Pericardial Effusion and Cardiac Tamponade: Etiology and Evolution in the Contemporary Era

• Main Author: Queiroz,Claudio Martins de
• Publication Date: 2021
• Other Authors: Cardoso,Juliano, Ramires,Felix, Ianni,Barbara, Hotta,Viviane Tiemi, Mady,Charles, Buck,Paula de Cassia, Dias,Ricardo Ribeiro, Nastari,Luciano, Fernandes,Fábio
• Format: Article
• Language: eng
• Source: International Journal of Cardiovascular Sciences (Online)
• Download full: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472021000600024
• topic: Pericardium; Pericarditis; Cardiac Tamponade/therapy; Pericardial Effusion/therapy

Abstract Background: Pericardial effusion is a relatively common finding and can progress to cardiac tamponade; etiological diagnosis is important for guiding treatment decisions. With advances in medicine and improvement in the social context, the most frequent etiological causes have changed. Objectives: To evaluate the clinical and laboratory characteristics, etiology, and clinical course of patients with pericardial effusion and cardiac tamponade. Materials and methods: Patients with pericardial effusion classified as small (< 10 mm), moderate (between 10-20 mm), or severe (> 20 mm) were included. Data from the clinical history, physical examination, laboratory tests, and complementary tests were evaluated in patients with pericardial effusion and cardiac tamponade. The significance level was set at 5%. Results: A total of 254 patients with a mean age of 53.09 ± 17.9 years were evaluated, 51.2% of whom were female. A total of 40.4% had significant pericardial effusion (> 20 mm). Pericardial tamponade occurred in 44.1% of patients. Among pericardial effusion patients without tamponade, the most frequent etiologies were: idiopathic (44.4%) and postsurgical (17.6%), while among those with tamponade, the most frequent etiologies were postsurgical (21.4%) and postprocedural (19.6%). The mean follow-up time was 2.2 years. Mortality was 42% and 23.2 in those with and without tamponade, respectively (p=0.001). Conclusions: There is an etiological difference between pericardial effusion patients with and without cardiac tamponade. An idiopathic etiology is more common among those without tamponade, while postinterventional/postsurgical is more common among those with tamponade. The tamponade group had a higher mortality rate.