Etiology of large pericardial effusions

Corey, G. Ralph; Campbell, P.; Trigt, Peter Van; Kenney, Richard T.; O’Connor, Christopher M.; Sheikh, Khalid H.; Kisslo, Joseph; Wall, Thomas C.

doi:10.1016/0002-9343(93)90262-n

Cited by 230 publications

(154 citation statements)

References 18 publications

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“…Apesar do quadro clínico e, atualmente, dos exames não invasivos permitirem diagnóstico acurado de derrames e constrições pericárdicas, não temos a mesma facilidade, em se tratando do diagnóstico etiológico 1 . Métodos complementares invasivos têm sido utilizados para a detecção das causas das pericardites, principalmente a biópsia pericárdica.…”

Section: Valor Da Biópsia De Pericárdio No Diagnóstico Etiológico Dasunclassified

Valor da biópsia de pericárdio no diagnóstico etiológico das pericardiopatias

Fernandes¹,

Ianni²,

Arteaga³

et al. 1998

Arq. Bras. Cardiol.

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Section: Valor Da Biópsia De Pericárdio No Diagnóstico Etiológico Dasunclassified

Valor da biópsia de pericárdio no diagnóstico etiológico das pericardiopatias

Fernandes¹,

Ianni²,

Arteaga³

et al. 1998

Arq. Bras. Cardiol.

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“…In the past 2 decades, only 5 sizeable prospective series on the etiology of pericardial effusions have been reported. Two of those series included distinct populations in which tuberculosis and human immunodeficiency virus (HIV) are common, and thus the participants are not necessarily representative of other cohorts 11, 12, 13, 14, 15…”

mentioning

confidence: 99%

Etiology and Long‐Term Outcome of Patients Undergoing Pericardiocentesis

Strobbe

Adriaenssens

Bennett

et al. 2017

JAHA

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BackgroundPericardial effusions can be caused by a variety of disorders. The frequency of the underlying diseases varies with patient population; therefore, previously reported series are not necessarily representative of other populations. Our purpose was to examine the etiology of pericardial effusions and the survival of patients requiring pericardiocentesis at a tertiary center.Methods and ResultsWe performed a retrospective observational study of 269 consecutive patients who underwent percutaneous pericardiocentesis at our university hospital between 2006 and 2016 and had prospective follow‐up for up to 10 years. The most frequent etiologies were idiopathic (26%), malignancy (25%), and iatrogenicity (20%), whereas bacterial causes were very rare. The most frequent malignancies originated from the lung (53%) or breast (18%). A new cancer was diagnosed with malignant pericardial effusion as the presenting complaint for 9% of patients, whereas the pericardium was the first metastatic site of a known malignancy in 4% of patients. Survival was significantly poorer in malignancy‐related versus non–malignancy‐related effusions (P<0.001) and in cytology‐positive versus cytology‐negative effusions in the overall cohort (P<0.001). Among cancer‐only patients, however, there was no significant difference in long‐term survival between cytology‐positive and ‐negative effusions.ConclusionsIn this contemporary tertiary‐center cohort, pericardial effusions often represent the primary instance of a new malignancy, underscoring the importance of cytological analyses of noniatrogenic effusions in patients without known cancer, as survival is significantly worse. In cancer patients, however, the presence of pericardial malignant cytology does not appear to affect outcome significantly.

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“…Advent of echocardiography has made it possible to have an accurate, noninvasive method for diagnosing the presence of pericardial effusion, but this cannot determine the pathogenesis of effusion [4] . The ECG is abnormal in virtually all cases of tubercular pericardial effusion including the present case.…”

Section: Discussionmentioning

confidence: 99%

“…Being a disease of protean manifestation, it poses a diagnostic dilemma to medical practioners even in endemic areas where clinical suspicion is high [1][2][3][4] . In many patients, an exclusive workup fails to identify the etiological agent.…”

Section: Introductionmentioning

confidence: 99%