Pericarditis in Children

by Shaun Damon

Pericarditis is a condition characterized by inflammation of the pericardium or the protective sac around the heart. The thin sac can get inflamed, and its two layers begin to rub against each other. The amount of fluid between the two layers also tends to increase and a condition known as pericardial effusion occurs. Pericarditis is usually caused due to infectious conditions, especially those that affect the respiratory system. Since children have low immunities and can quickly develop infections that lead to pericarditis, they are at a slightly increased risk of developing pericarditis. Fortunately, even though children seem to be at an increased risk of developing the condition, pericarditis is rarely observed in children.

Causes of Pericarditis in Children

Children usually develop pericarditis due to bacterial, fungal, viral and parasitic infections. They may also develop heart conditions due to physical injuries and chest trauma. Some children may develop systemic connective tissue disorders, which may lead to pericarditis. An example of this is lupus, which may affect the heart muscles.

Symptoms of Pericarditis in Children

Children experience the symptoms of pericarditis differently. Some children will not have any discomfort, while others will often experience a lot of distress. The most common symptoms of this condition in children include the following.

Dull pain in the chest: This is usually experience right behind the breastbone or the collar bone. Sometimes, the pain radiates to the shoulders and the arms as well. Children may also experience this pain in their neck.
Sharp pain in the left side of the chest: Sometimes this pain can be experienced in the center of the chest as well. The pain is especially severe when the child engages in stressful play activities or takes in deep breaths. The pain is also severe when the child leans forward or tries to sit.
Low grade fever, fatigue and general malaise which renders the child incapable of following their regular routine.
High levels of irritability: The child may be difficult to soothe and may cry inconsolably. They may also show little interest in play, eating food, or sleeping soundly.
Irregular heartbeat as well as arrhythmias.

Unfortunately, children are not always able to explain their symptoms to their caretakers. Often, they can only cry and show their irritability. It is the care taker’s responsibility to ensure that they pay attention to the child’s symptoms and consult a pediatrician as soon as possible. The symptoms of pericarditis itself mimic those of other heart conditions and therefore, may require testing by the doctor.

Diagnosis of Pericarditis in Children

Pericarditis is not always easy to diagnose, especially in children. The doctor may try to listen to the child’s heart using a stethoscope. The doctor will also take down the child’s complete medical history and give them a physical examination. The doctor will then ask for a chest X-ray to check for effusion. Other tests may include blood tests to look for infections, and imaging tests such as chest CT scans, MRIs and echocardiographs as well as electrocardiogram.

Treatment of Pericarditis in Children

There are several treatment options, but they depend on the child’s age and general health. Like in adults, the treatment of pericarditis in children is also dependent on the cause of the condition. If pericarditis is caused due to an infection, the doctor may see it fit to treat it only with medications. However, if there are any complications or if the underlying cause is severe, the doctor may also consider surgery. In case there is large effusion in the chest cavity, the doctor performs a procedure for aspiration of excess fluids. Surgery is usually used only as a last resort.

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