CLINICAL AND LABORATORY PROFILE OF ADULT PATIENTS WITH PERICARDIAL EFFUSION AT DR GEORGE MUKHARI ACADEMIC HOSPITAL, PRETORIA, SOUTH AFRICA
DOI: 196 Downloads 5052 Views
Author(s)
Abstract
OBJECTIVE: Pericardial effusion has become a common clinical condition and consequent to human immunodeficiency virus pandemic, the condition has been on the increase. Its effects on the heart often present as an emergency requiring early recognition and interventions to prevent disability and death. This study evaluated the clinical, laboratory profile of patients and clinical outcomes of treatment of this condition.
METHODS: A cross-sectional study based on retrospective review of medical records of patients admitted for pericardial effusion, over an eleven-year period was undertaken. Outcome variables analysed were: demographics, percentage with cardiac, renal or liver failure and the percentage of those with abnormal ECG and echo findings. Correlation between biochemical results of pericardial fluid and final aetiology of pericardial effusion was determined.
RESULTS: 204 medical records of patients, aged between 25 and 55 years, with 50.7% males and 49.3% females, were reviewed. Cardiac, renal and liver failure were noted in 36.8%, 26.0% and 17.2% patients, respectively. Cardiogenic shock was found in 5.9%, and 96.5% had cardiomegaly on chest X-ray. From records of ECG, 22.8% had normal findings, 26.5% had small-QRS complexes and 57.4% presented with mild pericardial effusion based on echo findings. There was poor correlation (r = 0.44) between the biochemistry results of pericardial fluid and the aetiology of pericardial effusion.
CONCLUSION: Curative outcome was achieved in 78.9% of the patients and mortality rate among the patients was 88 deaths/1000 patients. Cardiomegaly was the most accurate investigation related to pericardial effusion but biochemical results were poorly correlated with the disease.
Keywords
Clinical/Laboratory features; Adult patients; pericardial effusion
Cite this paper
Mphahlele M.J., Motswaledi M.H., Towobola O.A.,
CLINICAL AND LABORATORY PROFILE OF ADULT PATIENTS WITH PERICARDIAL EFFUSION AT DR GEORGE MUKHARI ACADEMIC HOSPITAL, PRETORIA, SOUTH AFRICA
, SCIREA Journal of Clinical Medicine.
Volume 5, Issue 6, December 2020 | PP. 127-143.
References
[ 1 ] | Buiatti A, Merlo M, Pinamonti B, De Biasio M, Bussani R, Sinagra G. Clinical presentation and long-term follow-up of perimyocarditis. J Cardiovasc Med. 2013 Mar;14(3):235–241. |
[ 2 ] | Cherian G. Diagnosis of tuberculous aetiology in pericardial effusions. Postgrad. Med. J. 2004. 80: 262–266. |
[ 3 ] | Dunne J V., Chou JP, Viswanathan M, Wilcox P, Huang SH. Cardiac tamponade and large pericardial effusions in systemic sclerosis : A report of four cases and a review of the literature. Vol. 30, Clinical Rheumatology. 2011. p. 433–438. |
[ 4 ] | Eisenberg MJ, Munoz De Romeral L, Heidenreich PA, Schiller NB, Evans GT. The diagnosis of pericardial effusion and cardiac tamponade by 12-lead ECG: A technology assessment. Chest. 1996;110(2):318–324. |
[ 5 ] | Eysmann SB, Palevsky HI, Reichek N, Hackney K, Douglas PS. Two-dimensional and Doppler-echocardiographic and cardiac catheterization correlates of survival in primary pulmonary hypertension. Circulation [Internet]. 1989 Aug [cited 2019 Dec 2];80(2):353–60. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2752562 |
[ 6 ] | Hwang DS, Kim SJ, Shin ES, Lee SG. The N-terminal pro-B-type natriuretic peptide as a predictor of disease progression in patients with pericardial effusion. Int J Cardiol. 2012 May 31;157(2):192–196. |
[ 7 ] | Imazio M, Adler Y. Management of pericardial effusion. Eur Heart J [Internet]. 2013 Apr 2 [cited 2019 Dec 2];34(16):1186–1197. Available from: https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehs372 |
