Myocarditis and SIDS

January 29, 1997

I just received the autopsy report from my son's death. The ruling was that he died of myocarditis. Further, the coroner told me that myocarditis is a puzzle in the big SIDS picture and that it was only diagnosed under severe microscopic examination. She said it is still related to sleeping position and is caused by a coxaskie (sp?) virus.

Does anyone know about mycarditis? Is it hereditary? How is it related to SIDS?

I would like to address the medical questions you asked. Myocarditis is the term for an infection of the muscle tissue of the heart. As in this instance (Cocksackie virus), the infection is almost always caused by a virus. There is not yet any antibiotic that is effective against such viruses. Although generally not fatal, such infections can be very serious and sudden death does occur. This is not genetic, so there is no increased risk in subsequent children or in other family members.

The common interest and focus of all participants here is "Sudden Infant Death." For some families, the explanation is clearly SIDS; for some families, the cause MAY be SIDS; and for some families a specific and distinct explanation for the sudden death is found at autopsy. Regardless of which group an individual parent is in, most of the questions, concerns and burdens seem to have many common elements.

I hope these comments are helpful. I know that having such information can do nothing to reduce the sense of loss.

Carl E. Hunt, M.D.
Toledo/Washington D.C.

January 30, 1997

Myocarditis is inflammation of the heart muscle. It is most commonly due to a virus, usually the Coxackie virus. It is not hereditary and not uniformly fatal. Myocarditis can cause sudden death or heart failure. In infants, heart failure will present as fatigue- difficulty drinking the whole bottle, sweating with exertion -during feeding, rapid breathing, and a rapid heart rate. Sometimes, there is permanent heart damage that is so severe that a heart transplant is necessary. Other times, there is no permanent damage. When it results in the sudden unexpected death of an infant who never was autopsied, the likely diagnosis would be SIDS. It can be hereditary when not caused by a virus, as in muscular dystrophy or Pompe's disease (a disorder of sugar metabolism).

I hope this helps,

JDDeCristofaro, MD
Assistant Professor of Pediatrics
Medical Director, Infant Apnea Program
UMC Stony Brook, NY

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