Acute and Recurrent Pediatric Pericarditis

Le résumé fourni par la source

Acute pericarditis belongs to the group of inflammatory pericardial syndromes with or without pericardial effusion, and the diagnosis is confirmed by the presence of two of the four criteria defined by the European Society of Cardiology: (i) chest pain; (ii) pericardial friction; (iii) changes on the electrocardiogram; and (iv) pericardial effusion on echocardiography. The etiology of pericarditis can be divided into infectious and non-infectious, but in most cases, the underlying etiology cannot be identified, and such cases are called “idiopathic.” The clinical presentation is determined by the volume of fluid, the rate of accumulation, and the compliance of the myocardium. Anti-inflammatory therapy forms the cornerstone of pericarditis treatment. In acute pericarditis, it is necessary to use ibuprofen as monotherapy, and in case of risk factors, it is necessary to introduce colchicine immediately. Corticosteroids increase the risk of developing recurrent pericarditis. Recurrent pericarditis is the most common complication of acute pericarditis and is defined by the appearance of signs of pericarditis 4–6 weeks after a documented episode of acute pericarditis. It is treated with ibuprofen and colchicine. In the case of corticosteroid-dependent and colchicine-resistant pericarditis, anakinra can be used, even in children.

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