Clinical clues to the causes of large pericardial effusions

Sagristà-Sauleda, Jaume; Mercé, Jordi; Permanyer-Miralda, Gaietà; Soler‐Soler, Jordi

doi:10.1016/s0002-9343(00)00459-9

Cited by 327 publications

(232 citation statements)

References 15 publications

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“…In the past 2 decades, only 5 sizeable prospective series on the etiology of pericardial effusions have been reported. Two of those series included distinct populations in which tuberculosis and human immunodeficiency virus (HIV) are common, and thus the participants are not necessarily representative of other cohorts 11, 12, 13, 14, 15…”

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confidence: 99%

Etiology and Long‐Term Outcome of Patients Undergoing Pericardiocentesis

Strobbe

Adriaenssens

Bennett

et al. 2017

JAHA

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BackgroundPericardial effusions can be caused by a variety of disorders. The frequency of the underlying diseases varies with patient population; therefore, previously reported series are not necessarily representative of other populations. Our purpose was to examine the etiology of pericardial effusions and the survival of patients requiring pericardiocentesis at a tertiary center.Methods and ResultsWe performed a retrospective observational study of 269 consecutive patients who underwent percutaneous pericardiocentesis at our university hospital between 2006 and 2016 and had prospective follow‐up for up to 10 years. The most frequent etiologies were idiopathic (26%), malignancy (25%), and iatrogenicity (20%), whereas bacterial causes were very rare. The most frequent malignancies originated from the lung (53%) or breast (18%). A new cancer was diagnosed with malignant pericardial effusion as the presenting complaint for 9% of patients, whereas the pericardium was the first metastatic site of a known malignancy in 4% of patients. Survival was significantly poorer in malignancy‐related versus non–malignancy‐related effusions (P<0.001) and in cytology‐positive versus cytology‐negative effusions in the overall cohort (P<0.001). Among cancer‐only patients, however, there was no significant difference in long‐term survival between cytology‐positive and ‐negative effusions.ConclusionsIn this contemporary tertiary‐center cohort, pericardial effusions often represent the primary instance of a new malignancy, underscoring the importance of cytological analyses of noniatrogenic effusions in patients without known cancer, as survival is significantly worse. In cancer patients, however, the presence of pericardial malignant cytology does not appear to affect outcome significantly.

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mentioning

confidence: 99%

Etiology and Long‐Term Outcome of Patients Undergoing Pericardiocentesis

Strobbe

Adriaenssens

Bennett

et al. 2017

JAHA

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“…In the largest of these studies, 37% of patients with moderate and severe effusion had cardiac tamponade. The most common diagnosis was acute idiopathic pericarditis (20% of patients) followed by iatrogenic effusion (16%), neoplastic effusion (13%), and chronic idiopathic pericardial effusion (9%) [3]. Our patient had acute inflammatory signs initially suggesting an acute inflammatory pericarditis.…”

Section: Discussionmentioning

confidence: 69%

“…Aggressive work-up including pericardial biopsy failed to reveal a specific etiology. The patient recovered with conser- Four major studies [2][3][4][5] have addressed the investigation of large pericardial effusions of unknown etiology. In the largest of these studies, 37% of patients with moderate and severe effusion had cardiac tamponade.…”

Section: Discussionmentioning

confidence: 99%

A Curious Case of Pericardiohydroptysis

Mohammad

2013

J Med Cases

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Rupture of the heart or pericardium is a rare clinical finding almost always associated with trauma to the chest. Non-traumatic pericardial rupture into the lung parenchyma and pleural space has not been reported in literature. Hence the progression or natural course is not known and the optimal management not defined. We report a case of a 65-year-old male patient with past medical history of hypertension and alcohol abuse who presented with complaints of fever, and sharp retrosternal chest pain and was found to have rupture of the pericardium into the right pleural space and lung parenchyma. The diagnosis was established with a computed tomography scan of the chest and a cardiac magnetic resonance imaging. Routine investigation and a surgical biopsy of the pericardium could not establish a cause for the pericardial rupture. He was treated as idiopathic pericarditis with improvement over time, and a repeat echocardiogram showed resolution of the pericardial effusion. More than a year after the initial presentation, the patient is stable with no complications. From the sequence of events, we presume that the productive cough which immediately preceded this diagnosis represented the coughing up of pericardial fluid (pericardiohydroptysis).

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“…Viral etiologies of pericardial effusion have been described with the most common organisms being coxsackievirus (types A and B) and echovirus in children, and cytomegalovirus, herpes viruses, and HIV in adults (15). H1N1 as a cause of pericardial effusion and cardiac tamponade is extremely rare.…”

Section: Discussionmentioning

confidence: 99%

Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

Bainey¹,

Sidhu²,

Sharma³

et al. 2016

Res Cardiovasc Med

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Introduction: The cardiac manifestations of influenza A are broad, ranging from self-limited pericarditis to fatal cardiomyopathy. The 2009 H1N1 influenza A (H1N1) strain is a rare cause of pericarditis, and its role in developing a pericardial effusion leading to tamponade has infrequently been reported. Case Presentation: We describe a case of a young female with no prior cardiovascular history who presents with a pericardial effusion and shock secondary to cardiac tamponade from pericarditis due to H1N1 influenza A. Conclusions: This case highlights the potential severity of H1N1 infections and the utility of considering cardiac tamponade in patients presenting with influenza symptoms and circulatory collapse.

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Clinical clues to the causes of large pericardial effusions

Cited by 327 publications

References 15 publications

Etiology and Long‐Term Outcome of Patients Undergoing Pericardiocentesis

Etiology and Long‐Term Outcome of Patients Undergoing Pericardiocentesis

A Curious Case of Pericardiohydroptysis

Influenza H1N1 infection leading to cardiac tamponade in a previously healthy patient: A case report

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