Pericarditis—Child

Definition

Pericarditis is an inflammation (irritation and swelling) of the pericardium. This is the thin sac that surrounds the heart. In some cases, the inflammation may cause fluid to build up in the pericardium and restrict the heart’s action.

Pericarditis

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Causes

The cause of pericarditis is often unknown. In children, the cause can sometimes be linked to:

• Surgery to repair congenital (present at birth) heart defects or heart disease
• Infection (eg, virus, bacteria, parasite, fungus)
• Chest trauma or injury
• Connective tissue disorders, like lupus

Risk Factors

A risk factor is something that increases your child’s chance of getting a disease or condition. Risk factors for pericarditis include:

• Weakened immune system that is not able to fight off infections and other diseases
• Any of the causes listed above

Symptoms

Chest pain is a common symptom, especially over the left side or center of the chest. It can spread to the neck and left shoulder. It is usually a sharp, stabbing pain. Deep breathing or lying down may worsen the pain. Sitting up may lessen it. Other symptoms may include:

• Shortness of breath
• Coughing
• Fever and chills
• Pain when swallowing
• Weakness and fatigue
• Irritability
• Loss of appetite
• Irregular heartbeat

Notify your child’s doctor if your child has these symptoms.

Diagnosis

The doctor will ask about your child’s symptoms and medical history. She will also do a physical exam. She will listen for a grating or rubbing sound in your child’s heart. If the condition is severe, there may be a crackle sound in your child’s lungs. The following tests may be done:

• Chest x-ray —to show heart size and build-up of fluid
• Electrocardiograph (ECG or EKG)—to show electrical activity of the heart
• Echocardiogram —to show heart wall motion, heart size, and build-up of fluid
• Blood tests—to help determine causes
• Pericardiocentesis—drawing a sample of the fluid in the pericardium using a needle to test the fluid for infections
• Heart or chest MRI or CT scan —to obtain more detailed images if needed

Treatment

Treatment depends on the cause. In many cases, when the cause is unknown or viral pericarditis is suspected, pain relievers and anti-inflammatory medicines are given. In other cases, corticosteroids may be given. If it is caused by a bacterial infection, antibiotics are used.

Fluid may need to be removed through pericardiocentesis if it is building up and affecting the heart’s pumping. In rare cases, surgery may be done.

The illness can range from mild to life-threatening. Acute inflammatory pericarditis usually improves with treatment within a few weeks or months. But, if it is caused by chronic inflammatory diseases, like lupus or rheumatoid arthritis, it may last longer or tend to recur.

If your child is diagnosed with pericarditis, follow the doctor's instructions.

Prevention

There is no known way to prevent pericarditis.