CARDIAC TAMPONADE RELATED TO VIRAL RESPIRATORY INFECTION: UTILITY OF PERICARDIOSCOPY

Abstract

TYPE: Case Report TOPIC: Procedures INTRODUCTION: Recurrent pericardial effusion occur in lung cancer in 5% to 10% and in 60% of viral pericarditis. Recurrence after drainage occur in one third requiring a new pericardial puncture with better prognosis and refractory pericardial effusion a pericardiotomy pericardial cavity inspection is indicated looking for an etiological agent, obtain complete tissue, satisfactory pericardial exploration and, eventually, surgical repair of a bleeding site. CASE PRESENTATION: 42y female arrive to emergency room with cardiac tamponade a hemo pericardial tamponade was diagnoses during initial puncture refractory to treatment and puncture progressive with pleural effusion during hospital stay. The only previous symptoms that referred was a respiratory viral disease two previous weeks, first cytologic examination revel atipic cells, left thoracoscopic approach after dreinage of cavity throw the pericardial cavity ad the internal surface of the parietal pericardium the surface of the heart and the intrapericardial segments of the great vessels was done, macroscopic findigs revel pericardial thickening with a pearly appearence.the final hystopthologic and cultue report no malignant cells and no bacterial grow DISCUSSION: cardiac tamponade and pericarditis can be a manifestation of infection, connective tissue disorders, malignancy, hypothyroidism, trauma, and renal dysfunction, observed in more than half of viral pericarditis. During treatment heart failure improved with a single pericardial drainage but the inflammatory response and recurrence of the pericardial effusion may required a definitive surgical treatment CONCLUSIONS: Pericardioscopy increases the diagnostic sensitivity of surgical pericardial drainage and biopsy without increasing the specific risk, it should keep in mind when the target lesions can't be reach of more standard technique. DISCLOSURE: Nothing to declare. KEYWORD: PERICARDIOSCOPY