Pericarditis – clinical presentation and characteristics of a pediatric population

Perez-Brandão, Catarina; Trigo, Conceição; Pinto, Fátima F.

doi:10.1016/j.repce.2018.05.014

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…In contrast to adults, cardiac chest pain is rare in children and adolescents. In previous studies, ECG was performed in 27.8–62.4% of pediatric patients with the chief complaint of chest pain, with a sensitivity of 0–17.8% [ 1 , 3 , 9 , 11 , 12 , 13 , 46 ]. In addition, the actual specific ECG finding for cardiac etiology might be even lower because of the difference in the definition of “positive ECG findings” used in the studies.…”

Section: Common Examinations Performed For Pediatric Chest Pain In Th...mentioning

confidence: 99%

Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department

Huang,

Liu

2024

Diagnostics

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Pediatric chest pain is a common chief complaint in the emergency department. Not surprisingly, children with chest pain are usually brought to the emergency department by their parents out of fear of heart disease. However, chest pain in the pediatric population is generally a benign disease. In this review, we have identified musculoskeletal pain as the most prevalent etiology of chest pain in the pediatric population, accounting for 38.7–86.3% of cases, followed by pulmonary (1.8–12.8%), gastrointestinal (0.3–9.3%), psychogenic (5.1–83.6%), and cardiac chest pain (0.3–8.0%). Various diagnostic procedures are commonly used in the emergency department for cardiac chest pain, including electrocardiogram (ECG), chest radiography, cardiac troponin examination, and echocardiography. However, these examinations demonstrate limited sensitivity in identifying cardiac etiologies, with sensitivities ranging from 0 to 17.8% for ECG and 11.0 to 17.2% for chest radiography. To avoid the overuse of these diagnostic tools, a well-designed standardized algorithm for pediatric chest pain could decrease unnecessary examination without missing severe diseases.

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Section: Common Examinations Performed For Pediatric Chest Pain In Th...mentioning

confidence: 99%

Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department

Huang,

Liu

2024

Diagnostics

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“…Myocardial involvement during acute pericarditis occurs in about 15% of adult subjects (75) and up to 35% of pediatric patients (97). Myocardial inflammation is revealed by increased troponin levels or by myocardial inflammation/fibrosis at cardiac magnetic resonance (MR).…”

Section: Prognosis Of Recurrent Pericarditis In the Pediatric Agementioning

confidence: 99%

Recurrent Pericarditis in Children and Adolescents

et al. 2019

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Recurrent pericarditis (RP) is a clinical syndrome characterized by recurrent attacks of acute pericardial inflammation. Prognosis quoad vitam is good, although morbidity might be significant, especially in children and adolescents. Multiple potential etiologies result in RP, in the vast majority of cases through autoimmune or autoinflammatory mechanisms. Idiopathic RP is one of the most frequent diagnoses, that requires the exclusion of all known etiologies. Therapeutic advances in the last decade have been significant with the recognition of the effectiveness of anti IL1 therapy, but a correct diagnostic and therapeutic algorithm is of key importance. Unfortunately, most of evidence comes from studies in adult patients. Here we review the etiopathogenesis, diagnosis and management of RP in pediatric patients.

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Pediatric Pericarditis: Update

et al. 2023

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Purpose of Review While there have now been a variety of large reviews on adult pericarditis, this detailed review specifically focuses on the epidemiology, clinical presentation, diagnosis, and management of pediatric pericarditis. We have tried to highlight most pediatric studies conducted on this topic, with special inclusion of important adult studies that have shaped our understanding of and management for acute and recurrent pericarditis. Recent Findings We find that the etiology of pediatric pericarditis differs from adult patients with pericarditis and has evolved over the years. Also, with the current COVID-19 pandemic, it is important for pediatric clinicians to be aware of pericardial involvement both due to the infection and from vaccination. Oftentimes, pericarditis maybe the only cardiac involvement in children with COVID-19, and so caregivers should maintain a high index of suspicion when they encounter children with pericarditis. Summary Large-scale contemporary epidemiological data regarding incidence and prevalence of both acute and recurrent pericarditis is lacking in pediatrics, and future studies should focus on highlighting this important research gap. Most of the current management strategies for pediatric pericarditis are from experiences gathered from adult data. Pediatric multicenter trials are warranted to understand the best management strategy for those with acute and recurrent pericarditis. Case Vignette A 6-year-old child with a past history of pericarditis almost 2 months ago comes in with a 2-day history of chest pain and fever. Per mother, he stopped his steroids about 2 weeks ago, and for the last 2 days has had a temperature of 102F and has been complaining of sharp mid-sternal chest pain that gets worse when he lies down and is relieved when he sits up and leans forward. On examination, he is tachycardic (heart rate 160 bpm), with normal blood pressure for age. He appears to be in pain (5/10), and on auscultation has a pericardial friction rub. His lab studies are notable for elevated white blood cell count and inflammatory markers (CRP and ESR). His electrocardiogram reveals sinus tachycardia and diffuse ST-elevation in all precordial leads. His echocardiogram demonstrates normal biventricular function and a trace pericardial effusion. His cardiac MRI confirms recurrent pericarditis. He is started on indomethacin and colchicine. He has complete resolution of his symptoms by day 3 of admission and is discharged with close follow-up.

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Pericarditis – clinical presentation and characteristics of a pediatric population

Cited by 4 publications

References 15 publications

Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department

Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department

Recurrent Pericarditis in Children and Adolescents

Pediatric Pericarditis: Update

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