Abstract
Objectives: Contribute to improving the management of cardiac tamponade in Congo. Background: Cardiac tamponade is an acute or subacute compression of the heart chambers by pericardial effusion responsible for uncertain prognosis for patients. The objective of this study is to help improve the management of patients with cardiac tamponade. Patients and Methods: We conducted a retrospective and descriptive study at the University Hospital of Brazzaville, from January 2015 to December 31, 2019. Included were all patients hospitalized for cardiac tamponade. Epidemioclinical, therapeutic and evolutionary data were analyzed. Results: An overall of 14 patients were divided into 9 men (64.2%) and 5 women (35.7%), i.e. a sex ratio of 1.8. The mean age of patients was 34.2 ± 15.1 years old (18 years to 64). The most represented comorbidity was hypertension (n = 2; 14.3%). The most frequent clinical sign was dyspnea (n = 14; 100%). The ECG showed diffuse and concordant repolarization disturbances (n = 14; 100%), sinus tachycardia (n = 13; 92.8%), microvoltage (n = 12; 85.7%). Cardiomegaly was constant (n = 14; 100%). In terms of transthoracic ultrasound, we found: diastolic compression of the right ventricle (RV) (n = 12; 85.7%), dilation of the inferior vena cava (IVC) (n = 12; 85.7%). Treatment consisted of crystalloid vascular filling in all patients, pericardial puncture (n = 7; 50%), surgical drainage (n = 12; 85.7%), anti-tuberculosis drugs (n = 11; 78, 6%), antimitotics could be administered in one case (n = 1; 7.2%). Two cases of death were recorded, i.e. 14.3%. Conclusion: Cardiac tamponade, although it is a rare condition, remains a serious pathology and difficult to manage in our context.
Highlights
Cardiac tamponade is an acute or subacute compression of the heart chambers by pericardial effusion [1]
Treatment consisted of crystalloid vascular filling in all patients, pericardial puncture (n = 7; 50%), surgical drainage (n = 12; 85.7%), anti-tuberculosis drugs (n = 11; 78, 6%), antimitotics could be administered in one case (n = 1; 7.2%)
The standard of living was low in 50% (n = 7) of the cases, medium in 43% (n = 6) of the cases and high in 7% (n = 1). 2) Medical history and comorbidities The medical history and the co-morbidities encountered were tuberculosis (28.6%), hypertension (14.3%), diabetes mellitus (7.1%), tumors (7.1%), Gougerot-Sjögren syndrome (7.1%), pericarditis (7.1%). 3) Clinical data a) Functional signs The distribution of patients according to the functional signs presented during cardiac tamponade is given in Table 1. b) General signs Table 2 gives the distribution of patients according to the general signs presented by the patients during cardiac tamponade
Summary
Cardiac tamponade is an acute or subacute compression of the heart chambers by pericardial effusion [1] It can potentially be a complication of any pericarditis [2] and be life-threatening for the patient. The management of emergency tamponade remains the same, its etiopathogenic mechanisms are numerous, requiring careful etiological research, with a view to better management and to avoid recurrence. It is with this in mind that we have carried out this present work, the general objective of which is to help improve the management of patients with cardiac tamponade
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