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Evaluation of non-surgical causes of cardiac tamponade in children at a cardiac surgery center.
[acute rheumatic fever]
The
aim
of
this
study
was
to
examine
the
causes
of
cardiac
tamponade
in
children
undergoing
percutaneous
pericardiocentesis
.
Patients
who
presented
with
other
complaints
but
were
diagnosed
with
cardiac
tamponade
based
on
clinical
and
echocardiographic
findings
between
January
2010
and
January
2013
were
retrospectively
investigated
.
Electrocardiography
,
telecardiography
and
transthoracic
echocardiography
were
performed
.
Pericardiocentesis
was
performed
percutaneously
under
continuous
blood
pressure
and
rhythm
monitoring
with
echocardiography
and
fluoroscopy
.
Pericardial
fluid
was
analyzed
on
hemography
and
biochemistry
.
Fourteen
patients
(
six
boys
,
eight
girls
;
median
age
,
7
years
)
underwent
pericardiocentesis
for
cardiac
tamponade
.
At
presentation
,
78
%
had
dyspnea
,
56
%
chest
pain
,
and
49
%
fever
.
All
had
cardiomegaly
,
and
their
cardiothoracic
index
was
0
.
56
-
0
.
72
.
Also
,
all
patients
had
sinus
tachycardia
;
78
%
,
low
QRS
voltage
;
70
%
,
ST-
T
changes
;
and
50
%
QRS
alternans
.
On
echocardiography
the
widest
diameter
of
pericardial
effusion
was
between
12
 
mm
and
36
 
mm
depth
around
the
heart
.
The
pericardial
fluid
was
purulent
in
one
,
serohemorrhagic
in
seven
,
serofibrinous
in
two
,
and
serous
in
four
cases
.
Pericardiocentesis
was
unsuccessful
in
two
patients
,
who
underwent
open
surgical
drainage
,
with
no
complications
.
Based
on
pericardial
fluid
characteristics
and
additional
tests
,
cardiac
tamponade
was
caused
by
an
infection
in
five
patients
,
hypothyroidism
in
two
,
familial
Mediterranean
fever
in
two
,
malignancy
in
one
,
acute
rheumatic
fever
in
one
,
collagen
tissue
disease
(
systemic
lupus
erythematosus
)
in
one
,
catheter
placement-associated
damage
in
one
,
and
idiopathic
pulmonary
arterial
hypertension
in
one
patient
.
Pericardial
effusion
and
cardiac
tamponade
in
children
have
varied
causes
,
and
early
treatment
is
life
saving
.
Diseases
Validation
Diseases presenting
"chest pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
dedifferentiated liposarcoma
fabry disease
familial mediterranean fever
hydrocephalus with stenosis of the aqueduct of sylvius
liposarcoma
lymphangioleiomyomatosis
pleomorphic liposarcoma
pyomyositis
thoracic outlet syndrome
This symptom has already been validated