Study of etiological and clinical profile of pericardial effusion in a tertiary care hospital in Kosi region of Bihar, India

Abstract

Background: Pericardial effusion is one of the common diseases presenting in emergency and outpatient departments of a tertiary care center. Pericardial effusion can cause significant symptoms and diminished quality of life, but more importantly, is associated with increased risk of cardio respiratory failure, mortality and death. The etiology of pericardial effusion varies in different parts of the world and is related to the relative prevalence of different diseases. Methods: This is a retrospective where data from all the cases diagnosed with pericardial effusion in the medicine department of KMCH from July 2014 to July 2015 were included. Altogether 66 cases diagnosed with pericardial effusion were established by Echocardiograpy. Evaluation for the cause of pericardial effusion included complete blood count with ESR, Blood urea, serum creatinine, tuberculin skin test, Chest X-ray, ECG, Thyroid profile, ANA, Rheumatoid factor, CT chest / MRI and pericardiocentesis. Pericardial fluid was analysed for cells, proteins, LDH, malignant cells, ADA, PCR (for mycobacterium tuberculosis), gram staining, AFB staining and cultures. Iatrogenic (cardiac surgery, catherterization) and post-traumatic cases and age <15 years were excluded. Results: Majority of patients ware aged between 56-75 years. Thirty-five patients (53.03%) were male and 31 patients (46.96%) were female. Most common etiology of pericardial effusion was tuberculosis 27.27% followed by Idiopathic 19.69% then Uremia 16.66%, and Malignant 13.63%. The least common etiology of pericardial effusion was HIV infection 1.51%.The most common clinical feature was Tachycardia 69.69%, followed by Breathlessness 60.60% and fever was 54% of patients. Conclusions: By this study, we have observed various presenting feature for pericardial effusion are tachycardia, shortness of breath, fever, heaviness of chest, cough, chest pain etc. The important disease factor for the occurrence of pericardial effusion such as tuberculosis, idiopathic/viral, uremic, neoplastic, CCF, hypothyroidism, post MI, etc.