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Mohamed Elgayar։ Not Every Elevated Troponin in a Child Is Myocarditis
Mohamed Elgayar/LinkedIn
Apr 19, 2026, 08:33

Mohamed Elgayar։ Not Every Elevated Troponin in a Child Is Myocarditis

Mohamed Elgayar, Pediatric Cardiac Critical Care Specialist at Magdi Yacoub Foundation, shared a post on LinkedIn:

”Not every elevated troponin in a child is myocarditis.

Troponin is a marker of myocardial injury – the differential in children is broad and includes Kawasaki disease, MIS-C, ALCAPA, sepsis-induced cardiomyopathy, arrhythmia-mediated ischemia, AKI, and rhabdomyolysis – before ever reaching a diagnosis of myocarditis.

When myocarditis is suspected, the diagnostic workup follows a systematic path:

  • Serial troponin kinetics
  • Hemodynamic assessment first
  • Actively exclude competing diagnoses
  • ECG and Echo (GLS is the most sensitive echo marker)
  • Cardiac MRI with parametric mapping – Lake Louise Criteria 2018
  • Endomyocardial biopsy in selected indications (fulminant, giant cell, eosinophilic)

Key reminder: normal ECG and normal echo do not exclude myocarditis.

And in fulminant disease – early MCS support carries a 60–70% recovery rate in children. Bridge to recovery, not just bridge to transplant.”

Mohamed Elgayar։ Not Every Elevated Troponin in a Child Is Myocarditis

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