Cardiac tamponade and severe pericardial effusion in systemic sclerosis: report of nine patients and review of the literature

Morales, Alejandro Fernández; Iniesta, N Salido; Fernández‐Codina, Andreu; Cunha, Joana Vaz de; Romero, Teresa Pérez; García, Robert Hurtado; Simeón-Aznar, Carmen Pilar; Fonollosa, Vicent; Cervera, Ricard; Espinosa, Gerard

doi:10.1111/1756-185x.12952

Cited by 30 publications

(17 citation statements)

References 64 publications

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“…Another cohort study evaluated the risk of recurrence and prognosis of malignant effusion following surgical repair or percutaneous intervention and found better outcomes following surgical interventions. Many studies have correlated cardiac tamponade with worse short and long‐term outcomes in the patients undergoing pericardiocentesis . Our results are in line with those observations as more patients with tamponade underwent pericardiocentesis than surgical interventions with higher mortality rates.…”

Section: Discussionsupporting

confidence: 91%

Temporal trends, outcomes, and predictors of mortality after pericardiocentesis in the United States

Gad

Elgendy

Mahmoud

et al. 2019

Cathet Cardio Intervent

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Background Data regarding the temporal trends, outcomes, and predictors of in‐hospital mortality after pericardiocentesis are limited. Methods The National Inpatient Sample database was used to extract hospitalizations of patients who underwent pericardiocentesis from January 2007 to September 2015. We examined the rates of in‐hospital mortality, its predictors, and the temporal trends of pericardiocentesis utilization in the United States during the study period. We also examined trends and outcomes of pericardiocentesis associated with different cardiovascular procedures. Results A total of 96,377 hospitalizations with pericardiocentesis were examined. The number of pericardiocentesis procedures performed trended up significantly between 2007 and 2015 (p trend <.001), and this increase was observed predominantly in patients with unstable conditions. In‐hospital mortality after pericardiocentesis decreased over time (14.6% in 2007 vs. 12.0% in 2015, p trend <.001), but remained higher than that after surgical pericardial intervention (13.1 vs. 8.9%, p value <.0001), predominantly attributable to a higher patient risk profile. Rates of in‐hospital mortality were not statistically different between the procedural cohort and the nonprocedural cohort, 13.5 versus 13.0%, p value = .051. After multivariable adjustment, structural heart interventions (odds ratio [OR] 2.86; 95% confidence interval [CI] 2.35–3.49), bacterial and/or infective endocarditis (OR 2.09; 95% CI 1.72–2.54) and active neoplasms (OR 1.72; 95% CI 1.6–1.85) were independently associated with increased in‐hospital mortality in pericardiocentesis patients. Conclusion In this nationwide analysis, the number of pericardiocentesis procedures increased significantly over time. Structural interventions, endocarditis, and active neoplasms were associated with increased in‐hospital mortality after pericardiocentesis.

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Section: Discussionsupporting

confidence: 91%

Temporal trends, outcomes, and predictors of mortality after pericardiocentesis in the United States

Gad

Elgendy

Mahmoud

et al. 2019

Cathet Cardio Intervent

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“…Up to 25% of patients with rheumatologic diseases were unable to receive a definitive diagnosis, while others were undiagnosed for an average of 5 to 10 years. 2 The rheumatologic disorder diagnosed in this case study, scleroderma, has a prevalence of 135 million to 184 million cases in the U.S. 3 The majority of patients are female, 4 , 5 and those particularly with scleroderma present with a complication of pericardial effusion at an average age 52.2 ± 10.8 years. 1 …”

Section: Discussionmentioning

confidence: 90%

Scleroderma as an uncommon cause of pericardial effusion: a case report

Yee

Varada

Rahimi

et al. 2022

kjm

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“…Steen et al in an early study reported that cardiac involvements, including congestive heart failure and pericardial effusion, preceded the onset of SRC by 6 months (13). In the study of Fernandez Morales et al, 12.5% of patients with severe pericardial effusion eventually developed SRC (10). The reasons for the association of such rare events are not completely understood yet.…”

Section: Discussionmentioning

confidence: 97%

Severe Pericardial Effusion Heralding Scleroderma Renal Crisis: A Case Report and the Literature Review

Daraie

Khatami

Nili

et al. 2019

Iran Red Crescent Med J

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Introduction: Both scleroderma renal crisis and severe pericardial effusion are rare and life-threatening complications of systemic sclerosis. This article describes a case of scleroderma renal crisis heralded by severe pericardial effusion. Case Presentation: The patient was a 39-year-old woman with a history of 8 years diffuse cutaneous scleroderma and extensive skin involvement who referred to Imam Khomeini Hospital Complex, Tehran, Iran, with worsening dyspnea and pleuritic chest pain. Echocardiography revealed severe pericardial effusion, which was drained by the pericardial window. Thereafter, the patient became gradually anuric and her blood pressure was uncontrolled despite maximum doses of antihypertensive agents, including captopril. The serum creatinine level was increased progressively; thus, hemodialysis started. Concomitantly, microangiopathic hemolytic anemia complicated the course of the disease, which responded to plasma exchange. Kidney biopsy revealed pieces of evidence indicating thrombotic microangiopathy. Conclusions: This case report denotes to a probable association between scleroderma the renal crisis and severe pericardial effusion. Therefore, physicians should be vigilant about the renal crisis in patients with systemic sclerosis and pericardial effusion.

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Cardiac tamponade and severe pericardial effusion in systemic sclerosis: report of nine patients and review of the literature

Abstract: Although cardiac tamponade or severe pericardial effusion is an infrequent complication in SSc patients, it can be the first manifestation of disease associated with the diffuse cutaneous subset. No specific treatment for this complication is known.

Cited by 30 publications

References 64 publications

Temporal trends, outcomes, and predictors of mortality after pericardiocentesis in the United States

Temporal trends, outcomes, and predictors of mortality after pericardiocentesis in the United States

Scleroderma as an uncommon cause of pericardial effusion: a case report

Severe Pericardial Effusion Heralding Scleroderma Renal Crisis: A Case Report and the Literature Review

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