心包减压综合征：基于一名10岁男孩超声心动图检查结果对病理生理学的深入了解
Pericardial Decompression Syndrome: Insight Into Pathophysiology Based on Echocardiographic Findings in a 10-Year-Old Boy.
作者信息
Asakura Asaka, Honda Takashi, Takanashi Manabu, Mineo Eri, Hirota Eri, Yokosuka Tomoko, Shikata Fumiaki, Hirata Yoichiro, Miyaji Kagami, Ishikura Kenji
机构信息
Department of Pediatrics, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Department of Pediatrics, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
出版信息
JACC Case Rep. 2025 Jun 4;30(13):103539. doi: 10.1016/j.jaccas.2025.103539.
BACKGROUND
Pericardial decompression syndrome (PDS) is a rare but life-threatening complication that causes hemodynamic collapse after the drainage of pericardial effusion.
CASE SUMMARY
A 10-year-old boy with persistent cough and syncope presented at our hospital. An echocardiogram revealed a large pericardial effusion. Immediately after surgical pericardiostomy, the patient became slightly hypotensive. Massive tricuspid regurgitation developed, the right ventricle (RV) became enlarged, and RV dysfunction emerged. We initiated olprinone and diuretics. Hypotension recovered within the following 24 hours, and the size and function of the RV normalized within 12 days.
DISCUSSION
The RV was unable to adapt functionally and structurally to a rapid increase in preload after drainage. The detailed changes in echocardiographic findings in the present case provide novel information.
TAKE-HOME MESSAGE: Inasmuch as PDS can also develop in childhood, clinicians need to consider this potentially fatal complication when removing pericardial effusion even in pediatric patients.
背景
心包减压综合征（PDS）是一种罕见但危及生命的并发症，可在心包积液引流后导致血流动力学崩溃。
病例摘要
一名10岁男孩因持续咳嗽和晕厥前来我院就诊。超声心动图显示大量心包积液。心包切开术后，患者立即出现轻度低血压。出现大量三尖瓣反流，右心室（RV）扩大，右心室功能障碍出现。我们开始使用奥普力农和利尿剂。低血压在接下来的24小时内恢复，右心室的大小和功能在12天内恢复正常。
讨论
引流后右心室无法在功能和结构上适应前负荷的快速增加。本病例超声心动图检查结果的详细变化提供了新的信息。
要点
由于儿童也可能发生心包减压综合征，即使在儿科患者中，临床医生在清除心包积液时也需要考虑这种潜在的致命并发症。
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