Cardiac tamponade in Taiwan

We retrospectively reviewed all of the patients who were treated for cardiac tamponade at Linkou Chang Gung Memorial Hospital between January 1991 and December 1995. There were a total of 112 patients (57 males, 55 females) with a mean age of 51 +/- 14 years (53 +/- 15, 49 +/- 13, respectively). Dyspnea was the most common complaint (85%). The mean blood pressure was 129 +/- 24/78 +/- 17 mmHg, and only 8% had a systolic blood pressure of less than 90 mmHg. Sinus tachycardia was the most frequent electrocardiographic finding (72%, 62/86). Diffuse low voltage was noted in 35% (30/86) of the patients and electrical alternans was seen in 17% (15/86). The mean volume of pericardial effusion was 610 +/- 263 ml. Sixty-five percent of the pericardial effusions were bloody, 31% were serosanguineous, 2% were purulent and 2% were chylous. Overall, 54.5% of the patients had malignant diseases. Of the 61 patients who died, 79% had malignancies. Thirty-five (57%) of these 48 patients had lung cancer. The mean survival time from emergent pericardiocentesis was 3.4 months. In conclusion, non-traumatic cardiac tamponade had a poor prognosis because most patients had malignant etiologies. There is still no definitive treatment for recurrent malignant pericardial effusion-induced cardiac tamponade. Percutaneous pericardiocentesis as clinically required may be the most appropriate treatment, since it is questionable whether such subjects should be subjected to the unnecessary pain and suffering associated with an operative procedure, considering their short mean survival time.