The impacts of pericardial effusion on the heart function of infants and young children with respiratory syncytial virus infection

Patients infected with RSV may demonstrate clinical manifestations other than lower respiratory tract infection including cardiac involvement. The heart involvement following RSV infection varies from heart block, ventricular arrhythmia or a variable degree of pericardial effusion. This study was conducted to assess the impact of RSV infection on pericardial effusion and to compare the heart function among those with and without effusion in infants and children less than two years of age. All infants and children below the age of 2 years admitted with lower respiratory tract infection due to RSV infection over four year period were included in the study. Children with congenital heart diseases were excluded from the study. Electrocardiography, chest X-ray, echocardiography and color Doppler was performed to all the cases. Pericardial effusion was assessed by 2D echocardiography standard views, and long axis parasternal view was chosen for comparison and measurements M-mode echocardiograms were used to determine right ventricular dimensions. Doppler flow through the tricuspid valve was performed in four chambers. Pulmonary flow velocities in late diastole and time intervals were measured using a pulsed Doppler. These studies were performed during the acute illness within 72 hours of hospital admission. There were 83 children with a mean age was 7.05 months (±11) admitted with LRTI due to documented RSV infection and included in this study. Significant pericardial effusion (≥ 2.5mm.) was seen in 23 (27.7%) with a mean age of 8.4 months (± 8.8). There were significant statistical differences in heart function profiles studied between children with and without effusion. From this study we concluded that pericardial effusion is not an uncommon association with lower respiratory tract infection (LRTI) due to respiratory syncytial virus (RSV) infections, its incidence in this study found to be 23/83 RSV infection has pericardial effusion that is around 27.7%. However, the presence of effusion is not associated with a statistical differences effect on the heart function profiles when compared to those without effusion.