Most cases of myocarditis are thought to be secondary to viral infection; however, in many instances, documentation of viral infection is lacking. The most common viruses implicated in myocarditis include Coxsackie virus type B and parvovirus B19. Many children present with prodrome of illness which may include lethargy, poor feeding, irritability, respiratory distress, or even sudden collapse and cardiogenic shock. Myocarditis leads to poor ventricular function leading to poor cardiac output and pulmonary edema. Echocardiography shows dilation and poor function of the left ventricle. Echocardiography cannot differentiate acute myocarditis from dilated cardiomyopathy. Myocarditis may eventually lead to dilated cardiomyopathy. Treatment is mostly supportive to minimize effects of congestive heart failure.