Background: Pericardial effusion is the accumulation of fluid in the pericardial space. Any infection, neoplasm, autoimmune or inflammatory process that can cause pericarditis can cause an effusion. Even cardiac surgery, congestive heart failure, blunt and penetrating trauma can cause pericardial fluid accumulation. Effusions that develop slowly can be remarkably asymptomatic, while rapidly accumulating smaller effusions can present with tamponade. Management of pericardial effusion is primarily dictated by whether tamponade is present or has a high chance of developing in the near term. Several papers both local and international described the epidemiology of pericardial effusion. This study investigated the clinical profile of patients with pericardial effusion at Philippine Heart Center in 2014.
Methods: Adult patients aged 19 y/o and above admitted at the Philippine Heart Center in 2014 with final diagnosis of pericardial effusion was included in this study. The patient's charts were retrieved and reviewed. The clinical manifestations, laboratory finding, procedure and surgical intervention done were recorded. The 2D echocardiograms of the patients were also reviewed. Data were analyzed and presented as counts and percentages.
Results: Sixty seven patients were admitted at Philippine Heart Center with a diagnosis of pericardial effusion. Majority were male (58%) and middle aged (40-65 y/o) (49%). The most common symptom on presentation is difficulty of breathing (54%) followed by palpitation (10%). Out of the 53 patients, 19 (36%) had echocardiographic evidence of cardiac tamponade and most of the effusion were quantified as large 54%. The most common etiology is idiopathic followed by tuberculous pericarditis. Forty six percent of the patients underwent pericardial drainage, tube pericardiostomy being the more common procedure (65%). The remaining 54% of the cases were managed medically.
Conclusion: The most common etiology of pericardial effusion among patient admitted in Philippine Heart Center in 2014 is idiopathic, followed by tuberculous pericarditis. The most predominant symptom was difficulty of breathing, which is typical of the disease. A number of patients presented with echocardiographic evidence of tamponade but only a few patients presented with cardiac tamponade clinically. The management of pericardial effusion was directed at the etiology and both pericardial drainage procedures and medical management were done, the latter being done more commonly.