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Presenting Signs and Symptoms of Pericardial Effusions in the Pediatric Emergency Department
Matthew Cully1, Jason R Buckley2, Elysha Pifko3
1From the Divisions of Pediatrics.
Insights
Pediatric pericardial effusions often present with shortness of breath, fever, and fatigue. Recognizing these symptoms is crucial for early diagnosis in children.
Area of Science:
- Pediatric Emergency Medicine
- Cardiology
- Diagnostic Imaging
Background:
- Pericardial effusion is a critical condition in pediatric patients.
- Understanding common symptoms and their relation to effusion size is vital for timely diagnosis.
- Etiology of pediatric pericardial effusion requires further investigation.
Purpose of the Study:
- To determine the frequency of presenting signs and symptoms of pericardial effusions in children.
- To correlate symptoms with the size of pericardial effusions.
- To review the final etiology of pericardial effusions in a pediatric emergency department setting.
Main Methods:
- Retrospective chart review of pediatric patients (<17 years) diagnosed with pericardial effusion.
- Analysis of presenting signs, symptoms, vital signs, and final etiology.
- Data collected over a 10-year period from a tertiary care pediatric emergency department.
Main Results:
- Shortness of breath was the most common symptom (65%).
- Symptoms varied with effusion size: small (shortness of breath, chest pain), moderate (fever, cough, shortness of breath), and large (shortness of breath, abdominal pain).
- Cardiac and autoimmune diseases were the most common etiologies.
Conclusions:
- Specific symptoms should raise suspicion for pericardial effusion in pediatric emergency care.
- Early recognition of key symptoms can aid in prompt diagnosis and management.
- Further research into the diverse etiologies of pediatric pericardial effusion is warranted.
Objectives:
The primary objective of this study was to describe the frequency of the most common presenting signs and symptoms of pericardial effusions, particularly with relation to the size of the effusion. The secondary objective was to review the final etiology of the pericardial effusion in those patients who had presented to a tertiary care pediatric emergency department.
Methods:
This was a retrospective chart review of patients younger than 17 years who presented and were evaluated at the pediatric emergency department and subsequently diagnosed with a pericardial effusion during a period of 10 years.
Results:
A total of 23 patients matched the inclusion criteria. The most common symptom was shortness of breath (65%), followed by fever (52%), fatigue (44%), and chest pain (44%). Shortness of breath (60%) and chest pain (60%) were the most frequent symptoms among patients with a small pericardial effusion. Fever (86%), cough (71%), and shortness of breath (71%) were the most frequent symptoms among patients with moderate pericardial effusion. In patients with large pericardial effusions, the most frequent symptoms were shortness of breath (63%) and abdominal pain (63%). Tachycardia (52%) and tachypnea (52%) were the most common abnormal vital signs. The most common etiology was cardiac (44%) and autoimmune disease (26%).
Conclusions:
This study suggests that the presence of certain symptoms should be associated with a high index of suspicion for pericardial effusion for the pediatric emergency care physician.
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