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Erschienen in: Current Cardiology Reports 9/2023

29.07.2023 | Pericardial Disease (AL Klein and CL Jellis, Section Editors)

Pericardial Effusion and Cardiac Tamponade Pathophysiology and New Approaches to Treatment

verfasst von: Brian D. Hoit

Erschienen in: Current Cardiology Reports | Ausgabe 9/2023

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Abstract

Purpose of Review

The objective of this manuscript is to examine up-to-date approaches to the diagnosis and treatment of pericardial effusions and cardiac tamponade.

Recent Findings

Recent recommendations from the American Society of Echocardiography and the European Society of Cardiology have improved our management of the patient with pericardial effusion and cardiac tamponade, but significant knowledge gaps remain. Novel diagnostic and triage strategies have been suggested, and recent information have improved our facility to assess the presence and size of a pericardial effusion, assess its hemodynamic impact, and determine its cause.

Summary

Despite these recent findings, there is a scarcity of evidence-based data to direct the management of pericardial effusion and cardiac tamponade. While the first-line function of echocardiography in managing these disorders is undisputed, there are increasingly niche functions for multimodality imaging.
Literatur
1.
Zurück zum Zitat • Hoit BD. Anatomy and physiology of the pericardium. Cardio Clin. 2017;35:481–90. A contemporary review of the normal anatomy and physiology of the pericardium, and the implications for pathophysiology of pericardial effusion, cardiac tamponade, and constrictive pericarditis.CrossRef • Hoit BD. Anatomy and physiology of the pericardium. Cardio Clin. 2017;35:481–90. A contemporary review of the normal anatomy and physiology of the pericardium, and the implications for pathophysiology of pericardial effusion, cardiac tamponade, and constrictive pericarditis.CrossRef
3.
Zurück zum Zitat •• Adler Y, Charron P, Imazio M, Badano L, Baron-Esquivias G, Bogaert J, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36:2921–64. An exhaustive, authoritative document offering guidelines and recommendations (most representing a consensus of experts and/or small studies, retrospective studies, and registries) for all manifestations of pericardial disease.PubMedCrossRef •• Adler Y, Charron P, Imazio M, Badano L, Baron-Esquivias G, Bogaert J, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36:2921–64. An exhaustive, authoritative document offering guidelines and recommendations (most representing a consensus of experts and/or small studies, retrospective studies, and registries) for all manifestations of pericardial disease.PubMedCrossRef
4.
Zurück zum Zitat Buoro S, Tombetti E, Ceriotti F, Simon C, Cugola D, Seghezzi M, et al. What is the normal composition of pericardial fluid? Heart. 2020:heartjnl-2020-317966. Buoro S, Tombetti E, Ceriotti F, Simon C, Cugola D, Seghezzi M, et al. What is the normal composition of pericardial fluid? Heart. 2020:heartjnl-2020-317966.
5.
Zurück zum Zitat •• Imazio M, Adler Y. Management of pericardial effusion. Eur Heart J. 2013;34:1186–97. A critical evaluation of the pathophysiology, clinical presentation diagnosis, treatment, and follow-up of pericardial effusions.PubMedCrossRef •• Imazio M, Adler Y. Management of pericardial effusion. Eur Heart J. 2013;34:1186–97. A critical evaluation of the pathophysiology, clinical presentation diagnosis, treatment, and follow-up of pericardial effusions.PubMedCrossRef
7.
Zurück zum Zitat Buckley BJR, Harrison SL, Fazio-Eynullayeva E, et al. Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients. Eur J Clin Invest. 2021;51(11):e13679.PubMedPubMedCentralCrossRef Buckley BJR, Harrison SL, Fazio-Eynullayeva E, et al. Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients. Eur J Clin Invest. 2021;51(11):e13679.PubMedPubMedCentralCrossRef
