A structured, parsimonious approach to establish the cause of moderate-to-large pericardial effusion

Area of Science:

• Cardiology
• Internal Medicine

Background:

• Pericardial effusion diagnosis requires evaluating hemodynamic impact and etiology.
• A systematic diagnostic strategy for pericardial effusion is necessary.

Purpose of the Study:

• To assess the efficacy of a structured, stepwise approach in diagnosing the cause of moderate-to-large pericardial effusion.
• To determine the diagnostic yield of noninvasive testing in this patient cohort.

Main Methods:

• Retrospective cohort study of 103 patients with moderate-to-large pericardial effusion.
• Application of a stepwise, parsimonious approach for etiological diagnosis.
• Chart review for diagnosis confirmation and data collection.

Main Results:

• The cause of pericardial effusion was identified in 68% of patients using the structured approach and noninvasive testing.
• Malignant pericardial effusion was diagnosed in 19% of cases, all with prior malignancy history or suggestive findings.
• 63% of patients underwent pericardial effusion drainage or sampling.

Conclusions:

• A structured diagnostic approach is effective for determining the cause of moderate-to-large pericardial effusion.
• This strategy aids in guiding the necessity for pericardial drainage or sampling.
• Noninvasive targeted testing is valuable in the etiological workup of pericardial effusion.