“Across the United States, after succeeding in vaccinating over 50 % of our adult population with at least one does of the Covid vaccine, we are now experiencing a resurgence of COVID – 19 infections. The new cases are however predominantly in infants, children and adolescents who are primarily exposed in the household by parents and siblings who are unvaccinated.”
Pediatric urgent and primary care clinics are becoming quickly overwhelmed as they attempt to manage and diagnosis these new potentially deadly COVID infections among the hundreds of young patients with fever entering their clinics every day. Children’s Hospitals across the country, mainly in the deep south where vaccination rates are lower among adults, are at maximum capacity and utilization of Pediatric ICU beds. Pediatric patients with critical injuries or other life threating illnesses must be managed and treated next to those with life threatening COVID heart conditions.
The American Heart Association, considering the ongoing surge in COVID related cardiac sequelae, recently published guidelines for the Diagnosis and Management of Myocarditis. The guidelines are mainly for Cardiac Intensivist receiving these patients acutely ill in the hospital.
Pediatric physicians, both in primary care and in sub-specialty medicine must be on high alert as they continue to manage large numbers of infants, children and adolescents presenting to their clinics with fever, shortness of breath, fatigue, and dizziness/fainting, all common pediatric conditions, to identify those who might have serious COVID related Cardiac conditions called ‘Myocarditis’. Myocarditis is an inflammation of the heart muscle due to the COVID virus entering the muscle, destroying tissue, and causing an inflammatory response possibly leading to heart failure.
Children’s Cardiovascular Medicine in Atlanta Georgia, supporting the community of Pediatric Primary Care and Urgent Care physicians, offers the following red flags based on current data for initiating a cardiac evaluation and treatment protocol for those patients they suspect of have myocarditis.
These guidelines also serve to inform parents of infants, children, and adolescents with a febrile illness how to recognize potentially serious febrile COVID myocarditis in order that they may seek medical attention quickly:
- Rapid onset of Fever greater than 102 degrees that is persistent lasting more than three (3) hours, non-responsive to usual anti-pyretics
- Fever with associated moderate shortness of breath (dyspnea) and/or chest pain.
- Fever associated with a rapid or irregular heart rate that is out of proportion to level or activity.
- Fever with obtundation (reduced level of alertness)
- Fever associated with dizziness or syncope (fainting)
If you suspect a patient might have COVID -19 cardiac complications, please do not hesitate to request same-day pediatric cardiology evaluation by calling 404-943-0289 to schedule an appointment for echocardiogram. If as a physician, you have questions or concerns about management please feel free to contact Dr. Ed Montaña, your pediatric cardiologist directly on his mobile at 404-213-6060.
“Best in Health”