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Myocarditis — RACP Paediatrics MCQ

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HardCardiologyMyocarditisRACP Paediatrics

A 12-year-old has chest pain and dyspnoea one week after a viral illness. He is tachycardic out of proportion to fever, has gallop rhythm, hepatomegaly and cool peripheries. ECG shows diffuse ST-T changes and troponin is elevated. What is the most appropriate investigation?

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Correct answer: C — Urgent echocardiography

Myocarditis is suggested by viral prodrome, disproportionate tachycardia, heart failure signs, ECG changes and elevated troponin. Echocardiography assesses ventricular function, effusion and complications and should be urgent. Exercise testing is inappropriate in acute suspected myocarditis.

Reference: RCH Chest pain guideline; RACP Knowledge Guides