Chronic constrictive pericarditis in children - etiology, clinical picture and treatment. A report of 20 cases.

Twenty children with constrictive pericarditis are reported on. Tuberculous etiology was established in five, could not be excluded in 7, while the etiology could not be identified in 8 cases. The main symptoms were venous congestion involving the pulmonary and systemic circulation (hepatomegaly, pulmonary congestion), pericardial click at the apex, abnormalities of repolarization in the ECG. X-ray evidence of pericardial calcification and a "quiet heart" were occasionally found. Hypoproteinaemia, hypalbuminaemia and ascites, signs of an associated protein losing enteropathy may occur in constrictive pericarditis, but are not invariably present. Pericardiectomy is the most adequate form of treatment. Sixteen of the 17 cases in whom the operation was performed recovered completely; one child died.