Pneumonia is currently the leading cause of death in children younger than 5 years accounting for approximately 20% of childhood deaths.We prospectively studied 40 children aged 3-36 months admitted to the hospital because of pneumonia. Patients were classified according to the World Health Organization (WHO) criteria of pneumonia and evaluated by obtaining complete blood count, serum electrolytes, renal and liver function tests, blood gases, C-reactive protein, creatine kinas MB fraction (CK-MB), chest X-ray, electrocardiography (ECG), and echocardiography (ECHO).
Thirty four (85%) patients had positive C-reactive protein.Twenty four (60%) of the studied patients with pneumonia of different severity had elevated CK-MB and the serum levels were significantly increase with increasing the severity of pneumonia.Clockwise rotation, right axis deviation, and P pulmonale was found to be significantly higher in patients with severe and very severe pneumonia when compared to patients with pneumonia. The presence of tricuspid regurgitation, pericardial effusion, reduction of EF, increase in LVED and LVES are related to increased severity of pneumonia and the differences between the studied groups were highly significant when.
Our findings suggest that the incidence of myocarditis in children with pneumonia is significant. Since myocarditis can be a fatal disease, myocardial injury should never be based solely on the presence of CK-MB isoenzyme in the serum, but should be supported by electrocardiographic and echocardiographic findings.
Key Words: Cardiovascular changes, Pneumonia, Myocarditis, CK-MB, ECG, ECHO