Identification of cardiovascular abnormalities in children with empyema thoracis by two-Dimensional and doppler echocardiography

ABSTRACT

Echocardiographic assessment of children with empyema has not previously been reported in the literature. Two-dimensional and Doppler echocardiography were performed in 47 children with acute [n=23] and chronic [n=24] empyema and 34 control subjects. Echocardiography demonstrated pericardial effusion in 11/47 patients [23%]. Those with acute empyema had significantly thicker pericardium [p < 0.009] than control subjects. tricuspid regurgitation was present in 21/47 patients [45%]. The mean right ventricular internal dimension in diastole [RVID] was significantly larger in acute [p < 0.006] empyema than that of control subjects. the mean tricuspid pressure gradients indicated on elevated mean right ventricular systolic pressure with increased calculated mean pulmonary arterial systolic pressures of children with acute empyema [38.5 +/- 6.4 mmHg] and chronic [39.8 +/- 5.6 mmHg] empyema than the normal mean [20 +/- 4 mmHg] reported by Krovetz and Goldblom. Children with chronic empyema had significantly less mean left ventricular internal dimension in diastole [LVID] [p < 0.005] and in systole [LVIS] [p < 0.02] than control subjects. strikingly, their mean left ventricular mass was also significantly less [p < 0.05] than that of either acute empyema or control subjects. these results provide base line data for follow up of children with acute and chonic empyema