[Important pericardial effusions: apport of echocardiography guided pericardocentensis: about 30 consecutive cases]

Western countries have good mastery of abundant pericardial effusion while in Africa this still raises some problems regarding diagnosis and therapy. The aim was to see to what extent echo guided pericardiocentesis could contribute in severe cases.

All patients with abundant pericardial effusion diagnosed by echocardiography with or without compression were considered in a prospective study. They experienced a pericardiocentesis. Some patients did undergo an additional surgical biopsy. The liquid was preliminarily submitted to chemical, bacteriological, cytological analysis. Tissues were observed through an anatomic pathology in biopsy. Heart tuberculosis was diagnosed through histology for following therapeutic testing.

Thirty consecutive patients aged 37 in average were included. The sex ratio was 3.75. Prior to draining off, 3 neoplasies (2 of lung bronchitis, 1 of cervix ), 1 leukaemia, 2 extra pericardium tuberculosis and 1 amoebic abscess were diagnosed . Clinical occurrence: the most frequent case, besides the tampon (10 cases, i.e. 30%), was isolated pericardial effusion associated or not with an alteration of the global state (13 cases, i.e. 4%). The average quantity of liquid extracted was 600c c which provoked a kind of haemorrhage in 18 cases, i.e. 60%. Tuberculosis was the major aetiology: 15 cases e i 50% out of which 4 were HIV positive. Three additional surgical biopsies were carried out. Seven patients died. CCONCLUSION In addition to its diagnostic contribution, echo guided pericardiocentesis offers an alternative to endoscopy surgery.