Those who had the PCE identified by POCUS had an average time-to-pericardiocentesis of 28.1 h compared to > 48 h with other diagnostic modalities. The average time-to-diagnosis with POCUS was 5.9 h compared to > 12 h with other imaging including departmental ECHO. 86% of people presenting had an effusion > 1 cm, and 89% were circumferential on departmental echocardiogram (ECHO) with 64% having evidence of right atrial systolic collapse and 58% with early diastolic right ventricular collapse. The most common presenting symptom was dyspnea (64%) and the average systolic blood pressure (SBP) was 120 mmHg. We extracted the rate of presenting complaints, physical exam findings, X-ray findings, ECG findings, time-to-diagnosis, and time-to-pericardiocentesis and how these were impacted by POCUS. In a retrospective chart review, we looked at all patients between 20 at a major Canadian academic hospital who had a pericardiocentesis for clinically significant PCE. The purpose of this study is to evaluate the impact of point-of-care ultrasound (POCUS) on the diagnosis and therapeutic intervention of clinically significant PCE. In extreme cases, misdiagnosis can evolve into decompensated cardiac tamponade, a life-threatening obstructive shock. Symptomatic pericardial effusion (PCE) presents with non-specific features and are often missed on the initial physical exam, chest X-ray (CXR), and electrocardiogram (ECG). Severe cases had a high chance of pericardiocentesis, but other cases were mainly managed by treatment of the underlying causes. It is more common in less than 3-year-old patients, and chronicity is rare. True pericarditis cases are not common, except in severe cases. Only 6% had persistent PE for more than 3 months.Ĭhildhood PE is mostly a result of renal failure and noninfectious causes. In total, 14.1% (n = 21) of the patients needed pericardiocentesis that increased to 78.3% (n = 18) in severe cases. Viral (7%) and bacterial (5%) pericarditis were the seventh and eighth causes however, in severe cases, renal failure (22%) and bacterial pericarditis (14%) were dominant. In total, renal failure (22%) and parapneumonic effusion were the leading etiologies. Tamponade signs were presented in 2% (n = 3) of the patients, and 80.7% (n = 121) were in a stable hemodynamic condition. Most patients presented with acute symptoms (68%) and respiratory problems, as the most common symptoms (30.6%). The median age was 3.25 years (range:\ 2 days to 18 years interquartile range: 9.5), and 50% of them were under 3 years of age.
In general, 150 out of 63,736 admitted patients (0.23% of the total pediatric admissions) were diagnosed with PE (male/female 1:1.17). The patient's demographic, clinical, and paraclinical information was extracted and analyzed using SPSS software. We retrospectively analyzed the profile of PE patients who were under 18 years old from 2015 to 2020. We reinvestigated the causes, symptoms, and management of childhood pericardial effusion (PE) and its gradual changes during recent years in a referral pediatric cardiology center in the south of Iran.
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