Materiały źródłowe

• #1 Evaluation of pericardial effusion – Differential diagnosis of symptoms | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/458

  Pericardial effusion is present when the fluid in the pericardial space exceeds its physiologic amount (50 mL). In the clinical setting, pericardial effusion is relatively common. It may be detected incidentally on a cardiac or chest imaging study, or manifest on the background of a cardiac or systemic disease. […] Data from the Framingham cohort suggest that pericardial effusion may be present in up to 6.5% of the general adult population. Prevalence increased with age, from 1% in patients ages 20 to 30 years to more than 15% in patients ages 80 years and over. Most people in the study had small effusions and no recognizable cardiac disease. […] In the clinical setting, the prevalence of pericardial effusion depends on the patient population studied. Over a 6-year period, the mean annual prevalence and incidence of pericardial effusion in an echocardiography laboratory of a large Italian hospital was 3% and 9%, respectively. In high-risk emergency department patients, the prevalence of pericardial effusion has been reported in the range of 13% to 20%. One meta-analysis reported pooled pericardial effusion prevalence of 19.5% across studies that included patients with pulmonary arterial hypertension, chronic heart failure, myocardial infarction, and malignancy.

• #1 Pericardial Effusion: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/157325-overview

  Few large studies have characterized the epidemiology of pericardial effusion; however, the available data consistently show that pericardial effusion is more prevalent than is clinically evident. A higher incidence of it is associated with certain diseases. […] Small pericardial effusions are often asymptomatic, and pericardial effusion has been found in 3.4% of subjects in general autopsy studies. When associated with community-acquired pneumonia (CAP), small pericardial effusion is an independent predictor of adverse events including longer and more complicated hospital stays as well as increased mortality. […] A wide variety of malignant neoplasms and hematologic malignancies can lead to pericardial effusion. Data on the prevalence varies, with some studies showing the presence of pericardial effusion as high as 21% in such patients. A large study by Bussani et al showed cardiac metastases (9.1%) and pericardial metastases (6.3%) in cases of death from all causes in individuals with an underlying carcinoma at autopsy.

• #1 Asymptomatic Chronic Large Pericardial Effusions: To Drain or to Observe?

  https://www.mdpi.com/2077-0383/13/13/3887

  Pericardial effusion is a common pericardial syndrome with an estimated incidence of 3% and a prevalence of 5.7–9%. […] Most of the epidemiological data have been obtained from the Western world and mainly from specialized referral centers, and thus possibly subjected to referral bias. […] Relevant data from low-resource areas where tuberculosis is the main cause of pericardial syndromes overall are very scant. […] The contemporary International Classification of Diseases (ICDs) coding system raises additional concerns regarding the true frequency of pericardial effusions. […] Similarly, data on the eventual differences according to sex and age are scarce and limited to the presence of pericardial effusions in acute pericarditis where older patients present more often with pericardial effusions compared to younger individuals without any difference related to sex.

• #1 Pericardial Effusion: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/157325-overview

  Patients with HIV, with or without acquired immunodeficiency syndrome (AIDS), are also found to have an increased prevalence of pericardial effusion. Studies have shown the prevalence of pericardial effusion in these patients to range from 5-43%, depending on the inclusion criteria, with 13% having moderate to severe effusion. The incidence of pericardial effusion in patients infected with HIV has been estimated at 11%; however, it appears that highly active antiretroviral therapy (HAART) may have reduced the incidence of HIV-associated effusions. […] No consistent difference among races is reported in the literature. AIDS patients with pericardial effusion are more likely to be white. […] Pericardial effusion is observed in all age groups. The mean occurrence is in the fourth or fifth decades, although it is earlier than this in patients with HIV.

• #1 Pericardial effusion epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Pericardial_effusion_epidemiology_and_demographics

  Pericardial effusion occurs commonly in fourth or fifth decade of life. However, it can occur in all age groups. Patients with AIDS are at higher risk of developing effusion earlier when compared to general population. […] Malignant pericardial effusion is seen in approximately 50-60% of patients presenting with pericardial effusion who have history of malignancy. […] Among patients presenting with pericarditis or pericardial effusion with no history of malignancy, undiagnosed underlying malignancy was detected in 4-7%. […] Pericardial effusion secondary to HIV and tuberculosis is one of the major cause of acute pericarditis in developing countries. […] The incidence of pericardial effusion in patients with asymptomatic AIDS was 11% per year before the introduction of effective highly active antiretroviral therapy (HAART). The 6 month survival rate of AIDS patients with effusion was significantly shorter (36%) than the survival rate without effusions (93%). This shortened survival rate remained statistically significant after adjustment for lead-time bias and was independent of CD4 count and albumin level.

• #1 The Epidemiology and Outcome of Pericardial Effusion in Hospitalized Children: A National Database Analysis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/35835227/

  Objectives: To describe the epidemiology of pericardial effusion in hospitalized children and evaluate risk factors associated with the drainage of pericardial effusion and hospital mortality. […] Results: We analyzed hospitalized pediatric patients from the neonatal age through 20 years in the Kids’ Inpatient Database 2016, extracting the cases of pericardial effusion. Of the 6 266 285 discharged patients recorded, 6417 (0.1%) were diagnosed with pericardial effusion, with the highest prevalence of 2153 patients in teens (13-20 years of age). […] The overall mortality in children with pericardial effusion was 6.8% and 10.9% of those who required pericardial effusion drainage (P .001). […] The risk of mortality in hospitalized children with pericardial effusion was higher in younger children with solid organ tumors and those who required pericardial effusion drainage. In contrast, it was lower in older children with cardiac or rheumatologic diagnoses.

