Abstract
Introduction: Pericardial effusion is one of the common cardiac problems in our part of the world and adds burden to the health and economy of the country, as it is associated with high risk of morbidity and mortality. Our objective of the study was to determine the etiological spectrum of pericardial effusion, their clinical presentations and complications and assessing the usefulness of echocardiographic features of effusion in helping to determine the etiology. Methods: A cross-sectional observational prospective study of 63 patients with diagnosis of pericardial effusion was enrolled in the study. Pericardial effusion was diagnosed by echocardiography and pericardiocentesis was done in the cardiac catheterization room. Patients were followed up 3 monthly for 1 year and reassessed clinically and by echocardiography. Results: Patients presenting with pericardial effusion belonged to the age group of 8 to 88 years. The most common etiology was tuberculosis (36.5%) followed by malignancy (19%) and idiopathic/Viral (12.6%). Among malignancies, carcinoma lung was the most common cause followed by lymphoma. Pericardiocentesis was done in 46 patients (73%) and the approach was subxiphoid. The procedure-related complications were in 4 patients (6.3%) and there was no death as a consequence of the procedure. The total mortality was 12 (19%) with in-hospital death of 6 patients (9.5%). Conclusions: The study showed tuberculosis as the most common cause of pericardial effusion in developing countries like Nepal and as a cause of cardiac tamponade in contrast to the studies from the developed world where malignancy remains the leading cause.
Highlights
Pericardial effusion is one of the common cardiac problems in our part of the world and adds burden to the health and economy of the country, as it is associated with high risk of morbidity and mortality
Our objective of the study was to determine the etiological spectrum of pericardial effusion, their clinical presentations and complications and assessing the usefulness of echocardiographic features of effusion in helping to determine the etiology
Pericardial cavity which is in between the parietal and visceral pericardium is filled with 10 - 50 cc of fluid an ultra filtrate of plasma that is produced by the visceral pericardium
Summary
Pericardial effusion is one of the common cardiac problems in our part of the world and adds burden to the health and economy of the country, as it is associated with high risk of morbidity and mortality. Patients were followed up 3 monthly for 1 year and reassessed clinically and by echocardiography. The most common etiology was tuberculosis (36.5%) followed by malignancy (19%) and idiopathic/Viral (12.6%). Conclusions: The study showed tuberculosis as the most common cause of pericardial effusion in developing countries like Nepal and as a cause of cardiac tamponade in contrast to the studies from the developed world where malignancy remains the leading cause. Pericardial effusion can develop in patients with any condition that affects the pericardium including acute pericarditis and a variety of systemic disorders. The etiology of pericardial effusion has changed over time and varies depending on geography and the population [2]
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