Children presenting with acute pericarditis to the emergency department

Abstract

Objective: The objective of the study was to evaluate the clinical features and the outcome of children who presented to the emergency department and were ultimately diagnosed with pericarditis.

Methods: A retrospective chart review of all children diagnosed with acute pericarditis from January 2000 through March 2007 was conducted.

Results: There were 94 children with pericarditis as the sole or one of the discharge diagnoses: 34 with postsurgical pericarditis and 38 with pericarditis as a component of a generalized illness were not examined further. Of the 22 children included in the study, the mean age was 12.3 (SD, 2.7) years, and 80% were males. Chest pain was present in 96%, and fever was present in 56%. All children had electrocardiographic changes comprising ST and T-wave abnormalities. Initial chest radiographs were reported as normal in 40%; although 82% (n = 18) had a pericardial effusion on echocardiography, 7 (32%) required pericardiocentesis. The etiology was considered idiopathic in 68% (n = 15). All children improved on treatment with nonsteroidal anti-inflammatory drugs. Eight children (36%) had recurrent pericarditis, of whom 2 had multiple recurrences.

Conclusions: Children presenting with chest pain require further investigation if electrocardiographs show any abnormalities. Children presenting with pericarditis require follow-up and caution about recurrence.