Etiology of Pericardial Effusion and Outcomes Post Pericardiocentesis in the Western Region of Saudi Arabia: A Single-center Experience

Albugami, Saad; Al-Husayni, Faisal; Almalki, Abdullah; Dumyati, Mohammed Saleh; Zakri, Ysear; AlRahimi, Jamilah

doi:10.7759/cureus.6627

Cited by 13 publications

(21 citation statements)

References 13 publications

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“…Our residents’ perceptions of the applicability of FoCUS and their skills gap ( Table 2 ) are similar to those reported by Canadian IM residency programs [ 8 ]. This may be because, despite the regional differences in the epidemiology of pericardial effusion [ 14 ], for example; use of FoCUS to detect pericardial effusions is applicable worldwide. This observation suggests that international standardization of FoCUS training may be possible and that other countries’ curricula may be relevant in Saudi Arabia.…”

Section: Discussionmentioning

confidence: 99%

Focused Cardiac Ultrasound is Applicable to Internal Medicine and Critical Care but Skill Gaps Currently Limit Use

Mahmood¹,

Souleymane²,

Rajendram³

et al. 2020

Journal of the Saudi Heart Association

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Context: Coronavirus Disease 2019 (COVID-19) put a spotlight on focused cardiac ultrasound (FoCUS). However, the spectra of cardiac disease, and the resources available for investigation vary internationally. The applicability of FoCUS to internal medicine (IM) and critical care medicine (CCM) practice in Saudi Arabia and their current use of FoCUS are unknown. Aims: To determine the applicability of FoCUS to IM and CCM practice in Saudi Arabia and quantify the residents' current proficiency, accreditation and use of FoCUS. Methods: A questionnaire was distributed to the residents in IM and CCM at our institution to determine their proficiency, use of FoCUS, and perceptions of its applicability. Results: In total, 110 residents (IM 100/108; CCM 10/10) participated (Response rate 93.2%) and reported that FoCUS was very applicable to their practice, most specifically for pericardial effusion, right heart strain, and left ventricular function. Two IM residents had received postgraduate training, ten used FoCUS regularly, none were accredited and overall selfreported proficiency was poor. In contrast all CCM residents had received postgraduate training and reported regular use of FoCUS. Two were accredited. Conclusions: Whilst FoCUS is applicable to IM practice in Saudi Arabia, significant skills gaps exist. The skills gap in CCM is lower but unaccredited practice is common. Our residents' responses were similar to those from Canada. Thus, international standardization of FoCUS training could be considered.

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Section: Discussionmentioning

confidence: 99%

Focused Cardiac Ultrasound is Applicable to Internal Medicine and Critical Care but Skill Gaps Currently Limit Use

Mahmood¹,

Souleymane²,

Rajendram³

et al. 2020

Journal of the Saudi Heart Association

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“…Khan et al reported a success rate of 95.5% for echocardiography guided pericardiocentesis [6]. Albugami et al reported re-accumulation of pericardial effusion as high as 21% [7]. Rate of major complications including pneumothorax and myocardial perforation under echocardiographic or fluoroscopy-guided pericardiocentesis is reported to be 0.3 to 3.9% in observational studies [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…In the study by Khan et al, malignancy was the cause of pericardial effusion in more than 50% of the patients [ 6 ]. In another study from Saudi Arabia, in 48.7% of the patients, malignancy was the cause of the pericardial effusion [ 7 ]. Malignancies and uremia were reported to be the most common cause in the western population [ 8 , 9 ], while Turank et al reported that the most common cause of pericardial effusion is idiopathic [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Pericardiocentesis Indications and Complications: A Retrospective Observational Study in a Tertiary Care Hospital in Karachi, Pakistan

Baqi

Ahmed

2020

Cureus

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Introduction: Pericardiocentesis is crucial for the diagnosis and management of diseases responsible for significant pericardial effusions. Pericardiocentesis was performed the first time by Riolanus for cardiac tamponade. He described the process of trephination of the sternum to remove the abnormally accumulated fluid from the pericardial space. However, with the advancement of expertise in echocardiography assisted procedures, echocardiography-guided diagnostic and therapeutic pericardiocentesis is now considered standard clinical practice in the treatment of pericardial effusions. Objectives: We aim to study different causes of pericardial effusion and indications of pericardiocentesis as well as complications associated with it in our population.

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“…In cases without pre-existing cancer, malignancy must be excluded because PE may be the rst manifestation of malignancy. Some studies reported PE attributed to unknown causes at a rate of 10-20% [5,6]. It may be di cult to diagnose malignant PE even if cytology or epicardial and pericardial biopsy are performed [7].…”

Section: Introductionmentioning

confidence: 99%

Low pericardial fluid glucose concentration combined with computed tomography evaluation as a malignancy-related marker in symptomatic patients undergoing pericardiocentesis: a retrospective study

Nakamura

Okune

Yasuda

et al. 2021

Preprint

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Background: We evaluated malignancy according to the characteristics of pericardial fluid in symptomatic Japanese patients undergoing pericardiocentesis and computed tomography (CT).Methods: This was a retrospective, single-center, observational study of 125 symptomatic patients undergoing pericardiocentesis. The patients were classified into two groups: a malignancy group and a non-malignancy group, according to the primary disease and cytology of the pericardial effusion (PE). We compared the pericardial fluid sample and CT measurements between both groups.Results: All patients were diagnosed as having exudative PE by Light’s criteria. PE with malignant cells was demonstrated in 76.8% of the malignancy group patients. A ratio of pericardial to serum lactate dehydrogenase (LDH) >0.6 as one of Light’s criteria, and lower serum brain natriuretic peptide (BNP: 126.9±89.8 pg/ml vs 409.2±97.7 pg/ml, malignancy vs non-malignancy groups, respectively; p = 0.037) were associated with malignancy (both, p < 0.05). A significant difference was observed in pericardial fluid glucose level between the malignancy and non-malignancy groups (pericardial fluid glucose: 78.25±48.29 mg/dl vs 98.41±44.85, respectively; p < 0.05). Moreover, CT attenuation values (Hounsfield units (HU)) tended to be higher in the malignancy group vs the non-malignancy group (22.7 [interquartile range (IQR), 17.4–26.0] vs 17.4 [IQR, 13.7–26.4], respectively; p = 0.08). Pericardial fluid glucose level ≤70 mg/dl and CT attenuation values >20 HU were strongly associated with malignancy.Conclusions: Lower pericardial fluid glucose level with higher CT attenuation values may suggest malignancy-related PE.

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Etiology of Pericardial Effusion and Outcomes Post Pericardiocentesis in the Western Region of Saudi Arabia: A Single-center Experience

Cited by 13 publications

References 13 publications

Focused Cardiac Ultrasound is Applicable to Internal Medicine and Critical Care but Skill Gaps Currently Limit Use

Focused Cardiac Ultrasound is Applicable to Internal Medicine and Critical Care but Skill Gaps Currently Limit Use

Pericardiocentesis Indications and Complications: A Retrospective Observational Study in a Tertiary Care Hospital in Karachi, Pakistan

Low pericardial fluid glucose concentration combined with computed tomography evaluation as a malignancy-related marker in symptomatic patients undergoing pericardiocentesis: a retrospective study

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