Objective: Acute heart failure due to heart muscle disease is potentially fatal in pediatric patients. Heart transplantation (Tx) is utilized to improve survival. However, spontaneous recovery may occur. The outcome of patients treated in centers with no Tx option was studied. Patients and Methods: A retrospective review of infants and children (≤16 years) who presented with heart muscle disease (left ventricular shortening fraction, LVSF ≤ 25%) between 1992 and2007, intwo medical centers in Jerusalem, was performed.Results: There were 62 patients, mean age 2.5 years, mean LVSF 16.3%. The 5-year survival was 73%. Lower LVSF at presentation (p = 0.006) was independently associated with mortality. Recovery (normalization of LVSF) occurred in 56% of survivors. Of the 38 patients who were eligible for Tx at their presentation, according to the AHA guidelines, 22 (58%) survived and 13 (34%) recovered.Conclusions: This study shows the long term outcome of pediatric patients with acute heart muscle disease treated with no Tx option. These findings may reflect the impact of improved medical management of these patients in recent years.
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