Objective: We report a retrospective series of cases of myocarditis in KK Women’s and Children’s Hospital.

Methods: Between January 1997 and November 2004, 28 patients with myocarditis were identified. The case records were reviewed.

Results: The patients ranged in age from 2 months to 14 years 5 months, with equal number of boys and girls. The initial diagnosis of myocarditis was based on history and physical examination. Chest radiographs showed cardiomegaly (54%), and pulmonary oedema (32%). ST-T wave changes were seen in 61% of patients. 2D echocardiography findings included reduced fractional shortening (FS), valve incompetence, wall motion abnormalities and pericardial effusion. 77% showed elevated serum creatinine kinase (CK), and 84% had raised CK-MB. 71% of patients required admission into the Children's ICU. Treatment was mainly supportive. However, 4 patients required extracorporeal membrane oxygenation (ECMO) - 2 survived, with 1 having reduced cardiac function. Six patients needed cardiac pacing for atrioventricular block - only 1 required permanent pacemaker subsequently. Mortality rate was 30%, and 75% of survivors went on to have normal cardiac function upon recovery.

Conclusion: Myocarditis could be missed as patients who present with viral illness or non-specific symptoms could lead clinician astray. Hence, it should be considered in the differential diagnosis, to avoid delay in diagnosis and treatment. Children who presented with sudden cardiorespiratory collapse have poor outcome. Approximately half of our patients experience a complete recovery of normal cardiac function.