Profile of cardiac tamponade in the medical emergency ward of a North Indian hospital

Abstract

Objective: To determine the profile of patients presenting to the medical emergency ward with cardiac tamponade.

Design: Retrospective observational study.

Setting: Tertiary care hospital in North India.

Patients: Thirty patients (19 men and 11 women) presenting to the medical emergency ward with cardiac tamponade from March 1, 1995 to March 31, 1997.

Main results: The mean age was 36.5+/-7.6 years for the men and 34+/-12.4 years for the women. Breathlessness, fever, cough, chest pain and easy fatigability were present in 97%, 90%, 70%, 57% and 37% of patients, respectively. Etiologically, tuberculosis accounted for 60%, malignant disease for 33% and hypothyroidism for 7% of cases of cardiac tamponade. Echocardiographically guided pericardiocentesis was carried out in all patients without any complications. Six patients underwent catheter pericardial drainage and, of these, four required pericardiostomy.

Conclusions: Tuberculosis ranked as the most common cause of cardiac tamponade in Northern India, followed by malignancy. Therapeutically, echocardiographically guided pericardiocentesis for cardiac tamponade is a safe and effective procedure. For those with recurrent pericardial effusions, catheter pericardial drainage is a safe option until the underlying cause can be treated or surgery planned.