Page 118 - Abstract Book KONIKA 18

Cardiology

P-CAR-003
Impending Tamponade et causa Massive Pericardial Effusion and Hypothyroid
in 7-month-old Baby: A Case Report

Endarwati Nurdin, St. Aizah Lawang
Department of Pediatrics, Faculty of Medicine Universitas Hasanuddin/Dr. Wahidin Sudirohusodo Hospital,
Makassar, South Sulawesi, Indonesia

Abstract
Background Impending tamponade is a critical condition that can lead to cardiac tamponade that occurs
after sudden and/or excessive accumulation of fluid in the pericardial space. Pericardial effusion occurs
in 5-30% of patients with hypothyroidism. Echocardiography is an accurate, sensitive, and noninvasive
diagnostic tool. Management of impending tamponade is pericardiocentesis to prevent cardiac tamponade.
Objective To demonstrate an impending tamponade et causa massive pericardial effusion, the etiology, and
complication in seven-month-old female. Case A seven months old female was referred from Sawerigading
Hospital with pericardial effusion. The chief complaint was shortness of breath two days before being
hospitalized. There was a history of frequent hospitalization due to shortness of breath. There was a history
of growth faltering. From the physical examination, there was a dysmorphic face. There was a subcostal
retraction. Pulmonary auscultation revealed rales in both hemithorax, cardiovascular auscultation revealed a
systolic ejection murmur. There was non-pitting edema in the extremities. Laboratory findings within normal
limit except for thrombocytopenia and elevated TSHs. Echocardiography at dr. Wahidin hospital showed
Massive pericardial effusion (Impending Tamponade), with Atrial Septal Defect, Tricuspid regurgitation,
and pulmonary regurgitation. A Pericardiocentesis was performed. The patient received levothyroxine. After
the 18th day of hospitalization, the patient resolved and discharged. Conclusion One of the uncommon
cause of massive pericardial effusion that can lead to impending tamponade was hypothyroid. Besides
echocardiography, a Thyroid function test is needed to eliminate massive pericardial effusion caused by
hypothyroid.
Keywords: impending tamponade; pericardial effusion; hypothyroid

P-CAR-004
Case Report: Pediatric Supraventricular Tachycardia,
Management in Rural Area

Himatun Istijabah, Rosidin
Muhammadiyah Siti Aminah Bumiayu General Hospital, Brebes, Central Java, Indonesia
Abstract
Background Pediatric supraventricular tachycardia occurs in 90% cases of pediatric arrhythmias, with an
estimated incidence up to 1 in 250 children. Untreated SVT can lead into congestive heart failure. The first-line
medication for treating SVT, adenosine, is often difficult to obtain, especially in rural hospitals. Amiodarone
and digoxin are anti-arrhythmic drugs that are known to be effective for pediatric SVT treatment, and easier
to obtain in rural area. Objective To report the management of pediatric SVT in rural hospital. Case A 10
years-old girl was admitted to the emergency room of Muhammadiyah Siti Aminah Bumiayu Hospital due
to palpitations triggered by excessive activity 2 hours prior her hospital admission. There was no history of
recurrent acute respiratory infections, nor previous heart disease. The history of basic immunizations were
completed. On physical examination, the consciousness was compos mentis, blood pressure was 100/60
mmHg, heart rate was 240 beats/minute (bpm), respiratory rate was 22 breaths/minute with SpO 98%
2
and temperature was 36.7 C. Anthropometric assessment showed normal nutritional status. There were no
o
abnormalities on cardiac physical examination nor chest X-ray. Electrocardiography (ECG) result showed
SVT. Management includes oxygenation, intravenous amiodarone, and intravenous digoxin. The ECG
evaluation’s result showed a decrease in the rate to 107 bpm with conversion into sinus rhythm. Conclusion
In rural hospitals where adenosine is not available, amiodarone and digoxin may still be considered as an
effective therapy in treating pediatric SVT.
Keywords: pediatric supraventricular tachycardia; amiodarone; digoxin; rural hospital

70 KONIKA XVIII Abstract Book