[ 8 ] | Imazio M, Brucato A, Trinchero R, Adler Y. Diagnosis and management of pericardial diseases. Nat. Rev. Card. 2009. 6: 743–751. |
[ 9 ] | Jung HO. Pericardial effusion and pericardiocentesis: Role of echocardiography. Korean Circ J. 2012 Nov;42(11):725–734. |
[ 10 ] | Kabangila R, Mahalu W, Masalu N, Jaka H, Peck RN. Recurrent, massive Kaposi’s sarcoma pericardial effusion presenting without cutaneous lesions in an HIV infected adult: A case report. Tanzan J Health Res. 2011;13(1):103–108. |
[ 11 ] | Kim S-H, Kwak MH, Park S, Kim HJ, Lee H-S, Kim MS, et al. Clinical Characteristics of Malignant Pericardial Effusion Associated with Recurrence and Survival. Cancer Res Treat. 2010;42(4):210- 216. |
[ 12 ] | Lazaros G, Aggelis A, Tsiachris D, Iliadis K, Scarpidi E, Bratsas A, et al. Pericardial effusion in a young patient with newly diagnosed systemic lupus erythematosus and a mediastinal mass. Hellenic J Cardiol [Internet]. [cited 2019 Dec 2];52(5):448–451. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21940294 |
[ 13 ] | Leedy PD, Ormrod J. Practical Research: Planning and Design. 8th ed. New Jersey: Pearson Merrill Prentice Hall; 2005. |
[ 14 ] | Lind A, Reinsch N, Neuhaus K, Esser S, Brockmeyer N, Potthoff A, et al. Pericardial effusion of HIV-infected patients - results of a prospective multicenter cohort study in the era of antiretroviral therapy. Eur J Med Res. 2011;16(11):480-485. |
[ 15 ] | Maisch B, Ristic A, Pankuweit S. Evaluation and management of pericardial effusion in patients with neoplastic disease. Prog Cardiovasc Dis. 2010;53(2):157–163. |
[ 16 ] | Mayosi BM, Burgess LJ, Doubell AF. Tuberculous pericarditis. Circulation [Internet]. 2005 Dec 6 [cited 2019 Dec 2];112(23):3608–3616. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16330703 |
[ 17 ] | Mayosi BM, Ntsekhe M, Bosch J, Pandie S, Jung H, Gumedze F, et al. Prednisolone and Mycobacterium indicus pranii in Tuberculous Pericarditis. N Engl J Med [Internet]. 2014 Sep 18 [cited 2019 Dec 2];371(12):1121–1130. Available from: http://www.nejm.org/doi/10.1056/NEJMoa1407380 |
[ 18 ] | Ntsekhe M, Mayosi BM, Gumbo T. Quantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept study. Cardiovasc Ultrasound. 2012;10. |
[ 19 ] | Peebles CR, Shambrook JS, Harden SP. Pericardial disease-anatomy and function. Br J Radiol. 2011 Dec 1;84(SPEC. ISSUE 3). |
[ 20 ] | Raymond RJ, Hinderliter AL, Willis IV PW, Ralph D, Caldwell EJ, Williams W, et al. Echocardiographic predictors of adverse outcomes in primary pulmonary hypertension. J Am Coll Cardiol. 2002 Apr 3;39(7):1214–1219. |
[ 21 ] | Reuter H, Burgess LJ, Doubell AF. Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect. 2005 Jun;133(3):393–399. |
[ 22 ] | Sahay S, Tonelli AR. Pericardial effusion in pulmonary arterial hypertension. Pulm Circ. 2013 Sep 1;3(3):467–477. |
[ 23 ] | Santas E, Núñez J. Prognostic implications of pericardial effusion: The importance of underlying etiology. Int J Cardiol. 2016 Jan 1;202:407. |
[ 24 ] | Sampat K, Rossi A, Garcia-Gutierrez V, Cortes J, Pierce S, Kantarjian H, et al. Characteristics of pericardial effusions in patients with leukemia. Cancer. 2010 May 15;116(10):2366–2371. |
[ 25 ] | Shahbaz Sarwar CM, Fatimi S. Characteristics of recurrent pericardial effusions. Singapore Med J [Internet]. 2007 Aug [cited 2019 Dec 2];48(8):725–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17657378 |
[ 26 ] | Zhang R, Dai LZ, Xie WP, Yu ZX, Wu BX, Pan L, et al. Survival of Chinese patients with pulmonary arterial hypertension in the modern treatment era. Chest. 2011 Aug 1;140(2):301–309. |