Cardiogenic shock.

A 4 year-old boy is brought in with chest pain, difficulty breathing, and fever. He has had flu-like symptoms, malaise, muscle weakness, and vomiting. His status worsens with fluid administration. He develops a wide-complex tachycardia and pulmonary edema.

Goals and Objectives

Objectives (Medical and CRM):

Medical:

• Recognize the nonspecific presentation of myocarditis in children, and have a low threshold of suspicion in a child presenting with fever and respiratory symptoms.
• Recognize cardiogenic shock.
• Recognize management of wide-complex tachycardia with a pulse.
• Discuss basic myocarditis management principles.

CRM:

• Demonstrate effective team communication.