Abstract
PURPOSE: To examine whether the size of the effusion, the presence of tamponade, and
inflammatory signs are useful in determining the causes of moderate or severe pericardial
effusions.
SUBJECTS AND METHODS: All echocardiograms performed at a general hospital between
January 1990 and April 1996 were screened for pericardial effusion. Patients with
moderate (echo-free space of 10 to 20 mm during diastole) or severe (echo-free space
>20 mm) effusions were studied.
RESULTS: We identified 322 patients (166 [52%] men, mean [± SD] age 56 ± 17 years
[range 15 to 88 years]), 132 (41%) with moderate and 190 (59%) with severe pericardial
effusion. The most frequent etiologic diagnoses were acute idiopathic pericarditis
(n = 66 [20%]), iatrogenic effusions (n = 50 [16%]), cancer (n = 43 [13%]), and chronic
idiopathic pericardial effusion (n = 29 [9%]). In 192 (60%) of the patients, the cause
of the effusion was a known medical condition. In the 130 other patients, inflammatory
signs were associated with acute idiopathic pericarditis (likelihood ratio = 5.4,
P < 0.001), severe effusions without inflammatory signs or tamponade were associated
with chronic idiopathic pericardial effusion (likelihood ratio = 20, P < 0.001), and tamponade without inflammatory signs was associated with malignant
effusions (likelihood ratio = 2.9, P < 0.01).
CONCLUSIONS: In many patients, pericardial effusions are due to a known underlying
disease or condition. In patients without underlying diseases, inflammatory signs,
the size of effusion, and the presence or absence of cardiac tamponade can be helpful
in establishing cause.
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Article Info
Publication History
Published online: August 16, 2004
Accepted:
April 25,
2000
Received in revised form:
April 25,
2000
Received:
August 23,
1999
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
