RESUMO
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 (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.
Assuntos
Tamponamento Cardíaco/etiologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico , Derrame Pericárdico/etiologia , Pericardite/complicações , Pericardite/diagnóstico , Adolescente , Tamponamento Cardíaco/microbiologia , Tamponamento Cardíaco/cirurgia , Criança , Pré-Escolar , Drenagem , Ecocardiografia , Eletrocardiografia , Feminino , Seguimentos , Neoplasias Cardíacas/diagnóstico por imagem , Humanos , Lactente , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/diagnóstico , Masculino , Mycobacterium tuberculosis , Derrame Pericárdico/microbiologia , Derrame Pericárdico/cirurgia , Pericardiectomia/efeitos adversos , Pericardiocentese , Pericardite/diagnóstico por imagem , Pericardite/microbiologia , Radiografia Torácica , Estudos Retrospectivos , Streptococcus pneumoniae , Tomografia Computadorizada por Raios X , Resultado do Tratamento , TurquiaRESUMO
Henoch-Schönlein purpura is the most common systemic vasculitis during childhood. Many antigenic stimuli and infectious agents have been proposed as a trigger of the disease. Group A beta-hemolytic streptococcus is the most common proposed infectious agent as a trigger for Henoch-Schönlein purpura. We report a 9-year-old boy who has Henoch-Schönlein purpura and acute rheumatic fever with complete atrioventricular block.
