Iyer Venkatesh Harohalli Aswathanarayana, Sharma Deepa Mohan, Charki Siddhu, Mohanty Pankaj Kumar
Department of Neonatology, Manipal Hospital, Bangalore, Karnataka, India.
BMJ Case Rep. 2014 Dec 22;2014:bcr2014207040. doi: 10.1136/bcr-2014-207040.
Cardiac tamponade is a clinical emergency. Detection of a swinging heart rate is one of the earliest markers of large pericardial effusion, in which the four cardiac chambers are free to float in a phasic manner. We present a case of a preterm baby, one of the twins, who developed sudden onset of deterioration in the form of swinging heart rate, fluctuation in blood pressure and desaturation, requiring emergency intubation and inotropic support. Bedside functional echo was performed, which demonstrated cardiac tamponade; an immediate echocardiography-guided tap was initiated and fluid was aspirated from the pericardial space.
心脏压塞是一种临床急症。发现心率摆动是大量心包积液最早的征象之一，此时四个心腔可呈阶段性自由浮动。我们报告一例早产双胞胎婴儿，其中一个突然出现心率摆动、血压波动和血氧饱和度下降等病情恶化表现，需要紧急插管及使用血管活性药物支持治疗。进行了床边功能性超声心动图检查，结果显示为心脏压塞；随即在超声心动图引导下进行穿刺，从心包腔抽出液体。
