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Diagnosis and management of chronic pericardial effusions
N Karam1, P Patel, C deFilippi
1Division of Cardiology, the University of North Carolina, Chapel Hill, USA.
Insights
Managing chronic pericardial effusions presents challenges. This review covers diagnosis and effective treatments like pericardiocentesis with sclerosing agents, radiation, and pericardiotomy for malignant effusions.
Area of Science:
- Cardiology
- Thoracic Surgery
Background:
- Chronic pericardial effusions cause significant morbidity.
- Acute effusions (tamponade) are treated with pericardiocentesis.
- Long-term management of chronic effusions is complex.
Observation:
- This review focuses on chronic symptomatic pericardial effusions.
- Malignant pericardial effusions are emphasized.
- Various diagnostic and treatment modalities are discussed.
Findings:
- Pericardiocentesis with sclerosing agents is effective.
- Radiation therapy offers a treatment option.
- Percutaneous and surgical pericardiotomy are efficacious.
Implications:
- Tailoring treatment to the underlying cause and patient prognosis is crucial.
- Improved management strategies can reduce morbidity.
- This review provides insights for clinical practice.
Abstract:
Chronic pericardial effusions are a major cause of morbidity in some clinical settings. Although the treatment of choice for acute symptomatic pericardial effusions (tamponade) is pericardiocentesis, the long-term management of symptomatic chronic pericardial effusions provides a greater challenge. The aim of this review is to provide insight into the presentation,diagnosis, and different treatment options available to patients with chronic symptomatic pericardial effusions,with emphasis on malignant pericardial effusions. Peri-cardiocentesis with sclerosing agents, radiation therapy,percutaneous, and surgical pericardiotomy and other surgical techniques are particularly efficacious, depend-ing on the underlying cause and the patient's prognosis.