2020, Number 3
<< Back Next >>
Cardiovasc Metab Sci 2020; 31 (3)
Severe pericardial effusion etiologies
Arango-Moreno R, Múnera-Echeverri AG, Gaviria-Aguilar MC, Mejía-Zuluaga M, Duque-González L, Duque-Ramírez M
Language: English
References: 17
Page: 71-75
PDF size: 187.36 Kb.
ABSTRACT
Introduction: The etiology of pericardial effusion is highly variable around the world. The present study describes the clinical features and etiologies of severe pericardial effusion in a series of cases treated at a third-level hospital in Medellín, Colombia.
Material and methods: Retrospective case series based on clinical records. All patients treated between 2006 and 2018 with severe pericardial effusion requiring intervention for pericardial fluid drainage were included. The exclusion criteria were the absence of more than 50% of the data in the clinical history and the recurrence of the pericardial effusion after its first drainage. Etiology, indications for pericardial drainage and patient comorbidities are described.
Results: 48 patients were included, 50% men with a mean age of 52.4 years (SD 17.5). Non-infectious etiologies were the most common causes of severe pericardial effusion (66.7%), followed by idiopathic (20.8%) and infectious causes (12.5%), being tuberculosis the most important. The main indication for pericardial drainage was to determine its etiology (58.0%) and the most relevant comorbidity was hypertension (40.0%).
Conclusions: The main causes of severe pericardial effusion were non-infectious, unlike previous reports from developing countries where infectious diseases are considered the most common. Although, the frequency of idiopathic etiology was lower than that reported in other series, it continues to be a representative number of patients in which the etiology cannot be established.
REFERENCES
Imazio M, Mayosi BM, Brucato A, Markel G, Trinchero R, Spodick DH et al. Triage and management of pericardial effusion: J Cardiovasc Med. 2010; 11 (12): 928-935.
Maisch B, Seferovic’ PM, Ristic’ AD, Erbel R, Rienmüller R, Adler Y et al. Guía de Práctica Clínica para el diagnóstico y tratamiento de las enfermedades del pericardio. Rev Esp Cardiol. 2004; 57 (11): 1090-1114.
Azarbal A, LeWinter MM. Pericardial effusion. Cardiol Clin. 2017; 35 (4): 515-524.
Retter AS. Pericardial disease in the oncology patient. Heart Dis. 2002; 4 (6): 387-391.
Figueras J, Barrabés JA, Serra V, Cortadellas J, Lidón RM, Carrizo A et al. Hospital outcome of moderate to severe pericardial effusion complicating ST-elevation acute myocardial infarction. Circulation. 2010; 122 (19): 1902-1909.
Biteker FS, Biteker M, Başaran Ö, Doğan V, Özlek B, Yıldırım B et al. A small pericardial effusion is a marker of complicated hospitalization in patients with community-acquired pneumonia. J Crit Care. 2018; 44: 294-299.
Lind A, Reinsch N, Neuhaus K, Esser S, Brockmeyer N, Potthoff A et al. Pericardial effusion of HIV-infected patients - results of a prospective multicenter cohort study in the era of antiretroviral therapy. Eur J Med Res. 2011; 16 (11): 480-483.
Tsang TSM, Enriquez-Sarano M, Freeman WK, Barnes ME, Sinak LJ, Gersh BJ et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc. 2002; 77 (5): 429-436.
Ilan Y, Oren R, Ben-Chetrit E. Etiology, treatment, and prognosis of large pericardial effusions. Chest. 1991; 100 (4): 985-987.
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: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2015; 36 (42): 2921-2964.
Ma W, Liu J, Zeng Y, Chen S, Zheng Y, Ye S et al. Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients. Herz. 2012; 37 (2): 183-187.
Levy PY, Corey R, Berger P, Habib G, Bonnet JL, Levy S et al. Etiologic diagnosis of 204 pericardial effusions. Medicine (Baltimore). 2003; 82 (6): 385-391.
Sagristà-Sauleda J, Mercé J, Permanyer-Miralda G, Soler-Soler J. Clinical clues to the causes of large pericardial effusions. Am J Med. 2000; 109 (2): 95-101.
Reuter H, Burgess LJ, Doubell AF. Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect. 2005; 133 (3): 393-399.
Wall TC, Campbell PT, O’Connor CM, Van Trigt P, Kenney RT, Sheikh KH et al. Diagnosis and management (by subxiphoid pericardiotomy) of large pericardial effusions causing cardiac tamponade. Am J Cardiol. 1992; 69 (12): 1075-1078.
Marín JE, Duque M, Uribe W, Medina E. Guías de manejo de enfermedad pericárdica y miocarditis. Rev Col Cardiol. 2005; 11 (7): 319-332.
Vakamudi S, Ho N, Cremer PC. Pericardial effusions: causes, diagnosis, and management. Prog Cardiovasc Dis. 2017; 59 (4): 380-388.