PEDIATRIC TUBERCULOSIS WITH CARDIOVASCULAR INVOLVEMENT: CLINICAL MANIFESTATIONS AND THERAPEUTIC CONSIDERATIONS

Abstract

Pediatric tuberculosis with cardiovascular involvement is a complex condition that is often challenging to diagnose and treat in children. This review addresses the clinical manifestations of this rare form of tuberculosis, focusing on relevant therapeutic aspects. In children, cardiovascular tuberculosis can manifest itself in several ways, including pericarditis, endocarditis and aortitis, with varied symptoms such as chest pain, dyspnea and signs of heart failure. Early diagnosis is crucial but is often delayed due to the insidious nature of the symptoms and low initial clinical suspicion. Objective: This study aims to carry out a systematic review of the literature to synthesize the available data on clinical manifestations and therapeutic approaches to pediatric tuberculosis with cardiovascular involvement. Methodology: Using the PRISMA checklist, we carried out a systematic search in the PubMed, Scielo and Web of Science databases for articles published in the last 10 years. The descriptors used were "tuberculosis", "pediatric", "cardiovascular", "clinical manifestations", and "therapeutic considerations". Inclusion criteria were original studies and reviews that directly addressed pediatric tuberculosis with cardiovascular manifestations. Exclusion criteria included articles not available in full text, studies in adults, and studies with small sample sizes or methods not clearly described. Results: The analysis of the studies identified that pericarditis is the most common manifestation, followed by endocarditis and aortitis. Treatment is based on standard antituberculous therapy, often complemented by corticosteroids in cases of significant cardiac involvement. The response to treatment is generally favorable with early diagnosis and appropriate therapy. Conclusion:The review highlights the importance of early clinical suspicion and multidisciplinary management to optimize outcomes in children with tuberculosis and cardiovascular involvement. Continued education and increased awareness are essential to improving the diagnosis and treatment of this rare but potentially fatal condition in children.