Cardiac tamponade in medical patients: Treatment and prognosis in the echocardiographic era

Markiewicz, W.; Borovik, R.; Ecker, S.

doi:10.1016/0883-9441(87)90168-7

Cited by 3 publications

(5 citation statements)

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“…1 Carcinomas of the lung and breast, as well as lymphoma, are the most common oncologic etiologies. 11 Previous reports [12][13][14] have demonstrated the poor prognosis of populations with these diseases, and malignant effusions are usually a marker of advanced, systemic disease. Thus, efforts to minimize hospitalization and improve quality of life in these patients should be paramount.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of malignant pericardial effusion, using weekly paclitaxel, in a patient with breast cancer

et al. 2006

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We report a case of metastatic breast cancer with pericardial effusion that was successfully treated with weekly paclitaxel. A 46-year-old woman underwent modified radical mastectomy in April 1997 and was readmitted to the hospital for dyspnea in March 2002. A diagnosis of cardiac tamponade due to breast cancer relapse was made, and the patient was treated with weekly paclitaxel (80 mg/m2) and insertion of a drainage catheter. This treatment was effective in preventing reaccumulation of the pericardial effusion until her death. The concentration of paclitaxel in the cardiac effusion was 45 ng/ml at 3 h, 15 ng/ml at 12 h, and less than 10 ng/ml at 24 h after paclitaxel infusion, indicating good transportation of the drug from the blood to the pericardial effusion. These findings suggest that weekly intravenous infusion of paclitaxel could be effective for the treatment of patients with malignant pericardial effusion.

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Section: Discussionmentioning

confidence: 99%

Successful treatment of malignant pericardial effusion, using weekly paclitaxel, in a patient with breast cancer

et al. 2006

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“…It may be performed at bedside or in the cardiac catheterization laboratory under electrocardiography or two-dimensional echocardiographic guidance. Markiewicz et al 11 and Wong et al 12 reported 83% and 32% incidences of recurrent tamponade, respectively, and a 15% rate of serious complications (1 death, 1 cardiac arrest, and 5 ventricular puncture) using this technique in medical patients. A subxiphoid pericardial window is an excellent therapeutic choice with excellent results and low morbidity.…”

Section: Discussionmentioning

confidence: 93%

“…The classic physical fi ndings are often not evident, making them less sensitive for ruling out cardiac tamponade. The electrocardiogram 2 and the chest radiographs 11 give some information to suggest the diagnosis but echocardiography is now the primary means of diagnosing cardiac tamponade and it must be performed in all cases of suspected penetrating cardiac injury.…”

Section: Discussionmentioning

confidence: 99%

Delayed Cardiac Tamponade after Penetrating Thoracic Trauma

Rendón

Danés

Castro

2004

Asian Cardiovasc Thorac Ann

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“…• Pericardial effusion may occur as a result of a variety of clinical conditions, including viral, bacterial, or fungal infections and inflammatory, postinflammatory, autoreactive, and neoplastic processes [1][2][3][4]. More common causes of pericardial effusion and tamponade include malignancy, renal failure, viral and bacterial infectious processes, radiation, aortic dissection, and hypothyroidism.…”

Section: Opinion Statementmentioning

confidence: 99%

“…For many patients with pericardial effusion and tamponade, standard percutaneous pericardial drainage with an indwelling pericardial catheter is sufficient to avoid recurrence of pericardial effusion and tamponade. • Recurrences following catheter drainage have been reported in 14% to 50% of patients with pericardial effusion and tamponade [2,[12][13][14].…”

Section: Prevention Of Fluid Reaccumulationmentioning

confidence: 99%

Pericardial effusion and tamponade

Palacios

1999

Curr Treat Options Cardio Med

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Pericardial effusion may occur as a result of a variety of clinical conditions, including viral, bacterial, or fungal infections and inflammatory, postinflammatory, autoreactive, and neoplastic processes. More common causes of pericardial effusion and tamponade include malignancy, renal failure, viral and bacterial infectious processes, radiation, aortic dissection, and hypothyroidism. It can also occur after trauma or acute myocardial infarction (as in postpericardiotomy syndrome following cardiac or thoracic surgery) or as an idiopathic pericardial effusion. Although pericardial effusion is common in patients with connective tissue disease, cardiac tamponade is rare. Among medical patients, malignant disease is the most common cause of pericardial effusion with tamponade. Table 1 shows the causes of pericardial tamponade. The effusion fluid may be serous, suppurative, hemorrhagic, or serosanguineous. The pericardial fluid can be a transudate (typically occurring in patients with congestive heart failure) or an exudate. The latter type, which contains a high concentration of proteins and fibrin, can occur with any type of pericarditis, severe infections, or malignancy. Once the diagnosis of pericardial effusion has been made, it is important to determine whether the effusion is creating significant hemodynamic compromise. Asymptomatic patients without hemodynamic compromise, even with large pericardial effusions, do not need to be treated with pericardiocentesis unless there is a need for fluid analysis for diagnostic purposes (eg, in acute bacterial pericarditis, tuberculosis, and neoplasias). The diagnosis of pericardial effusion/tamponade relies on a strong clinical suspicion and is confirmed by echocardiography or other pericardial imaging modalities. Alternatively, when the diagnosis of cardiac tamponade is made, there is a need for emergency drainage of pericardial fluid by pericardiocentesis or surgery to relieve the hemodynamic compromise. Following pericardiocentesis, it is necessary to prevent recurrence of tamponade. Intrapericardial injection of sclerosing agents, surgical pericardiotomy, and percutaneous balloon pericardial window creation are techniques used to prevent reaccumulation of pericardial fluid and recurrence of cardiac tamponade.

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Cardiac tamponade in medical patients: Treatment and prognosis in the echocardiographic era

Cited by 3 publications

References 0 publications

Successful treatment of malignant pericardial effusion, using weekly paclitaxel, in a patient with breast cancer

Successful treatment of malignant pericardial effusion, using weekly paclitaxel, in a patient with breast cancer

Delayed Cardiac Tamponade after Penetrating Thoracic Trauma

Pericardial effusion and tamponade

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