Highlight
• Two-dimensional speckle tracking echocardiography detects subclinical ventricular dysfunction in nearly half of hospitalized MIS-C patients.
• Reduced LV longitudinal and circumferential strain parameters correlate strongly with adverse in-hospital cardiovascular outcomes.
• Most LV strain abnormalities peak around day 5 of illness and largely normalize within 50 days.
• Early assessment of LV strain may improve risk stratification and guide management in MIS-C.
