Causes, Symptoms & Treatment For Pericarditis In Children

Submitted by Nic on January 30, 2013

Pericarditis refers to the inflammation or infection of the membrane that surrounds the heart. This membrane or sac is known as the pericardium and forms a protective layer around the heart. If inflamed or infected, a build up of fluid develops between the layers of the membrane and a condition known as pericardial effusion may develop.

Causes

The exact causes of pericarditis still remain unknown. Possible causes include:

  • Infections such as viral infections that cause pneumonia or chest congestion
  • Influenza
  • Bacterial infections
  • Fungal infections (though this is rare)

Pericarditis may be seen in children who suffer from:

  • Cancers such as leukemia
  • Autoimmune diseases
  • HIV / AIDS
  • Hypothyroidism
  • Tuberculosis
  • Kidney damage
  • Rheumatic fever

If the child has undergone any form of surgery to the heart or the chest or is being treated with certain cancer medications or immunosuppressive drugs, the risk of developing pericarditis is high as well.

In children, the most common causes of pericarditis include heart surgery, congenital heart defects or infections. Trauma or injury to the chest may also lead to pericarditis.

Symptoms

The symptoms of pericarditis in children may include:

  • Chest pain that may be sharp and sudden
  • Pain in the neck, back, shoulder and abdomen
  • Pain that increases when lying down or when coughing or deep breathing
  • Pain that decreases when sitting up or leaning forward
  • Fever
  • Chills
  • Excessive sweating
  • Water retention in the ankles (though this is occasional)
  • Dry cough
  • Weakness and fatigue
  • Feeling of anxiety
  • Low-grade fever
  • Irritability and fussiness
  • Loss of appetite
  • Irregular heartbeat

Keep in mind that children may not be able to describe symptoms such as chest pain or breathing difficulties. If your child is experiencing any of the above symptoms, contact your doctor as soon as possible. Early intervention and treatment of pericarditis is essential for complete recovery.

Diagnosis and Tests

Diagnosis of pericarditis requires a thorough physical examination. When listening to the heart with a stethoscope, the heartbeat will sound muffled and there may be indications of pericardial effusion or fluid in the pericardium. In severe cases, breathing may be labored and there may be signs of fluid in the lungs as well. Apart from a physical examination, other tests used to check the heart include a chest MRI scan, x-rays, echocardiogram, heart CT scan and radionuclide scanning.

In order to determine the cause of the condition or if an infection is responsible, blood tests, tuberculin skin tests, and HIV tests may also be required. 

Treatment

If the cause of the condition is determined, treatment is more focused and successful. For example, if a bacterial infection is causing the pericarditis, antibiotics are prescribed. For fungal infections, antifungal drugs are necessary. In cases where the cause cannot be discerned, anti-inflammatory drugs are used to reduce the swelling around the heart. These will also help decrease any pain and discomfort caused by the swelling. If symptoms do not disappear after two weeks, a drug knows as colchicine is recommended. Other medications that may help include diuretics to treat water retention and corticosteroids to relieve pain and inflammation.

If the fluid built up around the heart is causing the heart to function poorly, more aggressive forms of treatment may be necessary. These include a procedure known as pericardiocentesis where the extra fluid is drained from the sac by an echocardiography-guided needle. For severe or chronic cases of pericarditis, a surgery known as pericardiectomy may be performed that involves the removal of a part of the pericardium.

Prognosis

Mild cases if treated immediately are usually resolved in a few weeks time. For more severe cases, complications such as heart damage and excess fluid build up may prove fatal. Pericarditis may also recur and become chronic if the symptoms are not treated properly.

References

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