A 4 year old child child presents with fever, vomiting, and shortness of breath on exertion. Physical exam shows muffled heart sounds, fever, a gallop rhythm, and tachycardia. The best diagnosis for this child is
a. pericarditis
b. costochondritis
c. myocarditis
d. mitral valve prolapse
e. none of the above.
he correct answer is a. pericarditis.
The child’s symptoms and physical exam findings are consistent with pericarditis, an inflammation of the pericardium, the sac surrounding the heart. The key findings are:
– Muffled heart sounds (due to fluid accumulation in the pericardial space)
– Fever
– Gallop rhythm (a third heart sound, indicating increased fluid or pressure)
– Tachycardia (rapid heart rate)