REVIEW article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1601307
This article is part of the Research TopicAdvances and Challenges in Autoimmune Myocarditis and Other Inflammatory Cardiomyopathies: Implications for Diagnosis and TreatmentView all 4 articles
A Comparative Review of Myocarditis in Pediatrics versus Adults: Pathogenesis, Diagnosis, and Management
Provisionally accepted
Jacob Ricci1,2
Nick A Farahani1Cormac J Davis1Kyra G Ritter1Lauren M Parrow1Priya I Tomerlin1Ashley A Darakjian1,2Katherine Gegoutchadze1
Dipankar Gupta1,3
Katelyn Ann Bruno1,2*- 1Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States
- 2Center for Integrative Cardiovascular and Metabolic Disease, Department of Physical Medicine & Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida, United States
- 3Congenital Heart Center, Health Science Center, University of Florida, Gainesville, Alabama, United States
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Myocarditis is an inflammatory heart disease that is more prevalent in men. The etiology of myocarditis is often multifactorial with viral infections being a predominant cause of myocarditis. Other etiologies such as autoimmune mediated or secondary to certain medical therapies such as immune checkpoint inhibitors are also seen however less commonly. The wide spectrum of clinical symptoms with which these patients present and the lack of reliable patterns or biomarkers of progression make it difficult to both diagnose and risk-stratify patients. Importantly, this disease is widely prevalent in pediatric populations and is a leading cause of sudden cardiac death in young patients. However, much of the knowledge of pathogenesis and treatment of this disease is extrapolated from adult studies. Current research in myocarditis has increasingly identified the role of hormones and the apparent sex differences seen predominantly in adult patients; however, such data is not well established in pediatric patients. Thus, there is an increased need to evaluate the age and sex-based differences in pediatric patients with myocarditis. Therefore, this review aims to present an overview of our current understanding of pathogenesis, diagnosis, and treatment strategies for myocarditis, with an emphasis on outlining both adult and pediatric studies to emphasize the continued need for research into this disease.
Keywords: Myocarditis, dilated cardiomyopathy, Pediatrics, coxsackievirus, age differences
Received: 27 Mar 2025; Accepted: 03 Sep 2025.
Copyright: © 2025 Ricci, Farahani, Davis, Ritter, Parrow, Tomerlin, Darakjian, Gegoutchadze, Gupta and Bruno. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Katelyn Ann Bruno, Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, 32610, Florida, United States
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