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Identification of cardiovascular abnormalities in children with empyema thoracis by two-dimensional and Doppler
Y T Kishk1, A Abou-Elmagd, A M Abdel-Wahab
1Department of Medicine, Assiut University Hospital, Egypt.
Insights
Echocardiography revealed significant cardiac changes in children with empyema, including pericardial effusion and altered ventricular dimensions. This study establishes baseline cardiac data for pediatric empyema patients.
Area of Science:
- Pediatric Cardiology
- Thoracic Medicine
- Diagnostic Imaging
Background:
- Empyema in children can lead to serious complications.
- Echocardiographic findings in pediatric empyema are not well-documented.
Purpose of the Study:
- To investigate echocardiographic findings in children with acute and chronic empyema.
- To establish baseline cardiac data for this population.
Main Methods:
- Two-dimensional and Doppler echocardiography were performed on 47 children with empyema (23 acute, 24 chronic) and 34 controls.
- Echocardiographic parameters including pericardial effusion, ventricular dimensions, and pressures were analyzed.
Main Results:
- Pericardial effusion was observed in 23% of patients.
- Children with empyema showed thicker pericardium, enlarged right ventricles, and elevated pulmonary arterial pressures compared to controls.
- Chronic empyema was associated with reduced left ventricular dimensions and mass.
Conclusions:
- Echocardiography reveals significant cardiac abnormalities in children with empyema.
- This study provides crucial baseline data for monitoring cardiac health in pediatric empyema cases.
Abstract:
To our knowledge, echocardiographic assessment of children with empyema has not been reported previously in the literature. Two-dimensional and Doppler echocardiography were performed in 47 children with acute (n = 23) and chronic (n = 24) empyema and 34 control subjects. Echocardiography demonstrated pericardial effusion in 11 of 47 patients (23 percent). Those with acute empyema had significantly thicker pericardium (p < 0.009) than control subjects. Tricuspid regurgitation was present in 21 of 47 patients (45 percent). The mean right ventricular internal dimension in diastole was significantly larger in patients with acute (p < 0.00002) and chronic (p < 0.006) empyema than that of control subjects. The mean tricuspid pressure gradients indicated an elevated mean right ventricular systolic pressure with increased calculated mean pulmonary arterial systolic pressures of children with acute empyema (38.5 +/- 6.4 mm Hg) and chronic (39.8 +/- 5.6 mm Hg) empyema than the normal mean (20 +/- 4 mm Hg). Children with chronic empyema had significantly less mean left ventricular internal dimension in diastole (p < 0.005) and left ventricular internal dimension in systole (p < 0.02) than control subjects. Strikingly, their mean left ventricular mass was also significantly less (p < 0.05) than that of subjects with either acute empyema or control subjects. These results provide baseline data for follow-up of children with acute and chronic empyema.