Cardiac tamponade complicating postpericardiotomy syndrome

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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
PubMed

Insights

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.

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