Yakup ERGÜL, Kemal NİŞLİ, Aygün DİNDAR, Ümrah AYDOĞAN, Rukiye Eker ÖMEROĞLU, Türkan ERTUĞRUL

Transfüzyon Gerektiren Hemoperikardiyum ve Kalp Tamponadı

Kalp tamponadı perikarditli hastalarda gelişen, yaşamı tehdit eden, perikardiyosentez veya cerrahi olarak hemen girişim gerektiren kardiyolojik acillerdendir. Bu makalede ani gelişen solukluk ve halsizlik yakınması ile başvuran; fizik muayenede anemi, hepatomegali, zayıf kalp sesleri, düşük nabız amplitüdü ile taşikardi ve hipotansiyon sapta- nan 16 aylık bir erkek hasta sunuldu. Ağır anemisi nede- niyle kan transfüzyonu yapılan hastanın telegrafisinde kardiyomegali ve ekokardiyografik incelemede masif peri- kardiyal efüzyon ve kalp tamponadı bulguları saptandı. Acil perikardiyosentez uygulanan hastada 75 ml hemorajik sıvı boşaltıldı. Bu vaka travma ve kronik hastalık öyküsü olmayan çocuklarda akut gelişen anemi ve kalp yetersizliği durumunda hemoperikardiyum ve kalp tamponadının düşü- nülmesi gerektiğini vurgulamak amacıyla sunuldu

Anahtar Kelimeler:

Hemoperikardiyum, kalp tamponadı, perikardiyosentez

Hemopericardium and Cardiac Tamponade Which Require Transfusion

Cardiac tamponade is a life-threatening complication of pericarditis and pericardiosyntesis or pericardial drainage is needed urgently. In this study, a 16 months old boy who was noticed to be pale and lethargic suddenly was presen- ted. On physical examination, he was pale, tachycardic and hypotensive with filiform pulses. His liver was enlar- ged and telecardiogram revealed cardiomegaly. Massive pericardial effusion which caused to percardial tamponade was shown an echocardiographic investigation. Hemoragic effusion was drained by pericardiosyntesis which resulted in clinical improvement. Although there is no history of trauma and chronic disease hemopericardium and cardiac tamponade should be also considered in children with acut anemia and heart failure

Keywords:

Hemopericardium, cardiac tamponade, pericardiosyntesis,

PDF

___

1. Browne GJ, Hort J, Lau KC. Pericardial effusions in a pediatric emergency department. Pediatr Emerg Care 2002; 18:285-9.
2. Troughton RW, Asher CR, Klein AL. Pericarditis. Lancet 2004; 28:717-27.
3. Tanoue Y, Fujita S, Kanaya Y, Tominaga R. Acute cardiac tamponade due to a bleeding pericardial cyst in a 3-year-old child. Ann Thorac Surg 2007; 84:282-4.
4. Spodick DH. Acute cardiac tamponade. N Engl J Med 2003; 14:684-90.
5. Milner D, Losek JD, Schiff J, Sicoli R. Pediatric pericardial tamponade presenting as altered mental status. Pediatr Emerg Care 2003; 19:35-7.
6. Ball JB, Morrison WL. Cardiac tamponade. Postgrad Med J 1997; 73:141-5.
7. Reddy PS, Curtiss EI, Uretsky BF. Spectrum of hemodynamic changes in cardiac tamponade. Am J Cardiol 1990; 66:1487-91.
8. Mazurek B, Jehle D, Martin M. Emergency department echocardiography in the diagnosis and therapy of cardiac tamponade. J Emerg Med 1991; 9:27-31.
9. Geivitz MH, Vetter VL. Cardiac emergencies. In: Fleisher GR, Ludwig S eds. Textbook of pediatric emergency medicine, ed 4. Philadelphia: Lippincott Williams&Wilkins, 2000; 686–91.
10. Imai Y, Sunagawa K, Ayusawa M, et al. A fatal case of ruptured giant coronary artery aneurysm. Eur J Pediatr 2006; 165:130-3.
11. Reeves SD. Pericardiocentesis. In: Henretig FM, King C, eds. Textbook of pediatric emergency procedures. Baltimore: Williams & Wilkins, 1997: 777-82.
12. Leeman DE, Levine MJ, Come PC. Doppler echocardiography in cardiac tamponade: exaggerated respiratory variation in transvalvular blood flow velocity integrals. J Am Coll Cardiol 1988; 11:572-8.