8.
Zurück zum Zitat Sagrista-Sauleda J, Merce J, Permanyer-Maralda G, Soler-Soler J. Clinical clues to the causes of large pericardial effusions. Am J Med. 2000;109:95–101.PubMedCrossRef Sagrista-Sauleda J, Merce J, Permanyer-Maralda G, Soler-Soler J. Clinical clues to the causes of large pericardial effusions. Am J Med. 2000;109:95–101.PubMedCrossRef
9.
Zurück zum Zitat Corey GR, Campbell PT, VanTrigt P, Kenney RT, O’Connor CM, Sheikh KH, et al. Etiology of large pericardial effusion. Am J Med. 1993;95:209–13.PubMedCrossRef Corey GR, Campbell PT, VanTrigt P, Kenney RT, O’Connor CM, Sheikh KH, et al. Etiology of large pericardial effusion. Am J Med. 1993;95:209–13.PubMedCrossRef
10.
Zurück zum Zitat Levy PY, Corey R, Berger P, Habib G, Bonnet JL, Levy S, et al. Etiologic diagnosis of 204 pericardial effusion. Medicine (Baltimore). 2003;82:385–91.PubMedCrossRef Levy PY, Corey R, Berger P, Habib G, Bonnet JL, Levy S, et al. Etiologic diagnosis of 204 pericardial effusion. Medicine (Baltimore). 2003;82:385–91.PubMedCrossRef
11.
Zurück zum Zitat • Ma W, Liu J, Chen S, Chen S, Zheng Y, Ye S, et al. Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients. Herz. 2012;37:183–7. A contemporary review of the clinical characteristics and etiologies of moderate to large pericardial effusions that required drainage. Malignancy, infection, and iatrogenic were the three leading causes.PubMedCrossRef • Ma W, Liu J, Chen S, Chen S, Zheng Y, Ye S, et al. Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients. Herz. 2012;37:183–7. A contemporary review of the clinical characteristics and etiologies of moderate to large pericardial effusions that required drainage. Malignancy, infection, and iatrogenic were the three leading causes.PubMedCrossRef
12.
Zurück zum Zitat Kuvin JT, Harati NA, Pandian NG, Bojar RM, Khabbaz KR. Postoperative cardiac tamponade in the modern surgical era. Ann Thorac Surg. 2002;74:1148–53.PubMedCrossRef Kuvin JT, Harati NA, Pandian NG, Bojar RM, Khabbaz KR. Postoperative cardiac tamponade in the modern surgical era. Ann Thorac Surg. 2002;74:1148–53.PubMedCrossRef
13.
Zurück zum Zitat •• Meurin P, LeLay-Kubas S, Pierre B, Pereira H, Pavy B, Iliou MC, et al. Colchicine for post-operative pericardial effusion. J Am Coll Cardiol. 2015;66:1198–9. A letter which describes the preliminary results of the POPE-2 study. In patients with a moderate to large pericardial effusion persisting 1 week after cardiac surgery, colchicine had no significant effect on the size of the effusion.PubMedCrossRef •• Meurin P, LeLay-Kubas S, Pierre B, Pereira H, Pavy B, Iliou MC, et al. Colchicine for post-operative pericardial effusion. J Am Coll Cardiol. 2015;66:1198–9. A letter which describes the preliminary results of the POPE-2 study. In patients with a moderate to large pericardial effusion persisting 1 week after cardiac surgery, colchicine had no significant effect on the size of the effusion.PubMedCrossRef
14.
Zurück zum Zitat Seferovic PM, Ristic AD, Imazio M, Maksimovic R, Simeunovic D, Trinchero R, et al. Management strategies in pericardial emergencies. Herz. 2006;31:891–900.PubMedCrossRef Seferovic PM, Ristic AD, Imazio M, Maksimovic R, Simeunovic D, Trinchero R, et al. Management strategies in pericardial emergencies. Herz. 2006;31:891–900.PubMedCrossRef
16.
Zurück zum Zitat Freeman GL, LeWinter MM. Pericardial adaptations during chronic cardiac dilation in dogs. Circ Res. 1984;54:294–300.PubMedCrossRef Freeman GL, LeWinter MM. Pericardial adaptations during chronic cardiac dilation in dogs. Circ Res. 1984;54:294–300.PubMedCrossRef
17.
