Pericarditis in Children

What is pericarditis in children?

Pericarditis is inflammation or infection of the pericardium. The pericardium is two 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.

What causes pericarditis in a child?

In children, pericarditis is most likely to happen after surgery to repair heart defects. It may also be a result of a viral infection. Other causes may include:

• A bacterial infection.

• Autoimmune disorders, such as lupus or rheumatoid arthritis.

• Other rare causes, such as injury, medicine, or cancer.

What are the symptoms of pericarditis in a child?

The most common symptoms of pericarditis are:

• Chest pain. It's often described as sharp, and it occurs during deep breaths.

• A low-grade fever.

• An 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 doctor for a diagnosis.

How is pericarditis diagnosed in a child?

The doctor will ask about your child’s symptoms and past health. They will give your child a physical exam. The doctor 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 may be done to check for signs of inflammation and infection.

• A chest X-ray. This is an X-ray of the heart and lungs.

• An electrocardiogram (ECG). This is a simple test of the electrical activity of the heart. Often changes may occur from pericarditis.

• Echocardiography (echo). This test uses sound waves (ultrasound) to make moving pictures of the heart and heart valves.

• A CT scan or an MRI. These are imaging tests that show the heart structures and function.

How is pericarditis treated in a child?

Your child's doctor 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. It 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.

What are possible complications of pericarditis in a child?

Pericarditis may come back and may become long-term (chronic). In an extreme case, heart problems may occur, including cardiac tamponade.

When should I call my child's doctor?

Contact the doctor if your child's symptoms get worse, including chest pain and trouble breathing.

Key points about pericarditis in children

• Pericarditis is an inflammation or infection of the thin layers covering the heart.

• It is most often caused by an infection.

• Chest pain is the most common symptom. A child may be irritable, feed or eat poorly, and be tired.

• Treatment includes medicines for inflammation and pain. Antibiotics may be used for infections from bacteria.

Next steps

Here are some tips to help you get the most from a visit to your child’s doctor.

• 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 doctor 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 doesn't 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 doctor after office hours. This is important if your child becomes ill and you have questions or need advice.