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Chronic pericardial effusion: current concepts and emerging trends
George Lazaros1, Emilia Lazarou1, Panagiotis Tsioufis1
1First Department of Cardiology, "Hippokration" Hospital, University of Athens Medical School, Athens, Greece.
Expert Review of Cardiovascular Therapy
|May 6, 2022
Summary
Pericardial effusion (PEF) management is evolving, with imaging playing a key role in diagnosis and assessing hemodynamic impact. Current evidence favors a conservative approach for large, asymptomatic effusions, emphasizing the need for further research.
Area of Science:
- Cardiology
- Internal Medicine
- Medical Imaging
Background:
- Pericardial effusion (PEF) presents a spectrum from asymptomatic cases to life-threatening cardiac tamponade.
- Effective management requires understanding its pathophysiology, epidemiology, and etiology.
Purpose of the Study:
- To review the latest evidence on pericardial effusion diagnosis, management, and outcomes.
- To highlight the role of advanced imaging in evaluating PEF and its hemodynamic effects.
- To present simplified algorithms for PEF triage and treatment.
Main Methods:
- Comprehensive literature review focusing on recent advancements.
- Emphasis on the utility of imaging modalities for PEF detection and assessment.
- Inclusion of updated management guidelines and diagnostic algorithms.
Main Results:
- Imaging significantly aids in detecting PEF, differentiating causes, and evaluating diastolic dysfunction.
- Management strategies are increasingly guided by hemodynamic impact, inflammatory markers, etiology, and effusion characteristics.
- A conservative approach is recommended for large, asymptomatic, or 'idiopathic' PEFs.
Conclusions:
- Recent data support a more conservative management strategy for certain PEFs.
- Further research is crucial for developing tailored treatments and improving patient outcomes.
- Optimizing PEF management can enhance quality of life and reduce healthcare costs.
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