Perikardiosentesis Ekokardiografi pada Tamponade Jantung dan Suspek Hipertensi Pulmonal: Langkah-Langkah Prosedur dan Komplikasinya
DOI:
https://doi.org/10.55175/cdk.v50i3.663Kata Kunci:
Efusi perikardium, ekokardiografi, hipertensi pulmonal, perikardiosentesis, tamponade jantungAbstrak
Tamponade jantung merupakan kondisi emergensi yang disebabkan oleh peningkatan tekanan intraperikardium karena akumulasi cairan pericardium, sehingga terjadi kompresi ruang-ruang jantung, mengakibatkan curah jantung menurun. Terapi definitif tamponade jantung adalah perikardiosentesis, dapat dilakukan dengan bantuan ekokardiografi. Keberhasilan perikardiosentesis ekokardiografi mencapai >95%, namun juga memiliki risiko tinggi hingga beberapa komplikasi. Kasus seorang perempuan 17 tahun dengan SLE dan tamponade jantung datang dengan instabilitas hemodinamik. Perikardiosentesis ekokardiografi berhasil dilakukan. Laporan ini disertai langkah-langkah prosedur perikardiosentesis ekokardiografi dan pembahasan komorbiditas hipertensi pulmonal dan komplikasinya.
Cardiac tamponade is an emergency condition caused by intrapericardial pressure increase due to pericardial fluid accumulationresulting in compressed cardiac chambers and reduced cardiac output. Definitive therapy is pericardiocentesis, which could be done with the guidance of echocardiography. Echocardiography-guided pericardiocentesis procedure has a>95% success rate, but it carries some potential high risks and several complications. The case is a 17-year-old SLE female patient presenting with cardiac tamponade and hemodynamic instability. Echocardiography-guided pericardiocentesis was successfully done. This case report is supplemented by a step-by-step procedure and discussion on possible pulmonary hypertension comorbidities and their complications.
Unduhan
Referensi
Jung HO. Pericardial effusion and pericardiocentesis: Role of echocardiography. Korean Circulation J. 2012;42(11):725.
Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015;36(42):2921–64.
Maggiolini S, De Carlini CC, Imazio M. Evolution of the pericardiocentesis technique. J Cardiovascular Med. 2018;19(6):267–73.
Stawicki SP, Kumar R, Sinha A, Lin MJ, Uchino R, Butryn T, et al. Complications of pericardiocentesis: A clinical synopsis. Internati J Crit Illness Injury Sci. 2015;5(3):206.
Ainsworth CD, Salehian O. Echo-guided pericardiocentesis. Circulation 2011;123(4):201-11.
Zurwida, Gani A. Diagnosis dan manajemen kegawatdaruratan efusi perikardium dengan tamponade jantung akut. J Ked N Med. 2019;2(3):17-27.
Low QJ, Teo KZ, Thien LK, Lim TH, Cheo SW. Cardiac tamponade: Experience from a Malaysian district hospital. J Royal Coll Physicians of Edinburgh 2020;50(4):387–91.
Gedikli Ö. The cause and clinical symptoms of cardiac tamponade and outcomes of pericardiocentesis in the Black Sea region of Turkey. Eurasian J Med Investig. 2021;5(1):27-32.
Pérez-Casares A, Cesar S, Brunet-Garcia L, Sanchez-de-Toledo J. Echocardiographic evaluation of pericardial effusion and cardiac tamponade. Frontiers in Pediatrics 2017;5:79. doi: 10.3389/fped.2017.00079.
De Carlini CC, Maggiolini S. Pericardiocentesis in cardiac tamponade: Indications and practical aspects. Eur Soc Cardiology [Internet]. 2017 [cited 2022 May 20]. Available from: https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Pericardiocentesis-in-cardiac-tamponade-indications-and-practical-aspects
Peter O, Andrew B. Cardiac tamponade. Anaesthesia tutorial of the week 283 St. George’s Hospital. WFSA Resource Library [Internet]. 2020 [cited 2022 May 20]. Available from: https://resources.wfsahq.org/atotw/cardiac-tamponade-anaesthesia-tutorial-of-the-week-283/
Blanco P, Figueroa L, Menéndez MF, Berrueta B. Pericardiocentesis: Ultrasound guidance is essential. Ultrasound J. 2022;14(1):9. doi: 10.1186/s13089-022-00259-5.
Loukas M, Walters A, Boon JM, Welch TP, Meiring JH, Abrahams PH. Pericardiocentesis: A clinical anatomy review. Clin Anat. 2012;25(7):872–81.
Ozer HO, Davutoglu V, Cakici M, Dogan A, Sari I, Oylumlu M, et al. Echocardiography-guided pericardiocentesis with the apical approach. Arch Turk Soc Cardiol 2009;37(3):177-81
Sahay S, Tonelli AR. Pericardial effusion in pulmonary arterial hypertension. Pulmonary Circulation 2013;3(3):467–77.
Adams JR, Tonelli AR, Rokadia HK, Duggal A. Cardiac tamponade in severe pulmonary hypertension. A therapeutic challenge revisited. Anne Amer Thoracic Soc. 2015;12(3):455–60.
Xia YK, Tu SH, Hu YH, Wang Y, Chen Z, Day HT, et al. Pulmonary hypertension in systemic lupus erythematosus: A systematic review and analysis of 642 cases in Chinese population. Rheumatol Internat. 2012;33(5):1211–7.
Chen HA, Hsu TC, Yang SC, Weng CT, Wu CH, Sun CY, et al. Incidence and survival impact of pulmonary arterial hypertension among patients with systemic lupus erythematosus: A nationwide cohort study. Arthritis Res Ther. 2019;21(1):82. doi: 10.1186/s13075-019-1868-0.
Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2015;37(1):67–119.
Imazio M. Pericardial decompression syndrome: A rare but potentially fatal complication of pericardial drainage to be recognized and prevented. Eur Heart J: Acute Cardiovascular Care 2014;4(2):121–3.
Prabhakar Y, Goyal A, Khalid N, Sharma N, Nayyar R, Spodick DH, et al. Pericardial decompression syndrome: A comprehensive review. World J Cardiol. 2019;11(12):282–91.
Perez S, Amastha J, Vincent L, Alfonso C, Ede M. Severe right ventricular failure following pericardiocentesis: A case report of pericardial decompression syndrome. JACC Case Reports. 2020;3(1):58-63.
Unduhan
Diterbitkan
Cara Mengutip
Terbitan
Bagian
Lisensi
Hak Cipta (c) 2023 Cermin Dunia Kedokteran
Artikel ini berlisensi Creative Commons Attribution-NonCommercial 4.0 International License.
