Abstract
In this article, we report a case of a previously healthy 11-year-old male who presented
to our university hospital with a mediastinal mass, a left and right pleural effusion,
and a small pericardial effusion of 5 mm, detected on computed tomography scan and
echocardiography. On assessment, he had all the clinical features of superior vena
cava syndrome and tamponade, including muffled heart sounds, tachycardia, and pulsus
paradoxus. The patient developed increasing respiratory distress requiring tracheal
intubation and mechanical ventilation, and despite drainage of his larger pleural
effusion, continued to experience symptoms of respiratory distress. Finally, the small
pericardial effusion was confirmed on echocardiography and drained after a clinical
diagnosis of cardiac tamponade, leading to dramatic improvement in the patient's cardiovascular
status. Curiously, on pericardiocentesis, much less fluid was obtained than expected
for his presenting symptoms and clinical course.
Keywords
Cardiac tamponade - pericardial effusion - mediastinal cancer - lymphoblastic lymphoma
- pericardiocentesis - pediatrics
