Pericarditis - Clinical presentation and characteristics of a pediatric population
Catarina Perez-Brandão1, Conceição Trigo1, Fátima F Pinto1
1Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
Insights
Acute infectious pericarditis is common in children, often involving the heart muscle. Recurrent symptoms suggest current therapies may need adjustment for better pediatric pericarditis management.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Inflammation
Background:
- Pericarditis, inflammation of the pericardium, can be infectious or secondary to systemic conditions.
- Understanding pediatric pericarditis is crucial for effective management and improved patient outcomes.
Purpose of the Study:
- To analyze clinical findings, disease course, treatment strategies, and follow-up data for children diagnosed with pericarditis.
- To identify key characteristics and outcomes of pediatric pericarditis cases.
Main Methods:
- Retrospective analysis of pediatric patients diagnosed with pericarditis from 2003 to 2015.
- Summarized patient characteristics using descriptive statistics (frequencies, percentages, medians, percentiles).
Main Results:
- Fifty pediatric patients (median age 14 years; 80% male) were analyzed, with acute infectious pericarditis being the most frequent diagnosis (80%).
- Common symptoms included chest pain (70%) and fever (26%). Diagnostic findings revealed ECG abnormalities (60%), echocardiogram alterations (80%), and myocardial involvement in 34% of cases.
- Infectious causes were identified in 48% of patients; aspirin was the primary treatment in 50%, and 7 children experienced symptom recurrence.
Conclusions:
- Acute infectious pericarditis is the predominant form in children, frequently co-occurring with myocarditis (34%).
- The observed symptom recurrence rate highlights potential limitations in current therapeutic approaches for pediatric pericarditis.
- Further research into optimal treatment strategies is warranted to minimize recurrence and improve long-term outcomes in pediatric patients.
Introduction:
Pericarditis is an inflammation of the pericardium. It may be infectious or secondary to a systemic disease. The aim of this study was to analyze the clinical findings, course, treatment and follow-up of children diagnosed with pericarditis at our center.
Methods:
We performed a retrospective analysis of all children admitted to our pediatric cardiology unit with pericarditis between 2003 and 2015. Patient characteristics were summarized using frequencies and percentages for categorical variables and medians with percentiles for continuous variables.
Results:
Fifty patients were analyzed (40 male, 10 female) with a median age of 14 years. The most common diagnosis was acute pericarditis (80%). Thirty-five patients (70%) presented with chest pain and 26% reported fever. Cardiomegaly was identified on chest X-ray in 11 patients (22%), 30 patients (60%) had an abnormal ECG and 44 patients (80%) had alterations on the transthoracic echocardiogram. In 17 cases (34%) there was myocardial involvement. Forty-eight percent of patients presented with infectious pericarditis and the pathologic agent was identified in half of them. Postpericardiotomy syndrome was diagnosed in five cases. The first-line therapy was aspirin in 50% of cases. Pericardiocentesis was performed in 12 patients. The median length of stay was nine days. There was symptom recurrence in seven children.
Conclusions:
In this study, acute infectious pericarditis was the most common presentation and about one third of patients also had myocarditis. The symptom recurrence rate was not negligible and is probably related to the type of therapy employed.
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