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[Symptomatic pericardial effusions in childhood]
M L de la Morena Pardo1, M I Chamorro Romero, R Prados Bueno
1Servicio de Pediatria II, Hospital Gregorio Marañón, Madrid.
Insights
Symptomatic pericardial effusion (PE) in children requires echocardiography for diagnosis. Treatment varies by cause, with aspirin as first-line therapy and pericardiocentesis for cardiac tamponade.
Area of Science:
- Pediatrics
- Cardiology
- Internal Medicine
Context:
- Symptomatic pericardial effusion (PE) in pediatric patients presents diagnostic challenges due to non-specific symptoms.
- Etiologies of PE in this cohort included chronic renal failure, viral infections, post-cardiac surgery, juvenile rheumatoid arthritis, and chronic myelocytic leukemia, with four idiopathic cases.
Purpose:
- To present clinical data and management strategies for twelve pediatric patients diagnosed with symptomatic pericardial effusion.
- To highlight the diagnostic utility of echocardiography and the importance of hemodynamic assessment in managing PE.
Summary:
- Echocardiography is crucial for diagnosing PE in children when symptoms are non-specific.
- Hemodynamic assessment differentiates between PE and cardiac tamponade.
- Management involves identifying the underlying etiology, with aspirin as the primary treatment and pericardiocentesis indicated for cardiac tamponade.
Impact:
- This study underscores the necessity of echocardiography for timely PE diagnosis in children.
- It provides insights into diverse etiologies and effective management protocols, including medical and interventional approaches.
- Findings aid clinicians in optimizing treatment strategies for pediatric pericardial effusion.
Abstract:
We present the clinical data and the management of twelve patients with symptomatic pericardial effusion (PE). The etiology of PE was: Chronic renal failure, viral infection, cardiac surgery, juvenile rheumatoid arthritis and chronic myelocytic leukemia. Four cases were diagnosed as idiophatic. PE in childhood is usually asymptomatic. When symptoms are present they are non-specific and don't help to know the size of the effusion; therefore, it's necessary to practice an echocardiography to demostrate the presence of PE. The hemodynamic findings permit to diferentiate patients with and without cardiac tamponade. The treatment of first choice is aspirin. In patients with cardiac tamponade the treatment should be pericardiocentesis.