International Journal of Cardiovascular Sciences. 25/out/2021;34(5 Supl 1):24-31.

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

Claudio Martins de Queiroz , Juliano Cardoso , Felix Ramires , Barbara Ianni , Viviane Tiemi Hotta , Charles Mady , Paula de Cassia Buck , Ricardo Ribeiro Dias , Luciano Nastari, Fábio Fernandes

DOI: 10.36660/ijcs.20200247

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.