日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Acute pericarditis is commonly caused by viral infections. However, cardiac tamponade associated with viral pericarditis is a rare condition. This paper reports the case of a 12-year-old boy with a history of intracardiac repair for a ventricular septal defect at 11 months of age. Five days prior to admission, he presented with symptoms of gastroenteritis followed by seizures, which necessitated emergency transport to the hospital. He was in hypotensive shock, and echocardiography revealed significant pericardial effusion with right ventricular collapse. The central venous pressure (CVP) was elevated to 24 mmHg. The patient was diagnosed with low cardiac output syndrome due to cardiac tamponade, and pericardial drainage was performed. The blood pressure recovered promptly, and the CVP decreased to 13 mmHg. Loxoprofen and diuretics were initiated, and no reaccumulation of pericardial effusion was observed. The patient was discharged on the 14th day of hospitalization. Serological tests revealed that the Coxsackievirus A2 (CoxA2) antibody titer was 1:32 at admission, and increased to 1:128 three weeks later (a fourfold increase), confirming the diagnosis of acute CoxA2 pericarditis. To our knowledge, this is the first case report of acute CoxA2 pericarditis.