Evaluation of children with a large pericardial effusion and cardiac tamponade

• Published in: Acta Cardiologica Vol. 62; no. 2; pp. 129 - 133
• Main Authors: Guven, Hasan, Bakiler, A. Rahmi, Ulger, Zulal, Iseri, Bahadir, Kozan, Meral, Dorak, Coskun
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01-04-2007
• Subjects: Adolescent; aetiology; cardiac tamponade; Cardiac Tamponade - etiology; Cardiac Tamponade - microbiology; Cardiac Tamponade - surgery; Child; Child, Preschool; Drainage; Echocardiography; Electrocardiography; Female; Follow-Up Studies; Heart Neoplasms - complications; Heart Neoplasms - diagnosis; Heart Neoplasms - diagnostic imaging; Humans; Infant; large pericardial effusion; Lymphoma, Non-Hodgkin - complications; Lymphoma, Non-Hodgkin - diagnosis; Male; Mycobacterium tuberculosis; Pericardial Effusion - etiology; Pericardial Effusion - microbiology; Pericardial Effusion - surgery; Pericardiectomy - adverse effects; Pericardiocentesis; Pericarditis - complications; Pericarditis - diagnosis; Pericarditis - diagnostic imaging; Pericarditis - microbiology; Radiography, Thoracic; Retrospective Studies; Streptococcus pneumoniae; Tomography, X-Ray Computed; Treatment Outcome; Turkey
• ISSN: 0001-5385; 1784-973X; 0001-5385
• DOI: 10.2143/AC.62.2.2020232

Objectives - Large pericardial effusions and cardiac tamponade are rare in childhood.The aim of this study was to evaluate the aetiological factors and clinical findings of large pericardial effusion and cardiac tamponade in children.
Methods - We reviewed retrospectively the records of 10 (6male, 4female) patients (mean age: 8.05±4.4 y) with the diagnosis of large pericardial effusion and cardiac tamponade requiring pericardiocentesis and pericardial drainage between 2002 and 2004.
Results - After extensive diagnostic investigation we detected that three patients had tuberculosis, one patient had uraemic pericarditis; one patient had bacterial pericarditis; one patient had postpericardiotomy syndrome; two patients had malignancy and two patients had no identifiable aetiology. Echocardiography-guided percutaneous pericardial puncture and pigtail catheter placement is safe and effective for initial treatment of patients with large pericardial effusion and cardiac tamponade and in most cases, initial assessment with clinical, serologic, and radiologic investigation and careful follow-up can reveal the aetiology.
Conclusions - Although tuberculosis is rare in industrialized countries, in developing countries it remains one of the most important causes of large pericardial effusion and should be investigated and excluded in each patient.