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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
"echocardiographic findings between january 2010 and january 2013 were retrospectively investigated"
symptom
acute rheumatic fever
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