Management of cardiac tamponade in patients with malignancy

Abstract

From January 1967 through November 1983, 66 patients with a previously established diagnosis of malignancy were treated for pericardial effusion by the creation of a pericardial window. The majority of the patients had malignancies of the breast or lung, or lymphoma. There were no deaths or major complications attributable to the operative procedures. The presence of malignant pericardial effusion is usually evidence of far-advanced disease and, therefore, the prognosis is poor. Seventeen patients (26%) were alive 1 or more years postoperatively and 33 patients (50%) died within 3 months of operation. Despite the grave prognosis, it is still our belief that malignant pericardial effusion should be treated aggressively by open surgical drainage so that continuation of therapy for the primary malignancy would be possible.

Pericardial effusions in the cancer population: Prognostic factors after pericardial window and the impact of paradoxical hemodynamic instability

“…4,6,12 However, other sizable series have not encountered patients with hemodynamic instability after drainage, and some authors have questioned the existence of this entity. 7,[13][14][15][16] When reported, this phenomenon has been observed irrespective of the drainage approach, having been noted in patients undergoing subxiphoid pericardial window, window via thoracotomy, and pericardiocentesis. This phenomenon also appears to be independent of the underlying cause of the effusion, occurring in patients with malignant, infectious, and inflammatory effusions.…”

Malignant pericardial effusion in breast cancer: Terminal event or treatable complication?

“…In our study there was a low sensitivity when either examination was used individually with only two patients having both cytology and histopathology positive for metastatic disease. Creation of a pericardial window can be performed with little morbidity and is very effective in the permanent control of MPCE [4,10,11,22]. The 30-day mortality rate in our series is high.…”

“…Malignant pericardial effusion (MPCE) is a known complication of advanced malignancy [1][2][3][4][5][6][7][8][9][10][11]. In an autopsy series of patients with breast cancer, pericardial disease was found in 19% of cases and thought to be the immediate cause of death in 4% [12].…”

Metastatic Liposarcoma: A Cause of Symptomatic Acute Pericarditis

“…3 Treatment recommendations include the surgical removal of an isolated cardiac metastasis, radiation, combination chemotherapy, pericardiodesis and catheter drainage. 2 The cardiac symptoms experienced by our patient settled spontaneously, and treatment was directed at maintaining his good quality of life.…”