Zurück zum Zitat •• Klein AL, Abbara S, Agler DA, Appleton CP, Asher CR, Hoit B, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013;26:965–1012. A detailed, well-illustrated expert consensus statement from the ASE offering recommendations for integrated multimodality imaging in all manifestations of pericardial disease.PubMedCrossRef •• Klein AL, Abbara S, Agler DA, Appleton CP, Asher CR, Hoit B, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013;26:965–1012. A detailed, well-illustrated expert consensus statement from the ASE offering recommendations for integrated multimodality imaging in all manifestations of pericardial disease.PubMedCrossRef
18.
Zurück zum Zitat Kim MS, Kim EK, Choi JY, Oh JK, Chang SA. Clinical utility of [18F]FDG-PET CT in pericardial disease. Curr Cardiol Rep. 2019;21(9):107.PubMedCrossRef Kim MS, Kim EK, Choi JY, Oh JK, Chang SA. Clinical utility of [18F]FDG-PET CT in pericardial disease. Curr Cardiol Rep. 2019;21(9):107.PubMedCrossRef
20.
Zurück zum Zitat Fowler NO, Gabel M. Regional cardiac tamponade: a hemodynamic study. J Am Coll Cardiol. 1985;10:164–9.CrossRef Fowler NO, Gabel M. Regional cardiac tamponade: a hemodynamic study. J Am Coll Cardiol. 1985;10:164–9.CrossRef
22.
Zurück zum Zitat Brown J, MacKinnon D, King A, Vanderbush E. Elevated arterial blood pressure in cardiac tamponade. N Engl J Med. 1992;327:463–6.PubMedCrossRef Brown J, MacKinnon D, King A, Vanderbush E. Elevated arterial blood pressure in cardiac tamponade. N Engl J Med. 1992;327:463–6.PubMedCrossRef
23.
Zurück zum Zitat Reddy PS, Curtiss EI, O’Toole JD, Shaver JA. Cardiac tamponade: hemodynamic observations in man. Circulation. 1978;58:265–72.PubMedCrossRef Reddy PS, Curtiss EI, O’Toole JD, Shaver JA. Cardiac tamponade: hemodynamic observations in man. Circulation. 1978;58:265–72.PubMedCrossRef
24.
Zurück zum Zitat Cogswell TL, Bernath GA, Raff H, Hoffmann RG, Klopfenstein HS. Total peripheral resistance during cardiac tamponade: adrenergic and angiotensin roles. Am J Physiol. 1986;251:R916–22.PubMed Cogswell TL, Bernath GA, Raff H, Hoffmann RG, Klopfenstein HS. Total peripheral resistance during cardiac tamponade: adrenergic and angiotensin roles. Am J Physiol. 1986;251:R916–22.PubMed
25.
Zurück zum Zitat Sagrista-Sauleda J, Angel J, Sambola A, Alguersuari J, Permanyer-Miralda G, Soler-Soler J. Low-pressure cardiac tamponade: clinical and hemodynamic profile. Circulation. 2006;114:945–52.PubMedCrossRef Sagrista-Sauleda J, Angel J, Sambola A, Alguersuari J, Permanyer-Miralda G, Soler-Soler J. Low-pressure cardiac tamponade: clinical and hemodynamic profile. Circulation. 2006;114:945–52.PubMedCrossRef
26.
Zurück zum Zitat • Ristic AD, Imazio M, Adler Y, Anastasakis A, Badano LP, Brucato A, et al. Triage strategy for urgent management of cardiac tamponade: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2014;35:2279–84. A proposal for a step-wise scoring system based on the etiology, clinical presentation and imaging of pericardial effusions that identifies high risk patients requiring urgent pericardiocentesis and those patients that should be transferred to hospitals specializing in pericardial disease.PubMedCrossRef • Ristic AD, Imazio M, Adler Y, Anastasakis A, Badano LP, Brucato A, et al. Triage strategy for urgent management of cardiac tamponade: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2014;35:2279–84. A proposal for a step-wise scoring system based on the etiology, clinical presentation and imaging of pericardial effusions that identifies high risk patients requiring urgent pericardiocentesis and those patients that should be transferred to hospitals specializing in pericardial disease.PubMedCrossRef
27.
Zurück zum Zitat Himelman RB, Kircher B, Rockey DC, Schiller NB. Inferior vena cava plethora with blunted respiratory response: a sensitive echocardiographic sign of cardiac tamponade. J Am Coll Cardiol. 1988;12:1470–7.PubMedCrossRef Himelman RB, Kircher B, Rockey DC, Schiller NB. Inferior vena cava plethora with blunted respiratory response: a sensitive echocardiographic sign of cardiac tamponade. J Am Coll Cardiol. 1988;12:1470–7.PubMedCrossRef
