Pericarditis in Children

Pericarditis is inflammation or infection of the pericardium. The pericardium is 2 thin membranes that surround the heart. Normally, there is a small amount of fluid between the layers of the pericardium. When it becomes inflamed, the amount of fluid may increase. This is called pericardial effusion. If the amount of fluid increases quickly, it can impair how the heart pumps blood. This condition is called pericardial tamponade.

In children, pericarditis is most likely to happen after surgery to repair heart defects. Other causes may include:

• Viral or bacterial infection
• Autoimmune disorders, such as lupus or rheumatoid arthritis
• Other rare causes, such as injury, medicine, or cancer

These are the most common symptoms of pericarditis:

• Chest pain, often described as sharp and occurring during deep breaths
• Low-grade fever
• Irregular heartbeat
• Shortness of breath
• Feeling the heartbeat (heart palpitations)
• Fainting (syncope)

Children may not be able to describe that they have chest pain or be able to explain exactly how they feel. Sometimes a child may only be irritable, have no appetite, or be tired.

The symptoms of pericarditis can be like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. The provider may hear an abnormal heart sound called a rub, when listening to your child's heart with a stethoscope. A rub is an abnormal sound caused by irritation of the pericardium. Your child may need tests, such as:

• Blood tests. A complete blood count (CBC) and other tests to check for signs of inflammation and infection.
• Chest X-ray. An X-ray of the heart and lungs.
• Electrocardiogram (ECG). A simple test of the electrical activity of the heart. Often changes may occur from pericarditis.
• Echocardiography (echo). A test that uses sound waves (ultrasound) to make moving pictures of the heart and heart valves.
• CT scan or MRI. These are imaging tests that show the heart structures and function.

Your child's healthcare provider will likely refer you to a pediatric cardiologist. This is a doctor with special training to treat children with heart problems.

The goal of treatment for pericarditis is to find and eliminate the cause of the disease. Treatment may include:

• Medicine. Medicine can ease pain and inflammation. Antibiotics can treat an infection caused by bacteria. Medicine also can help the heart work better.
• Removing extra fluid in the pericardium (pericardiocentesis). The fluid may also be looked at using cultures and lab tests to find the cause of the pericarditis.
• Surgery to remove the fluid in the pericardium and the pericardium itself.

Pericarditis may come back and may become long-term (chronic). Heart problems may occur, including cardiac tamponade.

Call your child's healthcare provider if your child's symptoms get worse, including chest pain and trouble breathing.

• Pericarditis is an inflammation or infection of the thin layers covering the heart.
• Pericarditis is most often caused by an infection.
• Chest pain is the most common symptom of pericarditis. A child may be irritable, feed or eat poorly, and be tired.
• Treatment of pericarditis includes medicines for inflammation and pain. Antibiotics may be used for infections from bacteria.

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.