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The most probable etiology appears to be a congenital lesion. Additionally, a complication of pericarditis cannot be entirely ruled out. Another consideration is an ischemic lesion that may have resulted from impaired coronary circulation during the complicated course of MIS-C.
In a patient with pericarditis — OR — a large heart on chest X-ray — OR — simply unexplained dyspnea ( as in the November 28, 2022 post) — recognition of electrical alternans should suggest the possibility of a significant pericardial effusion that may be associated with tamponade.
That occurs in right heart failure and constrictive pericarditis. Constrictive pericarditis is an important cause for Kussmaul sign or inspiratory increase in jugular venous pressure. On the other hand, the Y descent is very prominent in constrictive pericarditis, and it is known as Friedreich’s sign.
Finally, congenital heart diseases (CHD) are a major public health issue in this country. Together, they have operated nine Patent Ductus Arteriosus and two Chronic Constrictive Pericarditis between 2012 and 2015. The two aforementioned reasons also explain the high prevalence of rheumatic heart disease among Congolese children.
The second most common cause of medical cardiac tamponade is acute idiopathic pericarditis. Less common etiologies include uremia, bacterial or tubercular pericarditis, chronic idiopathic pericarditis, hemorrhage, and other causes such as autoimmune diseases, radiation, myxedema, etc.
Though less prevalent in younger patients, occlusion MI may occur and requires the same early interventions as older patients. - - Pericarditis and myocarditis should be a diagnosis of exclusion. I've listed potential causes of acute pericarditis in My Comment at the bottom of the page in the June 11, 2022 post in Dr. Smith's ECG Blog.
Background Studies predating widespread COVID-19 vaccination identified patients with congenital heart disease (CHD) as a group at increased risk of severe outcomes from COVID-19. Here we evaluate the impact of vaccination on COVID-19 outcomes among patients with CHD. vs 0.2%, adjusted OR 2.24 (1.88–2.65); p<0.001) and death (0.5%
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