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Chronic pericardial constriction with effusion in childhood
Insights
Nontuberculous pericardial constriction with effusion in children is more common than previously believed, often stemming from prior viral infections. Delayed diagnosis impacts treatment effectiveness and patient outcomes.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Surgery
Background:
- Nontuberculous pericardial constriction with effusion is a rare condition in children.
- Previous viral infections are a suspected etiological factor.
- Diagnostic delays are common due to misdiagnosis of other conditions like hepatitis or nephrotic syndrome.
Observation:
- Five pediatric cases of nontuberculous pericardial constriction with effusion were analyzed.
- Patients presented with symptoms that led to initial misdiagnoses.
- The average diagnostic delay spanned months to years.
Findings:
- Pericardiectomy provided immediate symptom relief in two patients.
- Two patients exhibited poor myocardial function post-surgery, indicating potential long-term complications.
- Viral etiology is strongly suggested by the case series.
Implications:
- Increased clinical suspicion for this condition in children with relevant viral history is warranted.
- Early and accurate diagnosis is crucial for improving patient outcomes.
- Further research into the long-term effects of pericardial constriction and surgical interventions in pediatric populations is needed.
Abstract:
Five cases of children with nontuberculosis pericardial constriction with effusion are reported. The disease is not as rare as has been thought, and the aetiology in these cases was probably a previous virus infection. A previous diagnosis of hepatitis, nephrotic syndrome, or protein-losing enteropathy had been made and the correct diagnosis was delayed for months or even years. Pericardiectomy produced immediate relief from symptoms in 2 patients but in 2 others there was evidence of poor myocardial function postoperatively.