Pericarditis and Prolonged QTc in my daughter

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My daughter is almost 14, she has had incessant recurrent pericarditis since she was 12 and has to remain on medications or the pericarditis returns.  She has had several effusions, one of them moderate to large, which caused her heart to start collapsing in.  My main question is that she has ekg’s done every 1-2 months and always the QTc is above normal, sometimes its 450, sometimes it has been as high as 480.  Would this possibly be from the pericarditis?  Or is this something in addition to the pericarditis?


Do you know what caused the pericarditis? The recurrences suggests an ongoing problem that hasn’t been treated adequately. Sometimes the only answer is to remove the pericardium surgically (pericardiectomy), and I suspect that day may come sooner rather than later. Long QT is another matter and it needs to be looked at separately. However, both pericardial effusions and long QT can be associated with other EKG abnormalities (If you must know, Electrical alternans, a broad term that describes alternate-beat variation in the direction, amplitude, and duration of any component of the ECG waveform (ie, P, PR, QRS, R-R, ST, T, U).
Most diseases that cause true electrical alternans do not require surgical treatment. Pulmonary embolectomy may be required for unresolved large pulmonary emboli. Left-sided cervicothoracic sympathetic ganglionectomy may be required for patients with congenital long QT syndrome who continue to have episodes of syncope despite drug therapy. Recurrent pericardial effusions may benefit from pericardiectomy.
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Unfortunately, I can only advice in general terms, your daughter’s situation requires in-depth consultations and follow-up.
Hope this helps,
Dr T

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