Etiology

Involvement of the pericardium is most frequently observed in patients with advanced lung and breast cancer, leukemia, lymphomas and malignant melanoma. The onset of symptoms may be gradual or rapid, depending on the rate of fluid accumulation.

Evaluation of pericardial effusion

·         Symptoms associated with pericardium involvement are dyspnea, chest pain, cough, palpitations, orthopnea, fatigue and weakness, anxiety and confusion, fever, hiccups, oliguria and edema.

·         Echocardiography is considered the standard method for diagnosing pericardial effusion..

·         A computed tomography (CT) scan is an alternative in patients in whom echocardiography cannot be used

·         Pericardial fluid tapping establishes the etiology of the effusion and should be performed promptly if the patient presents with signs of cardiac tamponade. Biochemical, cytologic and microbiological analyses of the pericardial fluid are mandatory.

Treatment

Treatment depends on the underlying etiology and symptom progression. In patients with no or minimal symptoms, chemotherapy is used, especially in patients with chemo-sensitive cancers (lymphomas, leukemias, small cell lung cancer and breast cancer.