The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

Yıldırım, Mehmet Aykut; Ustaalioglu, Recep; Erkan, Murat; Ustaalioğlu, Bala Basak Oven; Demirbağ, Hatice; Yaşaroğlu, Murat; Doğusoy, Ilgaz; Okay, Tamer

doi:10.1532/hsf.1328

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…The patient was discharged with symptomatic treatment, but she was readmitted 1 month later with malaise, chest pain with hypothermia, and echocardiography indicated a small pericardial effusion. A single-center study involving 174 patients suggested that pericardial tissue biopsy is feasible for recurrent pericardial effusions to improve the likelihood of diagnosis in patients ( 17 ). Ultimately, this patient was diagnosed with TBP when a pericardial biopsy was performed to identify the source of the pericardial effusion, and a granuloma was found.…”

Section: Discussionmentioning

confidence: 99%

A case report and review of literature: Tuberculous pericarditis with pericardial effusion as the only clinical manifestation

Wang

Wang²,

Liu³

et al. 2022

Front. Cardiovasc. Med.

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Tuberculosis is a main cause of pericardial disease in developing countries. However, in patients with atypical clinical presentation, it can lead to misdiagnosis, missed diagnosis, and delayed treatment. In this study, we report a case of a 61-year-old woman admitted to the cardiac intensive care unit with “weakness and loss of appetite” and a large pericardial effusion shown by echocardiography. After hospitalization, a pericardiocentesis was performed, and the pericardial fluid was hemorrhagic. However, the Xpert MTB/RIF and T-SPOT tests were negative, and repeated phlegm antacid smears and culture of pericardial fluid did not reveal antacid bacilli. The patient eventually underwent thoracoscopic pericardial biopsy, which revealed extensive inflammatory cells and significant granulomas. Combined with the fact that the patient’s pericardial effusion was exudate, the patient was considered to be suspected of tuberculous pericarditis (TBP) and given empirical anti-tuberculosis treatment the patient’s symptoms improved and the final diagnosis was TBP. In this case report, it is further shown that a negative laboratory test cannot exclude tuberculosis infection. In recurrent unexplained pericardial effusions, the pericardial biopsy is feasible. In countries with a high burden of tuberculosis, empirical antituberculosis therapy may be used to treat the pericardial effusion that excludes other possible factors.

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Section: Discussionmentioning

confidence: 99%

A case report and review of literature: Tuberculous pericarditis with pericardial effusion as the only clinical manifestation

Wang

Wang²,

Liu³

et al. 2022

Front. Cardiovasc. Med.

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Pericardial Disease Associated with Malignancy

Schusler

Meyerson

2018

Curr Cardiol Rep

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Pericardiocentesis should be the first intervention but has high recurrence rates (30-60%). For patients with recurrence, repeat pericardiocentesis is indicated in those with limited expected lifespans. Extended pericardial drainage decreases recurrence to 10-20%. The addition of sclerosing agents decreases recurrence slightly but creates significant pain and can lead to pericardial constriction and therefore has fallen out of favor. Most patients with symptomatic pericardial disease have a short median survival time due to their underlying disease. In patients with a longer life expectancy, surgical drainage offers the lowest recurrence rate. Surgical approach is based on effusion location and clinical condition. Subxiphoid and thoracoscopic approaches lead to similar outcomes. Thoracotomy should be avoided as it increases morbidity without improving outcomes.

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