The Etiology and Management of Pericardial Effusion in a Tertiary Care Hospital

Abstract

Background: Pericardial effusion (PE) has diverse etiology. In developing countries tuberculosis is the frequent cause, while in developed countries postsurgical and viral etiology are most common. The gold standard method for PE etiology is pericradiocentesis. The aim of study was to determine the various etiologies of PE.

Method: It was a cross-sectional study done at Department of Paediatric Cardiology, NICVD, Karachi, Pakistan from February 2020 to July 2020. All patients presenting with significant PE or having signs of cardiac tamponade, were included in the study. Pericardial fluid obtained was sent for detailed report, culture and gram staining. Etiology of PE are divided as viral, bacterial,
tuberculous, malignant and post-operative.
Results: A total of 52 patients were enrolled in the study, who fulfilled the inclusion criteria. Patients from 1.5 months to 22 years were included in the study, among which 29 (55%) were male. Nearly all patients (47- 96%) had infectious etiology, out of these 31
(59.6%) had bacterial. Among these 9 (17.3%) had tuberculous whereas 7 (13.4%) had viral pericarditis and 3 (5.7%) had recurrent pericarditis. Patients referred for surgery due to organized PE were 9(17.3%), 1 (4%) had post pericardectomy syndrome and 2 (3.8%) patients had malignant etiology which were referred to oncology department later.

Conclusion: Bacterial infections are the most common cause of PE in our study with most significant symptom observed is dyspnea. Echocardiography-guided pericardiocentesis is a safe and effective method of draining pericardial fluid both for diagnostic and therapeutic purpose. We did not encounter any procedural complication during the study.
Keywords: Cardiac tamponade, Pericardial fluid, Pericardium, Pericardiocentesis.