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EPN 2021

Mily Ray

Mily Ray, Speaker at Pediatrics Conferences
Consultant Pediatric Cardiologist at Max Health Care, India
Title : Increase in the incidence of Tuberculous pericardial effusion in pediatric patients in asymptomatic post covid infection


Introduction: In children, up to 25% of cases of tuberculosis (TB) are of extrapulmonary TB (EPTB) . Tuberculous pericardial effusion (TB-PE), a rare manifestation of EPTB, is the most common cause of pericardial effusion in high-TB-burden settings The clinical spectrum of Covid-19 presentation ranges from asymptomatic to  multiorgan dysfunction.As this disease has developed into a global pandemic and millions of people have become infected, its extrapulmonary manifestations have become better understood. Similar to other viral infections, it has been postulated that Covid-19 may trigger cascades of inflammatory pathways which can potentially result in multi-organ injury including heart, lung, and the serosal surfaces encompassing them. When COVID-10 elicits this inflammatory response, it is reasonable that this may lead to pericarditis and pericardial effusion .

Materials & Method: It’s a retrospective study where the patients coming for pediatric cardiac referral was seen.Most of them came with the complains of fever,tachycardia and cardiac enlargement on X Ray.We did the echocardiogram in all and that is how pericardial effusion was detected. As a developing country, we consider tuberculosis infection in every patient with pneumonia or pleural effusion We appreciated that tuberculosis as a possible cause of the pericardial effusion.  Most The patients’had antibody positive for Covid 19 but no history indicating an asymptomatic affection.

Results: Early PE-TB diagnosis, interventions including medical and surgical management, and routine administration of steroids  with anti tubercular drugs in proper dosage  explain why there were no complications and good outcome of all the patients.


He initially worked as an institutional fellow and then completed training as a Fellow of the National Board( FNB ) in the Department of Pediatric Cardiology at the R N Tagore International Institute of Cardiac Sciences (RTIICS) in Kolkata West Bengal, now referred to as Narayana Hrudalaya Hospital. He spent one month training as an observational fellow at the All India Institute of Medical Sciences , New Delhi before he proceeded to New South Wales, Australia for an overseas stint. He worked as a Fellow in the Sydney Children Hospital Network for a year. After his return he joined Apollo Hospital and then in Max Hospital Group Delhi India. He has almost 15 years of experience in Pediatric Cardiology. His field of interests and expertise are  clinical pediatric cardiology, Fetal echocardiography and non invasive cardiology,also cardiac genetics. Also, he is teaching fellows and residents both in cardiology and pediatrics. He regularly conduct a functional echo training in pediatrics which is very useful in ICU and NICU settings.