Pericardial Effusion and Tamponade

Argulian, Edgar; Makani, Harikrishna; Herzog, Eyal

doi:10.1007/978-3-319-06124-5_10

Cited by 4 publications

(1 citation statement)

References 32 publications

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“…Idiopathic chylopericardium was found to be secondary to congenital aberrant lymphatic channels draining into the pericardial space, and she was successfully treated with thoracic duct embolization. Overall, it is estimated that the prevalence of pericardial effusion in the general population is up to 6.5% [10]. Less than 3% of identified pericardial effusions are found to be chylopericardium, with only about half of these being idiopathic in etiology [11,12].…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Chylopericardium in a 7-Year-Old Female with Latent Tuberculosis: A Case Report and Literature Review

2024

Cardiol Res Cardiovasc Med

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Diagnosing idiopathic (primary) chylopericardium is an extensive process that involves ruling out all potential secondary causes. Pericardiocentesis and fluid analysis are essential for diagnosis and additionally offer symptomatic relief. Management of idiopathic chylopericardium necessitates pinpointing and surgically correcting the lymphatic anomaly contributing to fluid accumulation. This case describes the diagnosis and management of idiopathic chylopericardium in a previously healthy 7-yearold female. Initial diagnosis was made with chest x-ray (CXR), transthoracic echocardiogram (TTE), and computed tomography (CT), followed by pericardiocentesis and pericardial drain placement. Pericardial fluid analysis revealed high triglycerides. Additional laboratory workup was largely unremarkable except for a positive QuantiFERON-TB Gold test. While disseminated tuberculosis infection can cause pericarditis and pericardial effusion, latent infection is unlikely to result in chylopericardium. Diagnosis of abnormal lymphatic perfusion and leakage into the pericardial sac was eventually established with dynamic contrastenhanced magnetic resonance lymphangiogram (DCMRL). Non-target embolization with lip iodol administered via bilateral inguinal lymph nodes was initially performed, but chylopericardium recurred. The patient subsequently underwent selective lymphatic embolization targeting an abnormally dilated lymphatic channel in the upper mediastinum. Repeat lymphangiogram immediately after selective embolization showed continued abnormal mediastinal lymphatic perfusion through diminutive lymphatic channels, which ultimately necessitated thoracic duct embolization. The patient had diminished pericardial effusion at three weeks post-embolization. She has been monitored with serial echocardiograms, with the most recent showing only a tiny/small amount of pericardial effusion. Continuous surveillance in the coming months and years will be essential to confirm successful embolization.

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Section: Discussionmentioning

confidence: 99%