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Pericarditis

  • Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.

    • often causes chest pain
    • usually sudden and short-lived (acute)
    • chest pain occurs when the inflamed layers of the pericardium rub against each other
    • mild cases may improve on their own
    • treatment for more-severe cases may include medications and, rarely, surgery

  • What is pericarditis?

    Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.

    Why is pericarditis a concern?

    When the pericardium is inflamed, it produces fluid. A large amount of fluid can compress the heart, limiting the ability of the heart to fill normally with blood, and thereby producing tachycardia (rapid pulse rate) and hypotension (reduced blood pressure).

    What causes pericarditis?

    There are multiple causes for pericarditis including:   

    • Infectious - viral, bacterial, tuberculous, fungal and protozoal
    • Postpericardiotomy syndrome - occurs in a small percentage of patients after the pericardium is surgically manipulated for cardiac surgery
    • Rheumatologic diseases - systemic lupus erythematosus, rheumatoid arthritis, rheumatic fever
    • Kawasaki disease
    • Drug-induced inflammation - notably hydralzaine or procainamide
    • End-stage renal disease
    • High-dose radiation associated with treatment of cancers, such as Hodgkin lymphoma

    What are the symptoms of pericarditis?

    Typical symptoms associated with pericarditis include fever and chest pain. The chest pain is often more severe when someone lies down and is less when she sits up and leans forward.

  • Your child's physician 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 for pericarditis may include:

    • blood tests (to evaluate the degree of inflammation).
    • chest x-ray - a diagnostic test which uses invisible X-ray energy beams to produce images of internal tissues, bones, and organs onto film.
    • echocardiography (echo) - a procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves.
  • How is pericarditis treated?

    Treatment depends on what is causing the inflammation and the amount of pericardial fluid that is collecting. Large fluid collections usually require drainage which can be accomplished non-surgically by placement of a draining catheter.

    Anti-inflammatory medication is helpful for many causes of pericarditis, and may include non-steroidal agents (ibuprofen, indomethacin, colchicine) or steroids (prednisone). Bacterial, fungal or protozoal infections require drainage for diagnosis and subsequent use of antibiotics.

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