<b>FREQUENCY OF MYOCARDITIS IN CHILDREN ADMITTED WITH PNEUMONIA AT A TERTIARY CARE HOSPITAL</b>

Background: Pneumonia remains a major cause of childhood morbidity and mortality, and myocardial involvement during respiratory infections is increasingly recognized. Early detection of myocarditis in children with pneumonia may prevent hemodynamic deterioration and improve outcomes. This pilot study aimed to determine the frequency of myocarditis among children admitted with pneumonia at a tertiary care hospital. Methods: A prospective pilot study was conducted at Patel Hospital over six months, enrolling 100 children aged >1 month to 13 years admitted with radiologically confirmed pneumonia. Consecutive sampling was used. Clinical examination, chest radiography, echocardiography, and cardiac biomarkers (troponin-I, NT-proBNP) were performed. Myocarditis was diagnosed based on reduced ejection fraction, ventricular dilation, or elevated cardiac biomarkers. Data were analyzed using SPSS 25.0, with chi-square, t-test, and Mann–Whitney U tests applied as appropriate. Results: Myocarditis was identified in 18% of children. Compared with non-myocarditis patients, affected children had significantly higher rates of tachycardia (83.3% vs. 42.7%, p = 0.002), hypotension (38.9% vs. 10.9%, p = 0.004), and poor pulses (55.5% vs. 14.6%, p < 0.001). Radiological cardiomegaly (55.5% vs. 14.6%, p < 0.001), reduced ejection fraction (77.8% vs. 3.6%, p < 0.001), and elevated troponin-I (88.9% vs. 2.4%, p < 0.001) were strongly associated with myocarditis. NT-proBNP elevation was observed in 72.2% of myocarditis cases. Conclusion: Nearly one in five children hospitalized with pneumonia demonstrated evidence of myocarditis. The strong association of myocardial involvement with tachycardia, hypotension, reduced ventricular function, and elevated biomarkers underscores the need for early cardiac evaluation in pediatric pneumonia. Larger studies are required to validate these findings and develop standardized screening strategies.