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Arch Dis Child Educ Pract Ed. 2019 Feb 1. pii: edpract-2018-316156. doi: 10.1136/archdischild-2018-316156. [Epub ahead of print]

Child presenting with breathlessness 1 month after cardiac surgery.

Author information

1
Cardiology Service, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo' - Trieste, Trieste, Italy.
2
School of Medicine, University of Trieste, Trieste, Italy.
3
Pediatric Emergency Department, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo' - Trieste, Trieste, Italy.

Abstract

1. What is your diagnosis?Atelectasis.Pneumothorax.Right pleural effusion.Pneumonia. 2. Considering the result of the chest X-ray and the clinical conditions, which treatment is required for this patient?Antibiotic treatment.Video-assisted thoracoscopy.Urgent thoracentesis.Medical treatment with diuretics and antibiotic. 3. Which additional investigations should be carried out?Lung and heart MRI scan.Cardiac evaluation with echocardiogram.Pulmonary CT.Bronchoscopy with bronchoalveolar lavage. 4. Which is the most likely cause of the pleural effusion?Heart failure.Pulmonary infection.A+B.Damage to the thoracic duct. Answers can be found on page 2.

KEYWORDS:

cardiac surgery; cardiology

Conflict of interest statement

Competing interests: None declared.

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