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Pericardial Effusions: Causes, Diagnosis, and Management.
Sneha Vakamudi1, Natalie Ho1, Paul C Cremer1
1Department of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
Progress in Cardiovascular Diseases
|January 8, 2017
Summary
Pericardial effusions, fluid around the heart, range from incidental findings to emergencies. Echocardiography is key for diagnosis and guiding treatment like pericardiocentesis or pericardial window procedures.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Pericardial effusion presentation varies widely, from asymptomatic to life-threatening emergencies.
- Causes are diverse, encompassing both inflammatory and non-inflammatory etiologies.
- Echocardiography is the cornerstone for diagnosing pericardial effusions.
Purpose of the Study:
- To outline the diagnostic and therapeutic strategies for patients with pericardial effusion.
- To highlight the role of echocardiography in assessing effusion severity and hemodynamic compromise.
- To differentiate management approaches based on effusion size, etiology, and presence of tamponade.
Main Methods:
- Echocardiography for effusion characterization (size, location, hemodynamic impact).
- Assessment of hemodynamic alterations including chamber collapse and respiratory inflow variations.
- Guidance of pericardiocentesis and consideration of pericardial window for malignancy.
Main Results:
- Echocardiography accurately identifies pericardial effusion and tamponade physiology.
- Pericardiocentesis is indicated for tamponade, often with echocardiographic guidance.
- Pericardial window is preferred for malignant effusions due to recurrence risk.
Conclusions:
- Prompt echocardiographic evaluation is crucial for suspected pericardial effusion.
- Management strategies are tailored to effusion characteristics and hemodynamic status.
- Timely intervention, including pericardiocentesis or pericardial window, improves patient outcomes.
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