Children presenting with acute pericarditis to the emergency department.

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.