28.
Zurück zum Zitat Singh S, Wann LS, Klopfenstein HS, Hartz A, Brooks HL. Usefulness of right ventricular diastolic collapse in diagnosing cardiac tamponade and comparison to pulsus paradoxus. Am J Cardiol. 1986;57:652–6.PubMedCrossRef Singh S, Wann LS, Klopfenstein HS, Hartz A, Brooks HL. Usefulness of right ventricular diastolic collapse in diagnosing cardiac tamponade and comparison to pulsus paradoxus. Am J Cardiol. 1986;57:652–6.PubMedCrossRef
29.
Zurück zum Zitat Gillam LD, Guyer DE, Gibson TC, King ME, Marshall JE, Weyman AE. Hydrodynamic compression of the right atrium: a new echocardiographic sign of cardiac tamponade. Circulation. 1983;68:294–301.PubMedCrossRef Gillam LD, Guyer DE, Gibson TC, King ME, Marshall JE, Weyman AE. Hydrodynamic compression of the right atrium: a new echocardiographic sign of cardiac tamponade. Circulation. 1983;68:294–301.PubMedCrossRef
30.
Zurück zum Zitat Leimgruber PP, Klopfenstein HS, Wann LS, Brooks HL. The hemodynamic derangement associated with right ventricular diastolic collapse in cardiac tamponade: an experimental echocardiographic study. Circulation. 1983;68:612–20.PubMedCrossRef Leimgruber PP, Klopfenstein HS, Wann LS, Brooks HL. The hemodynamic derangement associated with right ventricular diastolic collapse in cardiac tamponade: an experimental echocardiographic study. Circulation. 1983;68:612–20.PubMedCrossRef
31.
Zurück zum Zitat Hoit BD, Gabel M, Fowler NO. Cardiac tamponade in left ventricular dysfunction. Circulation. 1990;82:1370–6.PubMedCrossRef Hoit BD, Gabel M, Fowler NO. Cardiac tamponade in left ventricular dysfunction. Circulation. 1990;82:1370–6.PubMedCrossRef
32.
Zurück zum Zitat Merce J, Sagrista-Sauleda J, Permanyer-Miralda G, Evangelista A, Soler-Soler J. Correlation between clinical and Doppler echocardiographic findings in patients with moderate and large pericardial effusion: implications for the diagnosis of cardiac tamponade. Am Heart J. 1999;138:759–64.PubMedCrossRef Merce J, Sagrista-Sauleda J, Permanyer-Miralda G, Evangelista A, Soler-Soler J. Correlation between clinical and Doppler echocardiographic findings in patients with moderate and large pericardial effusion: implications for the diagnosis of cardiac tamponade. Am Heart J. 1999;138:759–64.PubMedCrossRef
33.
Zurück zum Zitat Hoit BD, Fowler NO. Influence of acute right ventricular dysfunction on cardiac tamponade. J Am Coll Cardiol. 1991;18:1787–93.PubMedCrossRef Hoit BD, Fowler NO. Influence of acute right ventricular dysfunction on cardiac tamponade. J Am Coll Cardiol. 1991;18:1787–93.PubMedCrossRef
34.
Zurück zum Zitat Chuttani K, Tischler MD, Pandian NG, Lee RT, Mohanty PK. Diagnosis of cardiac tamponade after cardiac surgery: relative value of clinical, echocardiographic, and hemodynamic signs. Am Heart J. 1994;127:913–8.PubMedCrossRef Chuttani K, Tischler MD, Pandian NG, Lee RT, Mohanty PK. Diagnosis of cardiac tamponade after cardiac surgery: relative value of clinical, echocardiographic, and hemodynamic signs. Am Heart J. 1994;127:913–8.PubMedCrossRef
35.
Zurück zum Zitat Permanyer-Miralda G, Sagrista-Sauleda J, Soler-Soler J. Primary acute pericardial disease: a prospective series of 231 consecutive patients. Am J Cardiol. 1985;56:623–30.PubMedCrossRef Permanyer-Miralda G, Sagrista-Sauleda J, Soler-Soler J. Primary acute pericardial disease: a prospective series of 231 consecutive patients. Am J Cardiol. 1985;56:623–30.PubMedCrossRef
36.
