Pericarditis in Children

Pericarditis is caused by inflammation or infection of the pericardium. This is the thin sac (membrane) that surrounds the heart. Normally, there is a small amount of fluid between the inner and outer layers of the pericardium and the heart. Often, when the pericardium becomes inflamed, the amount of fluid between it and the heart increases. This is called a pericardial effusion. If the amount of fluid increases quickly, it can impair the ability of the heart to pump blood well. This condition is called pericardial tamponade.

In children, pericarditis is most likely to occur following surgery to repair heart defects. However, other causes may include the following:

• Infection of the heart muscle (viral, bacterial, fungal, parasitic)

• Chest injury

• Connective tissue disorders such as lupus

The following are the most common symptoms of pericarditis. However, each child may experience symptoms differently. Symptoms may include:

• Chest pain that is often described as a sharp pain in the middle or left chest

• A low-grade fever

• Irregular heartbeat

• Shortness of breath

• Heart palpitations

• Fainting

Children may not be able to describe that they have "chest pain" or be able to explain exactly how they feel. Sometimes, nonspecific symptoms such as irritability, loss of appetite, or fatigue will be all that the child is able to express. The symptoms of pericarditis may resemble other medical conditions or heart problems. Always consult your child's healthcare provider for a diagnosis.

Your child's healthcare provider may have heard an abnormal heart sound called a rub, which occurs when there is irritation of the pericardial membranes. In addition to a complete medical history and physical exam, other tests may include:

• Blood tests. These are done to evaluate the degree of inflammation.

• Chest X-ray. A test that uses invisible X-ray energy beams to produce images of internal tissues, bones, and organs onto film. This helps evaluate the size of the heart.

• Echocardiography (echo). An ultrasound procedure that evaluates the structure and function of the heart by using sound waves to produce a moving picture of the heart and heart valves.

• Electrocardiogram (ECG). A simple test that detects and records the electrical activity of the heart.     

Specific treatment for pericarditis will be determined by your child's healthcare provider based on the underlying cause and degree of heart impairment.

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

• Medication, such as pain medications, medications that reduce inflammation, and antibiotic drugs. Treatment also may include medications that aid in heart function if it is significantly impaired

• Aspiration (removal) of excess fluid that has collected in the pericardial sac

• Surgery

Consult your child's healthcare provider for more information.