Disease relevance of Pericardial Effusion

• Intrapericardial tetracycline for the management of cardiac tamponade secondary to malignant pericardial effusion [1].
• In Transkei, 143 patients with active tuberculous constrictive pericarditis without significant pericardial effusion all received the same daily 6-month antituberculosis regimen of streptomycin, isoniazid, rifampicin, and pyrazinamide for 14 weeks followed by isoniazid and rifampicin [2].
• Adenosine deaminase and carcinoembryonic antigen in pericardial effusion diagnosis, especially in suspected tuberculous pericarditis [3].
• Pericarditis has been reported to occur in from 14 to 18 per cent of the cases of procainamide-induced lupus erythematosus, and occasional reports of massive pericardial effusion, pericardial tamponade and constrictive pericarditis have appeared in the literature [4].
• Echocardiographic findings included dilated cardiomyopathy in eight patients (11%), pericardial effusions in seven patients (10%) (one with impending tamponade), pleural effusion in four patients (6%) and mediastinal mass in one patient (1%) [5].

High impact information on Pericardial Effusion

• CONCLUSIONS: Large idiopathic chronic pericardial effusion is well tolerated for long periods in most patients, but severe tamponade can develop unexpectedly at any time [6].
• Treatment of intractable uremic pericardial effusion. Avoidance of pericardiectomy with local steroid instillation [7].
• Controlled clinical trial of complete open surgical drainage and of prednisolone in treatment of tuberculous pericardial effusion in Transkei [8].
• Pericardial effusions associated with minoxidil [9].
• Hemopericardium in a patient with systemic lupus erythematosus [10].

Chemical compound and disease context of Pericardial Effusion

• Forty-five patients with uremic pericardial effusion were treated with local instillation of nonabsorbable steroid through an indwelling pericardial drainage catheter and followed up from one to 54 months [7].
• Seven patients with pericardial effusion were restudied after periods of thyroxine replacement therapy ranging from six months to two years [11].
• The reabsorption rate of pericardial effusion is slow and, in our experience, mild or moderate pericardial effusion does not preclude heparin therapy [12].
• CONCLUSION: Although bleomycin and doxycycline are equally effective sclerosing agents, bleomycin is associated with significantly less morbidity and should be the first-line chemical sclerosing agent for malignant pericardial effusions [13].
• CONCLUSION: A short course of intracavitary treatment with thiotepa is highly effective and well tolerated in the treatment of malignant pericardial effusion [14].

Biological context of Pericardial Effusion

• The epidemiology of cardiac complications related to HIV including cardiomyopathy, increased left ventricular mass, myocarditis, pericardial effusion, endocarditis, and malignancy are discussed [15].
• CONCLUSIONS: The results of the present study suggest that diclofenac, even if without a striking effect, may lessen the degree of inflammatory reaction after cardiac surgery and may be useful in the prevention and in the management of early pericardial effusion after cardiac surgery [16].
• We report two patients with the early-onset, cardiac phenotype of very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency; in one patient, severe pericardial effusion was the predominating symptom [17].

Anatomical context of Pericardial Effusion

• Serum concentrations of thyroxine, 1.8+/-0.3 vs 1.5+/-0.1 mcg/dl and of thyroid stimulating hormone, 34+/-4 vs 38+/-5 muU/ml did not differ in the groups with and without pericardial effusion, respectively [11].
• The most important, the "retinoic acid syndrome", consists of a hyperinflammatory reaction with capillary leakage (edema, pleural, and pericardial effusion), infiltration of myeloid cells into internal organs and systemic signs of inflammation [18].
• The cells in the pericardial effusion were mainly eosinophils; interleukin 5 and interleukin 13 levels were predominantly elevated, and the effusion was drained for 5 days [19].
• This case report describes a late perforation of right heart wall, pericardium, and diaphragm by an active-fixation ventricular lead without development of pericardial effusion and cardiac tamponade even under oral warfarin treatment [20].
• Due to its toxic effect on epithelial cells bleomycin is also used for the treatment of malignant pleural or pericardial effusions [21].

Gene context of Pericardial Effusion

• The levels of IL-1 and IL-2 were furthermore significantly higher in pericardial effusions due to infective compared to tuberculous causes [22].
• RESULTS: The concentration of IFN-gamma was significantly higher in tuberculous pericardial effusions than in the other diagnostic classes (P < 0.0005) [22].
• We measured ADA and CEA levels in the pericardial fluid in 26 patients with moderate to large pericardial effusion and 19 control patients [3].
• We investigated ADA and CEA levels in patients with moderate to large pericardial effusions of different etiologies [3].
• Mean VEGF levels in malignant effusions in eight patients (five with pleural effusions, two with pericardial effusions, and one with both) were extremely high, especially in pericardial effusions ([mean +/- SD] pleural effusions, 531.9+/-285.4 pg/mL; pericardial effusion, 3,071.6+/-81.3 pg/mL) [23].

Analytical, diagnostic and therapeutic context of Pericardial Effusion

• Although pericardial effusion on echocardiogram occurred in 33% of the patients studied, ECG voltage decreased five to 14 days after beginning cyclophosphamide therapy even in those patients without pericardial effusion [24].
• Intractable congestive heart failure, malignant ventricular arrhythmia and pericardial effusion were more frequently found in the control group than in the nicorandil group (15% vs. 37%, 5% vs. 20% and 8% vs. 37%, p < 0.05, respectively) [25].
• In combination with careful clinical examination echocardiography allows differentiation between pericardial effusion, congenital or acquired valvular heart disease, or cardiomyopathy as the underlying cause of heart failure [26].
• Thirteen patients had chronic pericardial effusions, of whom one had epicardial constriction and two had cardiomyopathy [27].
• A patient with pericardial tamponade secondary to malignant pericardial effusion underwent pericardiocentesis followed by intrapericardial instillation of recombinant interferon alfa-2b (INTRON A; Schering-Plough; Kenilworth, NJ) [28].

References