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Published on: October 24, 2020
Evaluation of children with a large pericardial effusion and cardiac tamponade
Hasan Guven1, A Rahmi Bakiler, Zulal Ulger
1Department of Pediatric Cardiology, Tepecik Education and Research Hospital. drhasanguven@yahoo.com
Insights
Large pericardial effusions and cardiac tamponade in children are rare but serious. This study identified various causes, including tuberculosis, malignancy, and infections, emphasizing the need for thorough investigation in pediatric cases.
Area of Science:
- Pediatric Cardiology
- Thoracic Medicine
- Critical Care
Background:
- Large pericardial effusions and cardiac tamponade are uncommon pediatric emergencies.
- Prompt diagnosis and management are crucial for favorable outcomes.
Purpose of the Study:
- To investigate the etiological factors and clinical characteristics of large pericardial effusion and cardiac tamponade in children.
- To evaluate the safety and efficacy of echocardiography-guided percutaneous pericardial puncture.
Main Methods:
- Retrospective review of 10 pediatric patients (2002-2004) diagnosed with large pericardial effusion and cardiac tamponade.
- Patients underwent pericardiocentesis and pericardial drainage.
Main Results:
- Etiologies included tuberculosis (3), malignancy (2), uraemic pericarditis (1), bacterial pericarditis (1), post-pericardiotomy syndrome (1), and idiopathic (2).
- Echocardiography-guided percutaneous pericardial puncture with pigtail catheter placement was safe and effective for initial management.
- Clinical, serologic, and radiologic investigations with careful follow-up aided etiological diagnosis.
Conclusions:
- Tuberculosis remains a significant cause of large pericardial effusion in developing countries and requires exclusion.
- Early diagnostic evaluation and appropriate management are essential for pediatric patients with pericardial effusion and tamponade.
Objectives:
Large pericardial effusions and cardiac tamponade are rare in childhood. The aim of this study was to evaluate the aetiological factors and clinical findings of large pericardial effusion and cardiac tamponade in children.
Methods:
We reviewed retrospectively the records of 10 (6 male, 4 female) patients (mean age: 8.05 +/- 4.4 y) with the diagnosis of large pericardial effusion and cardiac tamponade requiring pericardiocentesis and pericardial drainage between 2002 and 2004.
Results:
After extensive diagnostic investigation we detected that three patients had tuberculosis, one patient had uraemic pericarditis; one patient had bacterial pericarditis; one patient had post-pericardiotomy syndrome; two patients had malignancy and two patients had no identifiable aetiology. Echocardiography-guided percutaneous pericardial puncture and pigtail catheter placement is safe and effective for initial treatment of patients with large pericardial effusion and cardiac tamponade and in most cases, initial assessment with clinical, serologic, and radiologic investigation and careful follow-up can reveal the aetiology.
Conclusions:
Although tuberculosis is rare in industrialized countries, in developing countries it remains one of the most important causes of large pericardial effusion and should be investigated and excluded in each patient.
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