Epidemiology

The extreme variability of clinical manifestations and frequently insidious onset of symptoms makes the true incidence and prevalence of myocarditis difficult to determine. Autopsy studies reveal myocarditis in 1% to 9% of routine postmortem exams, and a prospective postmortem study of sudden cardiac death in young adults suggests myocarditis as the etiology in approximately 10% of cases.[19][20][21]​ Additionally, a large prospective trial of patients with dilated cardiomyopathy revealed myocarditis as the etiology in 9% of patients.[22]

A Finnish study in children ages ≤15 years estimated the annual incidence of myocarditis to be approximately 2 cases per 100,000 children.[23] In a retrospective US study of 212 children, 46% of myocarditis cases were in those ages 13-18 years, with a median age of 13.1 years.[24] A slightly greater number of cases were in males (58%) than in females (42%).[24] Female sex and younger age appeared to correlate with a worse clinical presentation and prognosis.[24]

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