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Cardiac tamponade as the initial presentation of malignancy
Chest
|July 1, 1985
Summary
Cardiac tamponade is a rare initial presentation of cancer. Malignancy was newly diagnosed in 35% of patients with cardiac tamponade, often lung cancer, with poor prognosis. Pericardial fluid cytology is recommended for all tamponade cases.
Area of Science:
- Oncology
- Cardiology
- Pathology
Background:
- Neoplastic pericardial involvement is common postmortem but rare as a cause of cardiac tamponade ante-mortem.
- Cardiac tamponade as an initial presentation of malignancy is infrequent.
Purpose of the Study:
- To investigate the incidence of malignancy as the initial diagnosis in patients presenting with cardiac tamponade.
- To evaluate the diagnostic utility of pericardial fluid cytology in identifying malignancy.
- To assess the prognosis of patients with malignancy-induced cardiac tamponade.
Main Methods:
- Retrospective analysis of 23 patients presenting with cardiac tamponade.
- Review of diagnostic procedures, including pericardial fluid cytology.
- Correlation of cytological findings with clinical presentation and outcomes.
Main Results:
- Malignancy was the initial diagnosis in 8 of 23 patients (35%).
- Lung carcinoma (7 patients) and thyroid carcinoma (1 patient) were the most common malignancies.
- The prognosis for these patients was poor, with 7 of 8 dying within a mean of 7 weeks.
- Pericardial fluid cytology diagnosed malignancy in 14 of 19 patients (74%).
Conclusions:
- Cardiac tamponade can be the first sign of an underlying malignancy.
- Early recognition of malignancy in tamponade cases is crucial for timely treatment.
- Pericardial fluid cytology should be routinely performed in all patients with cardiac tamponade, irrespective of initial suspicion of cancer.
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