RT Book, Section
A1 Towbin, Jeffrey A.
A2 Rudolph, Colin D.
A2 Rudolph, Abraham M.
A2 Lister, George E.
A2 First, Lewis R.
A2 Gershon, Anne A.
SR Print(0)
ID 7048643
T1 Chapter 489. Diseases of Myocardium
T2 Rudolph's Pediatrics, 22e
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-149723-7
LK accesspediatrics.mhmedical.com/content.aspx?aid=7048643
RD 2024/04/24
AB The  myocardium  can  be  affected  by  inflammatory  (infectious  or  immune-mediated),  metabolic,  infiltrative,  ischemic,  or  primary  disease  processes.  These  disorders  may  be  inherited  and  may  have  significant  overlap  (eTable  489.1).  Myocardial  diseases  may  present  acutely,  with  signs  of  congestive  heart  failure  that  include  tachypnea,  often  with  rales;  tachycardia;  an  enlarged  but  quiet  heart;  soft  heart  sounds  that  may  have  a  tic-tac  rhythm;  cardiac  gallops;  and  either  no  murmurs  or  systolic  murmurs  of  mitral  or  tricuspid  regurgitation.  Alternatively,  they  may  present  chronically  with  failure  to  thrive,  decreased  exercise  tolerance,  and  more  subtle  findings  of  heart  failure.  Occasionally,  the  predominant  process  may  be  an  arrhythmia,  either  atrial  or  ventricular  tachycardia/fibrillation,  or  heart  block.  These  present  clinically  with  palpitations,  syncope,  or  sudden  death.  The  electrocardiogram  and  chest  x-ray  are  useful  in  confirming  the  presence  of  heart  disease,  but  are  rarely  diagnostic.