Pericardial effusion endangering cardiac tamponade in cases of patients suffering for malignant diseases – diagnostics and management Review article
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Abstract
Pericardial effusion endangering cardiac tamponade is a condition of high risk of life loss. In case of endangering cardiac tamponade the most important are: fast diagnosis, pericardiocentesis and drainage of the pericardial cavity. Etiology of cardiac tamponade is the same in cases of patients suffering for malignant disease and others patients – one and only difference is the proportion of etiological factors. The most problematical in clinical management are usually cases of pericarditis caused by neoplastic cells – most often in course of non-microcellular pulmonary carcinoma, mediastinal lymphomas, leukemias, esophageal cancer, breast cancer, malignant mesotheliomas, metastatic ovarian, prostate cancer or melanoma. Clinical course and increasing of symptoms are directly dependent on grade of heart’s hemodynamic incompetence caused by decrease of blood’s inflow into the heart’s cavities. Symptoms are also dependent on time during the liquid increase its’ value inside the pericardial cavity. Some patients usually don’t present the classic Beck’s triad of symptoms. Almost every single patient who is endangered cardiac tamponade presents other symptoms like: decrease of physical efficiency, static dyspnea, tachycardia and pulsus paradoxalis. Key role in diagnostics and assignment of indication for invasive intervention belongs to transthoracic echocardiography. Main and the most important procedures in most of cases of cardiac tamponade are pericardiocentesis and drainage of pericardial cavity. Evacuated liquid is a very valuable diagnostic material which can be helpful in final diagnosis’ establishment. Systemic causal treatment sometimes is added by intrapericardial infusions – in cases of neoplastic pericarditis there is a place of palliative intrapericardial administration of chemotherapeutics. Patients after the pericardiocentesis procedure should be admitted to Intensive Care Unit or Department and carefully observed.
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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