remains just within the age-adjusted normal range. Which disposition is most appropriate?