Pattern of Pericardial Disease in the Asir Region of Saudi Arabia

Abstract

Pericardial disease is a significant cause of morbidity and mortality in any hospital setting. Four important clinical syndromes have been recognized, which are acute pericarditis, pericardial effusion, cardiac tamponade and pericardial constriction. The pattern of pericardial disease has been well documented in the Western literature, 1-5 which shows pericardial disease as most frequently secondary to acute myocardial infarction (most cases of transmural infarction are associated with localized pericarditis, and in about 10% of patients it is symptomatic). The second most common variety is ideopathic or viral pericarditis. Small pericardial effusions are frequently present in any case of acute pericarditis. The most common causes of large effusions are tuberculosis, malignancy, cardiac trauma, uremia and myxedema. In the West, the most frequent cause of cardiac tamponade is malignancy. In contrast, the literature published from Saudi Arabia lacks information on local experience. We therefore retrospectively studied the clinical features, laboratory investigations, management and outcome of 46 patients with pericardial disease who were admitted to hospital over a four-year period from 1993 to 1996. Patients and Methods All patients with diagnosis of pericardial disease, both primary and secondary, were included. The study was conducted in the Cardiology Unit of the Asir Central Hospital, which is a 600-bed teaching hospital in Abha, in the southern region of Saudi Arabia. Pericardial disease was diagnosed when at least two of the following criteria were present: characteristic chest pain; pericardial friction rub; serial repolarization changes on ECG; and pericardial effusion on echocardiogram. Cardiac tamponade was diagnosed when clinical