title: Cardiac tamponade complicating postpericardiotomy syndrome.
abstract: We present 2 children who developed postpericardiotomy syndrome (PPS) and the rare complication of cardiac tamponade after cardiac surgery, each requiring life-saving pericardiocentesis in the emergency department (ED). Each child presented with vomiting as a chief complaint, an initial sign that has not been reported previously. As the frequency of orthotopic heart transplants and other cardiac surgeries among children increases, it is likely that ED physicians will encounter PPS and cardiac tamponade with greater frequency, and it is imperative that it be recognized promptly and treated appropriately. We review PPS, cardiac tamponade, and the proper performance of a pericardiocentesis.
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, PA, USA. Scarfone@email.chop.edu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Scarfone
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Donoghue
authors.forename: Evaline A
authors.initials: EA
authors.lastname: Alessandrini
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D016027:Heart Transplantation; D006801:Humans; D006993:Hypnotics and Sedatives; D007040:Hypoventilation / Q000517:prevention & control; D007649:Ketamine; D008297:Male; D010490:Pericardial Effusion / Q000209:etiology; D010492:Pericardiectomy / Q000009:adverse effects*; D020519:Pericardiocentesis / Q000379:methods; D013577:Syndrome; D014777:Virus Diseases / Q000175:diagnosis; D014839:Vomiting / Q000209:etiology
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D006993:Hypnotics and Sedatives; D007649:Ketamine