Caring for Kids With Pericarditis

Your child’s doctor will follow up with you often to track their symptoms.

Your child will need to rest after their pericarditis diagnosis. If they run around or play sports too quickly, the condition could flare up again. Generally, your child’s cardiologist won’t want them to be active until their symptoms have completely gone and all of the tests to check their heart function are normal. 

If your child plays a sport, they’ll most likely have to stay off the field for 3 months. Their cardiologist will also need to clear them before they start playing the sport again.

What to Expect Going Forward

About 35% of kids and teens with pericarditis see symptoms come back. Usually, these episodes are less severe than the first attack. It’s not completely clear why this happens, but one theory is that it’s due to an underlying autoimmune disorder. Your doctor will usually treat it in a similar way to the first pericarditis episode, with NSAIDs and colchicine. Sometimes they may recommend a steroid, too.

If your child's pericarditis doesn’t respond to treatment, the doctor may suggest a type of drug known as an IL-1 inhibitor, like rilonacept (Arcalyst). This medicine prevents certain inflammatory chemicals from coming in contact with the cells that are on the surface of your child’s pericardium. 

Whenever your child does have a recurrence, they’ll have to limit their activity until their symptoms resolve. That generally means that they can go to school and walk around but can’t work out or play sports.

In some cases, if your child’s pericarditis happens often, your doctor may recommend one of the two following procedures:

• Pericardiocentesis, to drain excess fluid from the pericardium
• Pericardiectomy, or surgery to remove the pericardium

Talking to Your Child About Their Pericarditis

Your child may be scared when they learn that they have pericarditis, especially if they need to be hospitalized. It’s important to reassure them. Most kids with pericarditis make a complete recovery and are able to return to normal activities within a few months. This is true even for those kids who develop recurrent pericarditis. 

Remember that every child handles illness in different ways. Here are a few tips on how to talk to them about pericarditis:

• Reassure them that you love them and repeat it often. 
• Discuss things a few details at a time. This will allow your child time to absorb information. 
• If you have a very young child, focus on concrete information, like how long they will be in the hospital, what’s going to happen there, and when they will be able to go back to school.
• An older child or teen may want to talk to other kids their age who have had pericarditis. Their medical team may be able to connect them with peers.
• Ask to meet with a child life specialist at the hospital or clinic who can help talk to your child.
• Make sure your child’s medical team talks to them directly and not just to you. You want to ensure that your child understands everything that is going on. It will also make it easier for them to understand certain things -- for example, why they can’t play sports for a few months.
• Encourage your child to come up with their own questions for their health care team.

How to Care for Your Child With Pericarditis

Most of the time, you can manage your child’s pericarditis at home. Here are some things to keep in mind:

• Take any medications as prescribed. 
• Follow the schedule your child’s care team has recommended. 
• If you have any questions, call their office or the hospital advice line.

Watch for the return of symptoms. This is important since pericarditis can return. These include:

• Sharp chest pain that worsens when they lie down and gets better when they lean forward
• Trouble breathing
• Feeling very tired, even during rest

If you notice any of these symptoms, call the doctor right away. 

Keep your child still. This may be the hardest part of the recovery process. Focus on activities such as playing games together, movies, and coloring. Encourage them to keep their mind active through books or puzzles. You can also teach them deep-breathing or relaxation exercises to help keep them calm and distract them from pain.

Set up a routine. Your child may not be back to regular activities yet, like school or sports, but you can get back to as much normalcy as you can. Routines will help both you and your child feel more in control. Here are some ideas:

• Stick to the same wake up and breakfast time each morning, even if your child doesn’t need to get up for school. 
• Have a family check-in. After breakfast, take some time to draw up plans for the day.
• Schedule activities. Set up blocks of time where you and your child will play games together, watch a movie or use electronics, and read books. Once they’re cleared by their doctor, add in light exercise like a walk around the neighborhood. 
• Keep a family dinnertime. Eating together as a family is a good way for everyone to talk about their day and connect. 
• Set up a bedtime routine. It’s important for your child to still go to bed at a regular time. Make sure there are specific things to do, like take a bath and read a bedtime story.

Just as important, plan for some “me time.” for yourself. Make sure you have time for yourself each day, whether it’s for some deep breathing, exercise, or just reading a good book. 

Pericarditis is rare in kids. And virtually all children and teens will make a full recovery and be able to return to their normal everyday activities and regular lives.