Health Library : Cardiovascular Disorders

Pericarditis

What is pericarditis?

Pericarditis is caused by inflammation or infection of the pericardium, the thin sac (membrane) that surrounds the heart. There is a small amount of fluid between the inner and outer layers of the pericardium. Often, when the pericardium becomes inflamed, the amount of fluid between its two layers increases, causing a pericardial effusion. If the amount of fluid increases quickly, the effusion caused can impair the ability of the heart to function properly. This condition is called pericardial tamponade.

What causes pericarditis?

In children, pericarditis is most likely to occur following surgery to repair congenital (present at birth) heart defects or acquired heart disease. However, other causes may include the following:

• Infection (viral, bacterial, fungal, parasitic)
• Chest trauma or injury
• Connective tissue disorders, such as systemic lupus erythematosus (lupus)

What are the symptoms of pericarditis?

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

• Chest pain that:
  • Can be felt especially behind the breastbone, and sometimes beneath the clavicle (collarbone), neck, and left shoulder.
  • Is a sharp, piercing pain over the center or left side of the chest that increases as the child takes a deep breath and usually decreases if the child sits up or leans forward.
• A low-grade fever
• Irritability
• Fatigue
• Loss of appetite
• Irregular heartbeat

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 health care provider for a diagnosis.

How is pericarditis diagnosed?

Your child's health care 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 examination, diagnostic testing for pericarditis may include:

• Blood tests.These are done to evaluate the degree of inflammation.
• Chest X-ray. A diagnostic test that uses invisible X-ray energy beams to produce images of internal tissues, bones, and organs onto film.
• 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 (EKG). A simple test that detects and records the electrical activity of the heart.

Treatment for pericarditis

Specific treatment for pericarditis will be determined by your child's health care provider based on:

• Your child's age, overall health, and medical history
• Extent of the disease
• Cause of the disease
• Your child's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

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

• Medication, such as analgesics, anti-inflammatory, and antibiotic drugs
• Aspiration (removal) of excess fluid
• Surgery

Consult your child's health care provider for more information.

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