Derrame pericárdico, enfrentamiento clínico

Abstract

Pericardial effusion is the main complication of pericarditis, and can create serious consequences depending on the speed of development and etiology. The most common causes are neoplasms and idiopathic, even though viral etiology is a frequently underestimated cause because of the difficulty in its confirmation. In cases of significant pericardial effusion, pericardiocenthesis has demonstrated to be an effective and safe procedure. We present a clinical case of a 14 year old adolescent who complained of persistent abdominal pain, and whose study showed significant pericardial effusion. Pericardiocenthesis was performed, along with installation of a pigtail catheter which drained 500 ml of serohematic pericardial effusion. The etiologic study included an PCR (polymerase chain reaction) positive for Enterovirus. The patient recovered favorably and was dismissed from the hospital in good condition. The objective of this report is to expose a current revision of the clinical management of pericardial effusion and the technical skills of pericardiocenthesis. Knowledge of the technique is fundamental in the treatment of pericardial effusion, especially in situations associated with hemodynamic compromise.