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Cardiac tamponade complicating postpericardiotomy syndrome
Richard J Scarfone1, Aaron J Donoghue, Evaline A Alessandrini
1University of Pennsylvania School of Medicine, Philadelphia, PA, USA. Scarfone@email.chop.edu
Pediatric Emergency Care
|September 16, 2003
Summary
Postpericardiotomy syndrome (PPS) with cardiac tamponade is a rare complication after pediatric cardiac surgery. Vomiting was an unusual initial symptom in two children requiring emergency pericardiocentesis.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Emergency Medicine
Background:
- Postpericardiotomy syndrome (PPS) is a known complication following cardiac surgery.
- Cardiac tamponade is a rare but life-threatening complication of PPS.
- The incidence of pediatric cardiac surgeries, including heart transplants, is increasing.
Observation:
- Two pediatric patients developed PPS and cardiac tamponade post-cardiac surgery.
- Both children presented to the emergency department (ED) with vomiting as their primary symptom.
- Vomiting has not been previously reported as an initial sign of PPS.
Findings:
- The presented cases highlight the potential for unusual presentations of PPS.
- Prompt recognition and intervention, such as pericardiocentesis, are crucial for managing cardiac tamponade.
- ED physicians must be aware of PPS and cardiac tamponade in children post-cardiac surgery.
Implications:
- Increased awareness of PPS and its varied presentations is necessary for emergency physicians.
- Timely diagnosis and treatment of cardiac tamponade can be life-saving in pediatric patients.
- This case series emphasizes the importance of considering PPS in the differential diagnosis for children with a history of cardiac surgery presenting with concerning symptoms.