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Etiology of large pericardial effusions
G R Corey1, P T Campbell, P Van Trigt
1Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710.
The American Journal of Medicine
|August 1, 1993
Summary
Subxiphoid pericardial biopsy with fluid drainage is effective for diagnosing large pericardial effusions. This procedure aids in identifying malignancy, infections, and other causes, improving patient diagnosis and management.
Area of Science:
- Cardiology
- Thoracic Surgery
- Diagnostic Medicine
Background:
- Large pericardial effusions require accurate diagnosis for effective management.
- Subxiphoid pericardial biopsy offers a minimally invasive approach for diagnosis and fluid drainage.
Purpose of the Study:
- To evaluate the diagnostic efficacy of subxiphoid pericardial biopsy with fluid drainage.
- To assess the effectiveness of preoperative evaluation in patients with new, large pericardial effusions.
Main Methods:
- Prospective interventional case series of 57 consecutive patients with new, large pericardial effusions.
- Comprehensive preoperative evaluation followed by subxiphoid pericardiotomy.
- Pathological examination and cultures of pericardial fluid and tissue for various pathogens.
Main Results:
- A diagnosis was achieved in 93% of patients.
- Malignancy (23%), viral infection (14%), and radiation-induced inflammation (14%) were primary diagnoses.
- Unusual infectious organisms, including cytomegalovirus and mycobacteria, were identified.
Conclusions:
- Systematic preoperative evaluation combined with subxiphoid pericardiotomy effectively diagnoses most large pericardial effusions.
- This approach can identify uncommon infectious agents in pericardial fluid and tissue.