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Radiation-induced pericardial disease: a case report
1Department of Medicine, University of Malaya, University Hospital, Kuala Lumpur, Malaysia.
Annals of the Academy of Medicine, Singapore
|May 1, 1995
Summary
This study presents a case of chronic pericardial effusion and cardiac tamponade, highlighting radiation as a cause. Definitive treatment involved a pleuro-pericardial window, with subtotal pericardiectomy recommended for symptomatic effusions.
Area of Science:
- Cardiology
- Oncology
- Thoracic Surgery
Background:
- Chronic pericardial effusion can lead to life-threatening cardiac tamponade.
- Radiation therapy, particularly cumulative doses around 4000 rads, is a known risk factor for developing pericardial disease.
- Pericardial disease typically manifests within 12 months of radiation exposure.
Observation:
- A case of chronic pericardial effusion causing cardiac tamponade is presented.
- The patient underwent pericardiocentesis for diagnosis and fluid drainage.
- A pleuro-pericardial window was performed as the definitive treatment.
Findings:
- Subtotal pericardiectomy is supported by evidence for symptomatic pericardial effusions.
- A window procedure is considered a temporizing measure for critically ill patients.
- Steroid therapy lacks strong evidence for efficacy in pericardial effusions and is reserved for mild, asymptomatic cases that may resolve spontaneously.
Implications:
- This case underscores the importance of considering radiation history in patients with pericardial effusion.
- The findings support current therapeutic strategies for managing symptomatic pericardial effusions.
- Further research may clarify the role of steroid therapy in specific pericardial effusion subtypes.