Pediatric Case Study

A Case Study of a 4 Days Infant with Cardiac Tamponed

  Cardiac tamponed occurs as a result of excessive accumulation of fluid in the pericardium, where it limits the ability of the heart to fully expand after every contraction leading to low carbon IV oxide.  Caroline, MacDonald, Burges, American Academy of Orthopaedic Surgeons, & Paramedic Association of Canada, (2010) explain that the condition occurs after fluid effusion causes a hemodynamic compromise. It mostly occurs as a result of trauma, pericarditis or tumors to the chest. Penetrating or blunt trauma may result to pericardial space bleeding which leads to abrupt blood accumulation.   

In the case study, the infant had issues with blood clotting process and on the removal of the pulmonary catheter; there was a continuous oozing of blood. The infant had an excessive mediastinal bleeding which is one of cardiac surgery complications. The condition as explained by Alameddine and Kacharava (2004) is caused by accumulation of gas, clots, fluids or blood in the pericardial space leading  to decreased ventricular filling and successive haemodynamic compromise.  According to Czer (2017), the bleeding tendency is mostly influenced by hemostatic derangements, mostly in the form of platelets dysfunction which causes excessive bleeding. Similar to the case study of the infant, a majority of patients with platelets dysfunction experience heavy bleeding during the early post-operative period. 

Surgical trauma is another cause of cardiac tamponed. According to Cappato et al. (2009), direct trauma may result from cardiac surgery, for example, a cardiac catheterization. This may cause extensive adhesions between the patient’s heart and the sternum causing excessive bleeding after surgical division. Mostly, as explained by Isselbacher, Cigarroa, and Eagle (2002), bleeding generally occur capillary ooze or leaking grafts and coagulopathy. The population which is at a higher risk is cardiac valvular surgery patients more than the bypass of coronary artery grafting. Therefore, the  four days old infant is suffering from cardiac tamponed which was caused by platelets dysfunction, cardiac surgery, removal of pulmonary catheter and

References

Alameddine, F., & Kacharava, A. (2004). Cardiac Tamopnade: Diagnosis and Treatment. HOSPITAL PHYSICIAN: CARDIOLOGY BOARD REVIEW MANUAL, 10(3). Retrieved from http://zwpuyfb.turner-white.com/pdf/brm_Card_V10P3.pdf

Cappato, R., Calkins, H., Chen, S., Davies, W., Iesaka, Y., & Kalman, J. et al. (2009). Prevalence and Causes of Fatal Outcome in Catheter Ablation of Atrial Fibrillation. Journal Of The American College Of Cardiology, 53(19), 1798-1803. http://dx.doi.org/10.1016/j.jacc.2009.02.022

Caroline, N., MacDonald, R., Burges, R., American Academy of Orthopaedic Surgeons., & Paramedic Association of Canada. (2010). Nancy Caroline’s emergency care in the streets (6th ed., pp. 27-34). Canada: Sudbury, Mass; Jones and Bartlett.

Czer, L. (2017). Mediastinal Bleeding After Cardiac Surgery: Etiologies, Diagnostic Considerations, and Blood Conservation Methods. Journal Of Cardiothoracic Anesthesia,, 3(6), 776-775.

Isselbacher, E., Cigarroa, J., & Eagle, K. (2002). Cardiac tamponade complicating proximal aortic dissection. Is pericardiocentesis harmful?. Circulation, 90(5), 2375-2378. http://dx.doi.org/10.1161/01.cir.90.5.2375