Etiology, diagnosis and management of severe pericardial effusion: A single center experience
Journal Title: Dicle Tıp Dergisi - Year 2014, Vol 41, Issue 4
Abstract
Objective: To show etiology, diagnostic methods, and treatment options of patients with severe pericardial effusion determined after echocardiography. Methods: In this study, we retrospectively analyzed etiology, diagnosis and treatment options of 43 patients with severe pericardial effusions (i.e. effusions more than 20 mm either in front of the right ventricle or posterior to left ventricle as assessed by transthoracic echocardiography). The pericardiocentesis procedures were performed via subxiphoid approach. Glucose, protein, lactate dehydrogenase levels, polymerase chain reaction for tuberculosis, cytological, microbiological examinations and cultures were obtained from pericardial fluid. Results: Cardiac tamponade was diagnosed in 23 patients (54%) and pericardiocentesis was immediately performed in these cases. Twenty patients who were unresponsive to empirical treatment, underwent pericardiocentesis to evaluate etiology and treatment.. Pericardial fluid was found to be exudate in 36 patients (83.7%) and transudate in 7 patients (16.2%). The most common causes were malignancy (26%), and uremia (16%) while idiopathic cases constituted 23% of the patient group. While malignant pericardial effusion was more common in males, idiopathic etiology and uremia were more common in female patients. Conclusion: Pericardiocentesis is the gold standard for clarifying the etiology and is also a lifesaving measure for cardiac tamponade. Delineating the specific etiology is particularly important for cases that do not respond to empirical treatment. A thorough history and physical examination, together with pericardiocentesis in selected cases will enable the accurate diagnosis of specific etiology and starting the treatment for this etiology. Key words: Pericardiocentesis, echocardiography, effusion
Authors and Affiliations
Mehmet Aytürk, Ahmet Ertem, Mustafa Duran, Selçuk Özkan, Hamza Sunman, Harun Kılıç, Ekrem Yeter
Keywords
Related Articles
- EP ID EP116459
- DOI 10.5798/diclemedj.0921.2014.04.0489
- Views 140
- Downloads 0
Meme kanseri dalak metastazına bağlı gelişen hipersplenizme yaklaşım: Olgu sunumu
Meme kanserinin en sık metastaz bölgeleri kemikler, akciğerler, karaciğer, lenf nodları ve beyindir. Meme kanserinin dalağa metastazı ise çok nadirdir. Hipersplenizm, karsinomalarda ciddi hemolitik aneminin bir nedeni...
Konjenital sağ ve sol koroner arter kaynaklı koroner-pulmoner arter fistülü
Koroner arter fistülü (CAF) , 50 000 canlı doğumda 1 görülen, nadir konjenital anomalidir. Fistül, vakaların %53 oranında sağ koroner arterde, %42 oranında sol koroner arterde ve %5 oranında iki koroner arterde gör...
Herediter anjioödemli hastanın anestezi yönetimi
Herediter anjioödem C1 esteraz inhibitör eksikliğine bağlı olarak gelişen otozomal dominant geçiş gösteren nadir bir hastalıktır. Herediter anjioödemli hastalar klinik olarak yüz, gövde, solunum yolları, abdominal organ...
Mean trombosit volume as a diagnostic indicator in hydatid disease
Objective: Since unilocular hydatid is an infectious disease, it progresses with inflammation. In our study we aimed to search if mean trombosit volume (MPV) which its results were known for inflammatory, the number o...
In-vitro susceptibility of methicillin-resistant Staphylococcus aureus strains to antibiotics
Objectives: Methicillin resistance of S.aureus strains sourced from hospitals and community-acquired has been increasing. The aim of this cross-sectional study is to determine the resistance rates to alternative antibiot...