Diagnosis and management of pericardial effusion

Table 1 Causes of pericardial effusion

Secondary to underlying known disease

Acute myocardial infarction

Cardiac surgery

Trauma

Widespread known neoplasia

Chest radiation

End-stage renal failure

Invasive cardiac procedures

Hypothyroidism

Autoimmune diseases

Without underlying known disease

Acute inflammatory pericarditis (infectious, autoimmune)

Previously unknown neoplasia

Idiopathic

Table 2 Moderate-large pericardial effusion trials

	Corey et al[26]	Colombo et al[10]	Sagristà-Sauleda et al[11]	Corey et al[27]
Effusion	> 5 mm	> 10 mm	> 10 mm	Not reported
n	57	25	322	106
Tamponade (%)	Not reported	44	37	Not reported
Idiopathic (%)	7	32	201	25
Chronic idiopathic effusion (%)	?	?	9	?
Neoplastic (%)	23	36	13	37
Uremia (%)	12	20	6	4
Iatrogenic (%)	0	0	16	0
Post-acute myocardial infarction (%)	0	8	8	0
Viral (%)	14	0	0	7
Collagen vascular disease (%)	12	0	5	5
Tuberculosis (%)	0	0	2	2
Other (%)	9	4	21	202

¹Acute idiopathic pericarditis;

²Includes 12 patients with bacterial pericardial effusion; ?: No distinction between acute idiopathic pericarditis and idiopathic chronic pericardial effusion.

Table 3 Procedures of pericardial drainage

Pericardiocentesis only

Indwelling pericardial catheter

Percutaneous ballon pericardiotomy

Subxiphoid pericardiotomy

Pleuropericardial window

Partial pericardiectomy

Wide anterior pericardiectomy