PMC8259459_01
An electrocardiogram on admission to the department of pediatrics showing typical features of acute pericarditis (chart speed: 50 mm/s, calibration: 1 mm/mV). Sinus tachycardia (145 bpm), diffuse concave ST-segment elevation with concomitant PR depression.
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F1
Additionally, there was a sinus tachycardia with diffuse ST elevations in precordial and limb leads (Figure 1).
Echocardiographic subcostal view of the patient at different stages of the disease. (A) On admission to the Clinic of Pediatric Cardiology (2nd episode of fever). Both of the pericardial laminae are thickened with a pathological layer of fluid in between and fibrous adhesions in the apical region. (B) 7th day of hospitalization (4th day on prednisone). The laminae are still thickened, despite considerable reduction of the effusion. (C) 7 weeks after discharge showing normal physiological image.
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F2
Moreover, a thickened parietal lamina was connected to the visceral lamina with hyper-echogenic fibrous adhesions (Figure 2A). On the 7th day of hospitalization (after four doses of prednisone), not only did the CRP level decrease, but the ECG improved (Figure 3B) and the effusion resolved completely (Figure 2B). In a 5-month follow-up, she remained asymptomatic, with physiological amounts of pericardial fluid (Figure 2C) and a normal ECG for her age (Figure 3C).
A 12-lead ECG at chart speed of 50 mm/s and calibration of 1 mm/mV. (A) On admission to the Clinic of Pediatric Cardiology (2nd episode of fever). Sinus tachycardia (140 bpm), negative T-waves in leads: I, II, III, aVF, and all precordial leads. Even though the QRS voltages are normal for age, they are markedly lower compared with the two following recordings. (B) 7th day of hospitalization (4th day on prednisone): sinus rhythm 100 bpm. The negative T-waves are still present in leads II, III, aVF as well as V1-V4; flattened in leads V5 and V6. (C) 7 weeks after the discharge: sinus rhythm 81 bpm. The T-waves are negative in leads V1-V3 (adequate for age).
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T-waves were recorded on the ECG (Figure 3A). On the 7th day of hospitalization (after four doses of prednisone), not only did the CRP level decrease, but the ECG improved (Figure 3B) and the effusion resolved completely (Figure 2B). In a 5-month follow-up, she remained asymptomatic, with physiological amounts of pericardial fluid (Figure 2C) and a normal ECG for her age (Figure 3C).