Zurück zum Zitat Seferović PM, Ristić AD, Maksimović R, Tatic V, Ostojic M, Kanjuh V. Diagnostic value of pericardial biopsy: improvement with extensive sampling enabled by pericardioscopy. Circulation. 2003;107:978–83.PubMedCrossRef Seferović PM, Ristić AD, Maksimović R, Tatic V, Ostojic M, Kanjuh V. Diagnostic value of pericardial biopsy: improvement with extensive sampling enabled by pericardioscopy. Circulation. 2003;107:978–83.PubMedCrossRef
37.
Zurück zum Zitat Maisch B, Ristić AD, Pankuweit S. Intrapericardial treatment of autoreactive pericardial effusion with triamcinolone; the way to avoid side effects of systemic corticosteroid therapy. Eur Heart J. 2002;23:1503–8.PubMedCrossRef Maisch B, Ristić AD, Pankuweit S. Intrapericardial treatment of autoreactive pericardial effusion with triamcinolone; the way to avoid side effects of systemic corticosteroid therapy. Eur Heart J. 2002;23:1503–8.PubMedCrossRef
38.
Zurück zum Zitat Ben-Horin S, Bank I, Shinfeld A, Kachel E, Guetta V, Livneh A. Diagnostic value of the biochemical composition of pericardial effusions in patients undergoing pericardiocentesis. Am J Cardiol. 2007;99:1294–7.PubMedCrossRef Ben-Horin S, Bank I, Shinfeld A, Kachel E, Guetta V, Livneh A. Diagnostic value of the biochemical composition of pericardial effusions in patients undergoing pericardiocentesis. Am J Cardiol. 2007;99:1294–7.PubMedCrossRef
39.
Zurück zum Zitat Hoit BD. Diagnosis and management of pericardial disease. J Intensive Care Med. 2000;15(1):14–28.CrossRef Hoit BD. Diagnosis and management of pericardial disease. J Intensive Care Med. 2000;15(1):14–28.CrossRef
41.
Zurück zum Zitat Vilela EM, Ruivo C, Guerreiro CE, Silva MP, Ladeiris-Lops R, Caeiro D, et al. Computed tomography-guided pericardiocentesis: a systematic review concerning contemporary evidence and further perspectives. Ther Adv Cardiovasc. 2018;12:299–307.CrossRef Vilela EM, Ruivo C, Guerreiro CE, Silva MP, Ladeiris-Lops R, Caeiro D, et al. Computed tomography-guided pericardiocentesis: a systematic review concerning contemporary evidence and further perspectives. Ther Adv Cardiovasc. 2018;12:299–307.CrossRef
42.
Zurück zum Zitat Tsang TS, Enriquez-Sarano M, Freeman WK, Barnes ME, Sinak LJ, Gersh BJ, et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocentesis: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc. 2002;77:429–36.PubMedCrossRef Tsang TS, Enriquez-Sarano M, Freeman WK, Barnes ME, Sinak LJ, Gersh BJ, et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocentesis: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc. 2002;77:429–36.PubMedCrossRef
43.
Zurück zum Zitat Kim SR, Kim EK, Cho J, Chang SA, Park SJ, Lee SC, et al. Effect of anti-inflammatory drugs on clinical outcomes in patients with malignant pericardial effusion. J Am Coll Cardiol. 2020;76(13):1551–61.PubMedCrossRef Kim SR, Kim EK, Cho J, Chang SA, Park SJ, Lee SC, et al. Effect of anti-inflammatory drugs on clinical outcomes in patients with malignant pericardial effusion. J Am Coll Cardiol. 2020;76(13):1551–61.PubMedCrossRef
44.
Zurück zum Zitat Hoit BD. Cardiac tamponade. In: Post TW (ed) published by UpToDate, Waltham MA 4/2023. Hoit BD. Cardiac tamponade. In: Post TW (ed) published by UpToDate, Waltham MA 4/2023.
45.
Zurück zum Zitat Ziskind AA, Pearce AC, Lemmon CC, Burstein S, Gimple LW, Herrmann HC, et al. Percutaneous balloon pericardiotomy for the treatment of cardiac tamponade and large pericardial effusions: description of technique and report of the first 50 cases. J Am Coll Cardiol. 1993;21:1–5.PubMedCrossRef Ziskind AA, Pearce AC, Lemmon CC, Burstein S, Gimple LW, Herrmann HC, et al. Percutaneous balloon pericardiotomy for the treatment of cardiac tamponade and large pericardial effusions: description of technique and report of the first 50 cases. J Am Coll Cardiol. 1993;21:1–5.PubMedCrossRef
46.
Zurück zum Zitat Mitiku TY, Heidenreich PA. A small pericardial effusion is a marker of increased mortality. Am Heart J. 2011;161:152–7.PubMedCrossRef Mitiku TY, Heidenreich PA. A small pericardial effusion is a marker of increased mortality. Am Heart J. 2011;161:152–7.PubMedCrossRef
