| Pericarditis |
- Sharp, pleuritic pain that improves with leaning forward
- Inability to lie flat
- May have friction rub
- Pulsus paradoxus, narrow pulse pressure, muffled heart sounds, distended neck veins with severe disease and pericardial effusion in tamponade
- May have history of infectious symptoms
- ECG with diffuse ST elevation
- +/- Cardiomegaly on chest X-ray (if effusion present)
|
| Myocarditis |
- Variable presentation, including impending shock
- Chest pain often with GI symptoms (ex: vomiting, abdominal pain)
- Often viral prodrome 1-2 weeks beforehand
- Possible signs of heart failure – sinus tachycardia, gallop, hepatomegaly, worsening tachycardia with IVF bolus
- ECG findings include ST elevation, wide complex rhythm, T wave inversion in lateral leads, ventricular ectopy
|
| Arrhythmia |
- Acute onset and offset of pain, palpitations
|
| Myocardial Infarction |
- Crushing chest pain radiating to neck and jaw with associated diaphoresis, dyspnea, and nausea
- Substance abuse
- Fortunately extremely rare in pediatrics
|