Myocarditis is defined, clinically and pathologically, as inflammation of the heart muscle. The autoimmune phase is belived to play a major role and the use immunosuppressive agents may be useful in containing myocyte destruction. Aims was to systematically review the impact of Immunomodulative therapy on the outcame of severe and acute myocarditis in children. We retrospectively studied all the children admitted to University Children s Hospital with an acute viral myocarditis (AVM) from 2003-2008y. Patients were included if they had 1.severe and acute heart failure, 2 left ventricular dysfunction assessed by echocardiography, 3. a recent history of viralillness and 4. absens of personal or familial history of cardiomyopthy. Fourteen patient (37%) had severe and acute myocaditys. Seven patients were treated with immunomodulative therapy and anticongestive therapy (group I). Other seven patients were treated with anticongestive therapi only (group II). We comparred the use of antikongestiv therapy alone, with a combination of immunomodulative. Such studies have documented succeful outcome of AVM with immunomodulative trearment.

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