Pericardial Effusion: Etiology, Diagnose And Management

Year 2012, Volume: 14 Issue: 2, 23 - 27, 01.07.2012

Osman Turak Özgül Malçok Gürel Kumral Çağlı Fırat Özcan Ayşenur Ekizler Muhammed Cebeci Ahmet İşleyen İbrahim Akpınar Enis Gırboviç Adnan Yalçınkaya Nurcan Başar

Abstract

Aim: The etiology, diagnosis and treatment options of patients with moderate-large volumepericardial effusions were evaluated, retrospectively.Patients and methods: 104 patients with pericardial effusion were enrolled into the study (54male, 50 female, mean age of 53±18 years, ranged from 14 to 85 years). The clinical features,laboratory tests and trans-thoracic echocardiography findings of the patients were recorded.Both diagnostic and therapeutic aimed pericardiocentesis procedures were performed viasubxiphioid route and glucose, total protein, cholosterol, lactic dehydrogenase levels, adenosinedeaminase activity, polymerase chain reaction for tuberculosis, cytological, microbiologicalexaminations and cultures were obtained from pericardial fluid.Results: By transthoracic echocardiography, 70 patients (67.3%) had large volume and 34patients had moderate volume pericardial effusion. Pericardiocentesis was performed to a totalof 46 patients and pericardial fluid was exudate in 22 patients (47.8%) and transudate in 24patients (52.2%). The most common cause of effusion was idiopathic and the other causes wereneoplasia, congestive heart failure and tuberculosis, respectively.Conclusion: The main problem in pericardial effusion is to find the etiology for clinicians.Carefully taken medical story, detailed physical examination and pericardiocentesis procedureif needed will help us to diagnose the disease and to start the treatment for the specific etiology

Keywords

etiology, pericardial effusion, pericardiocentesis

Perikardiyal Efüzyon: Etyoloji, Tanı Ve Tedavisi

Abstract

Amaç: Orta-büyük miktarda perikardiyal efüzyonlu olguların; etyoloji, tanı ve tedavi yöntemlerigeriye dönük değerlendirildi.Hastalar ve Yöntem: Çalışmaya kliniğimizde perikardiyal efüzyonla takip edilen 104 hastadahil edildi (54’ü erkek, 50’si kadın; ortalama yaş 53±18 yıl; dağılım 14–85 yıl). Hastalarınklinik özellikleri, laboratuvar ve transtorasik ekokardiyografi bulguları kaydedildi.Perikardiyosentez işlemi tanısal ve/veya tedavi amaçlı olarak subksifoid yaklaşımla yapıldı veperikardiyal sıvıda glikoz, total protein, kolesterol ve laktik dehidrogenaz düzeyi, adenozindeaminaz aktivitesi ve tüberküloz (tbc) polimeraz zincir reaksiyonu (PCR) bakıldı, sitolojik vemikrobiyolojik inceleme yapılarak, kültür sonuçları değerlendirildi.Bulgular: Transtorasik ekokardiyografi ile 70 hastada (%67,3) büyük, 34 hastada (%32,7) ortaderecede perikardiyal sıvı saptandı. Perikardiyosentez uygulanan 46 hastanın 22’sinde (%47,8)perikardiyal sıvı eksuda, 24’ünde (%52,2) transuda özelliğindeydi. Etyolojik neden olarak ensık idyopatik perikardit bulunurken, diğer en sık etyolojik sebebler sırasıyla neoplazi, konjestifkalp yetmezliği ve tüberkülozdu.Sonuç: Perikardiyal efüzyonlarda etyolojinin saptanması klinisyenler için temel sorundur.Dikkatli alınan öykü, detaylı fizik muayene ve gerekli görülen hastalarda yapılanperikardiyosentez işlemi ile spesifik tanı konulmalı ve etyolojiye yönelik tedaviye hemenbaşlanmalıdır

Keywords

etyoloji, perikardiyal efüzyon, perikardiyosentez

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