[Cardiac tamponade: clinical review of 53 cases]

Abstract

Background: To describe the clinical features and prognosis of the patients with cardiac tamponade admitted in the coronary care unit.

Methods: Analysis the clinical data, etiology, treatment, and short term outcome of fifty three patients presenting with cardiac tamponade that required pericardiocentesis.

Results: Neoplasm (21 cases) and idiopathic pericarditis (10 cases) were the most frequent causes of cardiac tamponade. In forty four patients an haemorrhagic fluid was obtained. Neoplastic pericardial fluid showed a higher haematocrit than the rest (18 +/- 8% vs 7 +/- 5%, p less than 0.01). Recurrence of tamponade occurred in all but one neoplastic patients, and was early (less than 48 h) in 18 patients. Twenty seven patients underwent pericardiectomy, and recurrence was the most frequent indication (18 cases). Overall in-hospital mortality was 26%. Ten out of 14 deaths occurred in neoplastic patients and 2 deaths after myocardial perforation related to temporary pacemaker. No patient with idiopathic or post-pericardiotomy cardiac tamponade died.

Conclusions: Short term outcome and prognosis in patients with cardiac tamponade mainly depends on the etiology. A high rate of early recurrence and death characterize the malignant cardiac tamponades.