Abstract

EVIDENCE-BASED ANSWER The presence of a small asymptomatic pericardial effusion is associated with a 20% increase in mortality at 1 year and is more common in patients with heart failure with reduced ejection fraction, diabetes mellitus, renal disease, and malignancy. Most (94%) effusions resolve or remain unchanged by 1-year follow-up evaluation (SOR: B, retrospective cohort study). Followup evaluation of a pericardial effusion should be based primarily on the size of the effusion, symptoms, and other clinical features such as known associated disease or inflammatory markers. Idiopathic effusions of less than 1 cm generally do not need follow-up (SOR: C, expert opinion).

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