Analysis of Baseline Characteristics and Etiology of Patients Admitted With Hemopericardiumanalysis of Baseline Characteristics and Etiology of Patients Admitted With Hemopericardium

Abstract

SESSION TITLE: Cardiothoracic Surgery SESSION TYPE: Original Investigation Slide PRESENTED ON: Sunday, October 29, 2017 at 01:30 PM - 03:00 PM PURPOSE: To identify the etiology and associated characteristics of patients admitted to the hospital with hemopericardium. METHODS: We conducted a retrospective study to identify all patients with a diagnosis of hemopericardium at our institution from April 2006 to April 2016. All patients with PCI were excluded. Only patients >18 years were included. Data was also collected regarding etiology of hemopericardium. Baseline patient characteristics were collected including demographics, comorbidities, ekg, chest x-ray and CT scan findings, pericardial fluid analysis, length of icu and hospital stay and in hospital death. RESULTS: A total of 70 patients were included in the study. The mean age was 65.5 (±14.6) years with 50% males. Majority were Caucasians (80%). Out of 70 patients with hemopericardium, 35 (50%) were due to procedures (placement of pacemaker, ICD, AV nodal ablation, CABG, valvular replacement/repair, and pericardiocentesis); 14 (20%) were after initiating anticoagulation; 9 (12.9%) had malignancy; 4 (5.7%) had concurrent aortic dissection; 4 (5.7%) were due to an unknown cause; 2 (2.9%) were in the setting of pericarditis; 1 (1.4%) had a connective tissue disease; and 1 (1.4%) had trauma. Majority of patients had smoking (47.1%) and alcohol use (35.7%). The main symptoms were shortness of breath (60%), chest pain (40%) and syncope (12.9%). The prominent physical sign was a SBP <90 mmHg (27.1%). Pericardiocentesis was performed in 31 patients (44.3%) and pericardiotomy in 29 (42.6%). The patients were taking aspirin (45.7%), clopidogrel (11.4%), dabigatran (2.9%), apixaban (2.9%), rivaroxaban (4.9%), LMWH (4.3%), and NSAIDs (4.8%). Overall, there was no statistical significance between the use of these medications and death. In terms of mortality 5 (7.1%) patients died. A higher percent of patients died with lung cancer (50%). Patients who died had a higher average INR and creatinine compared to patients who did not die (p=0.006 and p=0.033, respectively). CONCLUSIONS: The most prominent underlying etiology for hemopericardium is post procedure, followed by anticoagulation and then malignancy. CLINICAL IMPLICATIONS: Hemopericardium could occur due to many causes and the awareness of the underlying etiology is necessary for prompt management. The specific presenting signs and symptoms of patients with hemopericardium should be considered for diagnosis. DISCLOSURE: The following authors have nothing to disclose: Sidra Khalid, Jyothirmai Seepana, Bhavan Shah, Gaurav Kistangari, Praful Maroo No Product/Research Disclosure Information