Patient education: Pericarditis in children (The Basics)

What is pericarditis? — Pericarditis is a condition that causes irritation of the tissue around the heart. This tissue is called the "pericardium." It forms a sac that protects the heart and keeps it from rubbing against other nearby organs (figure 1).

Pericarditis is rare in children. Children who have certain medical conditions have a higher risk of getting it. These conditions include:

●An infection, often with a virus – Bacterial infection is less common.

●A disease called "lupus" – With lupus, the body's infection-fighting system, called the "immune system," attacks the body's own healthy tissues.

●Surgery for a heart condition that the child was born with – Sometimes, there is irritation around the heart after surgery.

What are the symptoms of pericarditis in children? — Symptoms can include:

●Chest pain

●Fever

●Feeling weak or tired

●Having trouble breathing

Chest pain is the most common symptom of pericarditis. It can be a sharp pain or a dull ache. The child might have pain in the front of the chest, the shoulder, or the upper back.

If your child has sharp chest pain, it might get worse when they take a deep breath. This pain might get better when the child sits up and lean forward.

Many other conditions can cause chest pain and fever in children. Because pericarditis is rare, a different condition could be causing these symptoms.

Should my child see a doctor or nurse? — Yes. Take your child to the doctor or nurse if the child:

●Has chest pain

●Has trouble breathing

●Has swelling in the legs or other parts of the body

●Is a baby, and gets sweaty when breastfeeding or bottle feeding

Will my child need tests? — Yes. The doctor or nurse will do an exam and ask about your child's symptoms. They can do 1 or more of these tests:

●An electrocardiogram (ECG) – This test measures the electrical activity in your child's heart (figure 2).

●An echocardiogram – This test uses sound waves to create a picture of your child's heart as it beats (figure 3).

●A chest X-ray – This test can show if there is a lot of fluid around your child's heart.

●Blood tests – These measure the levels of certain proteins in the blood. The protein levels are a clue to the health of your child's heart. They can also tell the doctor if your child has a disease that is causing the pericarditis, and if the pericarditis is improving.

How is pericarditis in children treated? — Treatment for pericarditis in children depends on the cause. Treatments might include:

●Medicines to reduce pain and inflammation, such as aspirin, ibuprofen (sample brand names: Advil, Motrin), or indomethacin (brand name: Indocin). Aspirin should not be used in children with fever, especially if they have symptoms of the flu or chickenpox.

●Steroid medicines to reduce inflammation (not the same steroids athletes take to build up muscle)

●Antibiotics – An antibiotic might be needed if a bacterial infection is causing the pericarditis.

●Draining extra fluid from around the heart – Doctors do this with a thin needle.

●Rest

If doctors do not already know what is causing your child's pericarditis, they will look for the cause and treat it, if possible. This can help the pericarditis.

More on this topic

Patient education: Pericarditis in adults (The Basics)
Patient education: Pleuritic chest pain (The Basics)

Patient education: Pericarditis (Beyond the Basics)
Patient education: Systemic lupus erythematosus (Beyond the Basics)