Clinical Analysis Of128Children With Pericardial Effusion

Objective:Summarize the clinical characteristics of pediatric pericardial effusion,in order to give guidelines for timely diagnosis and treatment,then reducing the misdiagnosis rate.Methods:we retrospectively reviewed128children with pericardial effusion admitted to our hospital from Jan.2003to Jun.2011,and the age,gender,region,clinical findings,auxiliary examination,etiological diagnosis, treatment, and prognosis were analyzed.Results:128cases of pediatric pericardial effusion we collected have101follow-ups(follow-up rate:78.9%).The most common symptoms include cough, dyspnea(61.7%), pleural effusion (75.0%), fatigued (59.4%),hepatomegaly,(85.2%), ascites (60.2%), facial oedema (25.8%), lower limb edema (37.5%), while pericardial chest pain or irritable,the pathognomonic features of pericardial effusion,only found in46.9%of all the cases.Paradoxus (4.7%) and pericardial friction rubs (9.4%) are rare.The pericardial effusion or cardiac tamponade signs, such as muffled heart sounds (93.7%), enlarged cardiac dullness (93.7%), jugular venous distention,hepatojugular reflex(76.6%),can be detected in most of cases.pericardial effusion may be part of systemic disease.In this series, paragonimiasis(60.2%),purulent pericarditis(14.8%), tuberculous pericarditis (8.6%) are the leading causes of pediatric pericardial effusion,and some autoimmune disease (rheumatic fever, juvenile idiopathic arthritis, postpericardiodomy syndrome) and certain endocrine diseases (hypothyroidism) also can lead pericardial effusion. The aetiological distribution of pericardial effusion in children is varied with different age. The causes of the pericardial effusion changed,the different clinical characteristics and prognosis showed.The data we collected show that people with tuberculous pericarditis conscripted most of the follow-ups who progressing into constrictive pericarditis,while purulent pericarditis and paragonimiasis take over the second and the third one respectively. Combined with clinical manifestations and assistant examinations, we can identifly the pericardial effusion early, have timely aetiological diagnosis, and further evaluate of the severity and the prognosis.Conclusion:The clinical manifestations of pericardial effusion in children are highly variable, and progressing fast. If we don’t forget the possibility of pericarditis on the process of some diseases, pay attention to heart-related signs, and have timely imaging examinations (especially echocardiography), the detection and diagnosis of pericardial effusion is not difficult.Aetiology diagnosis is still a challenge for clinician,which changes with age and region.It is essential for the diagnosis of the cause of the pericardial effusion to have analysis of pericardial fluid and tissue.The aetiology diagnosis changes,the prognosis varies.