[Medical pericarditis: study of 19 cases]

Area of Science:

• Pediatric Cardiology
• Intensive Care Medicine
• Pericardial Diseases

Background:

• Pericarditis, inflammation of the pericardium, can lead to significant morbidity in pediatric patients.
• Understanding the diagnostic and therapeutic approaches is crucial for managing pericarditis in the pediatric intensive care unit (PICU).

Purpose of the Study:

• To review diagnostic and therapeutic strategies for medical pericarditis in a PICU setting.
• To evaluate the utility of various diagnostic methods and interventions for pericarditis.

Main Methods:

• Retrospective review of 19 cases of medical pericarditis admitted to the PICU between 1978 and 1989.
• Analysis of diagnostic methods including echocardiography, etiological investigations, pericardial fluid analysis, pericardiocentesis, and biopsy.

Main Results:

• Low incidence of medical pericarditis (0.32%) in the PICU during the study period.
• Idiopathic pericarditis accounted for 42% of cases; tuberculous and purulent pericarditis were not observed.
• Echocardiography proved most effective for syndromic diagnosis.
• Etiological diagnosis was primarily achieved through non-invasive methods or by association with underlying conditions.
• Pericardial fluid analysis offered limited etiological value; pericardiocentesis was more effective therapeutically.
• No correlation was found between the volume of fluid from initial pericardiocentesis and subsequent effusion recurrence.
• Biopsies provided no specific etiological information.

Conclusions:

• Echocardiography is the preferred method for diagnosing pericarditis in the PICU.
• Pericardiocentesis should be primarily considered a therapeutic intervention rather than a diagnostic tool for etiological determination.
• Non-invasive methods and clinical context are key for identifying the cause of pericarditis in pediatric patients.