Evaluation of children with a large pericardial effusion and cardiac tamponade.
OBJECTIVE
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 (6 male, 4 female) 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 post-pericardiotomy 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.
Guven
Hasan
H
Department of Pediatric Cardiology, Tepecik Education and Research Hospital. drhasanguven@yahoo.com
Bakiler
A Rahmi
AR
Ulger
Zulal
Z
Iseri
Bahadir
B
Kozan
Meral
M
Dorak
Coskun
C
D000293:Adolescent; D002305:Cardiac Tamponade / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000175:diagnosis; D008297:Male; D009169:Mycobacterium tuberculosis; D010490:Pericardial Effusion / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D010492:Pericardiectomy / Q000009:adverse effects; D020519:Pericardiocentesis; D010493:Pericarditis / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000382:microbiology; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014421:Turkey