Pericarditis is an inflammation of the sac around the heart. In some children, this may cause fluid to build up in the sac and make it hard for the heart to move. Early treatment can improve outcomes.
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The exact cause is not known. Infections, injuries, or chronic disease may play a role.
Things that may raise the risk of this problem are:
- Surgery to repair heart defects or heart disease
- Infection from a virus, bacteria, parasite, or fungus
- Chest trauma or injury
- Connective tissue disorders, such as systemic lupus erythematosus
Chest pain is a common symptom. It may start over the left side or center of the chest and spread to the neck and left shoulder. It is usually a sharp, stabbing pain that may be worse with deep breathing or lying down.
Other problems may be:
- Shortness of breath
- Fever and chills
- Pain when swallowing
- Weakness and lack of energy
- Lack of hunger
The doctor will ask about your child’s symptoms and health history. A physical exam will be done. It will focus on the heart. The doctor will listen for a grating or rubbing sound in your child’s heart. There may also be a crackle sound in your child’s lungs.
Blood tests will be done to look for signs of inflammation.
Images of the chest may be taken. This can be done with:
Your child's heart activity may be tested. This can be done with an electrocardiogram (EKG).
Any underlying causes like infection will need to be treated. Other symptoms will be managed medicines, such as:
- Anti-inflammatory medicine
- Pain relievers
Children who are not helped by these methods may need surgery. Choices are:
- Pericardiocentesis to remove fluid around the heart using a needle
- Pericardiectomy to remove the sac around the heart (rare)
There are no current guidelines to prevent pericarditis.
- Acute and recurrent pericarditis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-and-recurrent-pericarditis.
- Pediatric pericarditis. Cincinnati Children's website. Available at: https://www.cincinnatichildrens.org/health/p/peri.
- Pericarditis. Seattle Children's Hospital website. Available at https://www.seattlechildrens.org/conditions/pericarditis.
- Yusuf SW, Hassan SA, et al. Pericardial disease: a clinical review. Expert Rev Cardiovasc Ther. 2016;14(4):525-539.
- Kari Kuenn, MD
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