47.
Zurück zum Zitat • Frohlich GM, Keller P, Schmid F, et al. Haemodynamically irrelevant pericardial effusion is associated with increased mortality in patients with chronic heart failure. Eur Heart J 2013;34:1414–23. In this retrospective observational study of nearly 900 patients with heart failure, the presence of a hemodynamically insignificant pericardial effusion was independently associated with a ~ 2-fold hazard of death at one year. • Frohlich GM, Keller P, Schmid F, et al. Haemodynamically irrelevant pericardial effusion is associated with increased mortality in patients with chronic heart failure. Eur Heart J 2013;34:1414–23. In this retrospective observational study of nearly 900 patients with heart failure, the presence of a hemodynamically insignificant pericardial effusion was independently associated with a ~ 2-fold hazard of death at one year.
48.
Zurück zum Zitat De Filippo O, Gatti P, Rettegno S, Iannaccone M, D’Ascenzo F, Lazaros G, et al. Is pericardial effusion a negative prognostic marker? Meta-analysis of outcomes of pericardial effusion. J Cardiovasc Med (Hagerstown). 2019;20(1):39–45.PubMedCrossRef De Filippo O, Gatti P, Rettegno S, Iannaccone M, D’Ascenzo F, Lazaros G, et al. Is pericardial effusion a negative prognostic marker? Meta-analysis of outcomes of pericardial effusion. J Cardiovasc Med (Hagerstown). 2019;20(1):39–45.PubMedCrossRef
49.
Zurück zum Zitat Sagristà-Sauleda J, Angel J, Permanyer-Miralda G, Soler-Soler J. Long-term follow-up of idiopathic chronic pericardial effusion. N Engl J Med. 1999;341:2054–9.PubMedCrossRef Sagristà-Sauleda J, Angel J, Permanyer-Miralda G, Soler-Soler J. Long-term follow-up of idiopathic chronic pericardial effusion. N Engl J Med. 1999;341:2054–9.PubMedCrossRef
50.
Zurück zum Zitat • Imazio M, Lazaros G, Valenti A, De Carlini CC, Maggiolini S, Pivetta E, et al. Outcomes of idiopathic chronic large pericardial effusion. Heart. 2019;105(6):477–81. In this prospective 100 patient study of large idiopathic chronic effusions with a median of 50 months follow-up, the risk of tamponade was 2.2%/year and complete resolution of the effusions was seen in 40% of cases. Recurrence- and complications-free survival rate was better in patients treated without interventions.PubMedCrossRef • Imazio M, Lazaros G, Valenti A, De Carlini CC, Maggiolini S, Pivetta E, et al. Outcomes of idiopathic chronic large pericardial effusion. Heart. 2019;105(6):477–81. In this prospective 100 patient study of large idiopathic chronic effusions with a median of 50 months follow-up, the risk of tamponade was 2.2%/year and complete resolution of the effusions was seen in 40% of cases. Recurrence- and complications-free survival rate was better in patients treated without interventions.PubMedCrossRef
51.
Zurück zum Zitat Lazaros G, Antonopoulos AS, Lazarou E, Vlachopoulos C, Foukarakis E, Androulakis A, et al. Long-term outcome of pericardial drainage in cases of chronic, large, hemodynamically insignificant, C-reactive protein negative. Idiopathic pericardial effusions. Am J Cardiol. 2020;126:89–93.PubMedCrossRef Lazaros G, Antonopoulos AS, Lazarou E, Vlachopoulos C, Foukarakis E, Androulakis A, et al. Long-term outcome of pericardial drainage in cases of chronic, large, hemodynamically insignificant, C-reactive protein negative. Idiopathic pericardial effusions. Am J Cardiol. 2020;126:89–93.PubMedCrossRef
Metadaten
Titel
Pericardial Effusion and Cardiac Tamponade Pathophysiology and New Approaches to Treatment
verfasst von
Brian D. Hoit
Publikationsdatum
29.07.2023
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 9/2023
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-023-01920-8

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