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Evaluation of Etiology and Causes of Massive Pericardial Effusion in Patients with Tamponade, in Mazandaran Heart Center and Shafa Hospital, Sari, Iran


Shervin Ziabakhsh Tabary, MD, FCTS*

 Background: Pericardial effusion is diagnosed as an echo-free space around the

heart. This fluid collection follows the anatomic landmarks of the pericardium,
covering both ventricles and most of the right atrium, whereas a small portion of
the LA wall is surrounded by pericardium. Pericardial effusion should be
differentiated from left pleural effusion, an echo free space that extends posterior
to the descending aorta, and from increased pericardial fat content, of typical
granular appearance, that does not deserve medical attention.
Aim: Aim of this issue is to find the presentation by which the patients have come
to the hospital that at last the diagnosis was massive pericardial effusion and
finding the laboratory and pathologic causes of this clinical problem.
Materials and Methods: We reviewed the patients who had been admitted in
Mazandaran Heart Center and Shafa hospital between Sept 2009 and Jan 2013
with diagnosis of pericardial effusion which were made by echocardiography.
Results: Among these patients there was a history of viral infection including
cough, fever, weakness in previous month in 32 (37%) patients and a history of
diagnosed malignancy in 15 patients (1%7) who at least had a course of
chemotherapy in their drug history and history of trauma in one patient, there
was history of chronic renal failure and repeated dialysis in 12(14%) but there
was no previous disease in the other patients (36%). There was a history of
previous surgery for tamponade in 3 of them (3%).After admission the diagnosis
of massive pericardial effusion had been made and in 48 (55%) of them, there
was echocardiographic signs of RA collapse and RV collapse.
Discussion: Most pericardial effusions are caused by inflammation of the
pericardium, a condition called pericarditis. As the pericardium becomes
inflamed, extra fluid is produced, leading to a pericardial effusion. Viral infections
are one of the main causes of pericarditis and pericardial effusions. in laboratory
and pathologic findings of specimen obtained from pericardial fluid and biopsy
specimen there was nothing specific to show the exact cause of effusion.

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