• #1 The epidemiology and outcomes of pericardial effusion in hospitalized children: a national database analysis – Congenital Heart International Professionals (CHiP) Network

  https://thechipnetwork.org/the-epidemiology-and-outcomes-of-pericardial-effusion-in-hospitalized-children-a-national-database-analysis/

  1) KIDS inpatient database, authors found a prevalence for pericardial effusion of 0.1% in inpatients; pericardial drainage occurred in 12.3% of these patients […] There were 6.26 million patients evaluated and 6417 (0.1%) were diagnosed as having a pericardial effusion. The prevalence was highest in infants (0.28%) and lowest in neonates (0.04%). The prevalence was twice as high in black children (0.15%) compared to white children (0.08%). […] Mortality occurred in 6.8% of children with pericardial effusion. Of those who required pericardial drainage, 10.8% died. Using an adjusted risk for mortality model, the adjusted risk for mortality was lowest in older age groups and highest in neonates.

• #1 Pericardial effusion and acute pericarditis: Management during pregnancy – UpToDate

  https://www.uptodate.com/contents/pericardial-effusion-and-acute-pericarditis-management-during-pregnancy

  Maternal pericardial effusion […] Epidemiology and clinical features — Pericardial effusion has been reported in the first and second trimester in 15 to 20 percent of pregnancies and in approximately 40 percent of pregnant patients during the third trimester. In general, these effusions are asymptomatic, benign, transient, and resolve spontaneously without therapy. In the absence of signs or symptoms of acute pericarditis or cardiac tamponade, neither diagnostic testing (generally with echocardiography) nor specific treatment is required.

• #1 Incidence of secondary pericardial effusions associated with different etiologies: a comprehensive review of literature | Journal of Cardiothoracic Surgery | Full Text

  https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-025-03370-5

  Pericardial effusion is a relatively common complication associated with inflammatory and non-inflammatory diseases. […] This comprehensive review focuses on the epidemiology of pericardial effusion and discusses pathophysiology, diagnostic approaches, and therapeutic options for different causes of secondary pericardial effusions. […] The main causes of pericardial effusion are different among developing and developed countries. The leading cause in developing countries is still tuberculosis. However, in the developed world, the leading causes include idiopathic pericardial effusion, inflammatory causes, malignancy-related PE, and complications of surgical and percutaneous cardiac procedures. […] The overall leading causes of PE in the developed countries, apart from up to 50%, which are idiopathic, are infections (15-30%), cancer-related causes (10-25%), iatrogenic causes (15-20%) and autoimmune or autoinflammatory causes (5-15%).

• #1 Pericardial Effusion – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431089/

  Pericardial effusion can occur across all ages and populations. The effusion’s predominant etiology varies by demographic characteristics such as age, geography, and comorbidities. Data regarding the prevalence and incidence of pericardial effusions is limited. Viral pericarditis leading to effusion is the most common cause in the developed world. In developing areas, pericardial effusion due to Mycobacterium tuberculosis is quite prevalent. Bacterial and parasitic etiologies are less common. […] Multiple malignant neoplasms can cause noninflammatory pericardial effusions. A malignant etiology is present in 12% to 23% of patients with pericardial effusion. In patients with human immunodeficiency virus, pericardial effusion is reported in 5% to 43%, depending on the inclusion criteria, with 13% having moderate to severe effusion. A pediatric study revealed that postcardiac surgery (54%), neoplasia (13%), renal (13%), idiopathic or viral pericarditis (5%), and rheumatologic (5%) were the major underlying etiologies of pericarditis and pericardial effusions in children.

• #1 Pericarditis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Pericarditis_epidemiology_and_demographics

  The incidence of acute pericarditis is approximately 27.7 per 100,000 individuals annually. […] The recurrence of pericarditis is seen in almost 30% of patients after first episode of disease. […] The mortality rate of acute pericarditis is approximately 1.1% in developed countries. […] In developing countries pericarditis is usually secondary to tuberculosis or HIV infection. […] Tuberculous pericarditis, caused by Mycobacterium tuberculosis, is found in approximately 1% of all autopsied cases of TB and in 1% to 2% of instances of pulmonary TB. […] The incidence and prevalence of viral pericarditis vary with season and region. […] It accounted for 69.5% (162 of 233) of cases referred for diagnostic pericardiocentesis in a study in Western Cape Province of South Africa, while the same accounts for 4% of cases in developed countries.

• #1 Asymptomatic Chronic Large Pericardial Effusions: To Drain or to Observe?

  https://www.mdpi.com/2077-0383/13/13/3887

  It is worth reporting that two additional causes of pericardial effusions emerged quite recently. […] The first is SARS-CoV-2 infection, which emerged as an important cause of pericardial effusion during the COVID-19 pandemic. […] The second challenging cause is anticancer therapy in the era of the widespread use of immune checkpoint inhibitors.

• #1 Pericardial Effusion: Causes, Symptoms and Treatment | Doctor

  https://patient.info/doctor/pericardial-effusion

  Small pericardial effusions are often asymptomatic and pericardial effusion has been found in 3.4% of general autopsy studies. […] Studies in the pre-highly active antiretroviral therapy (HAART) era reported an incidence of 11% of pericardial effusion in HIV patients. However, post-HAART the incidence is much reduced (only 2 patients in a cohort of 802 in one study). […] 10.7% of autopsies of cancer patients show pericardial effusion.

• #1 Pericardial Disease in Patients with Cancer: Clinical Insights on Diagnosis and Treatment

  https://www.mdpi.com/2072-6694/16/20/3466

  Pericardial disease is a common complication in patients with cancer and is usually associated with an unfavorable prognosis. In necropsy series of patients with cancer, pericardial involvement was observed from 2% to 15–30% of the time. The main forms of pericardial involvement include acute pericarditis, pericardial effusion, and constrictive pericarditis. The most common manifestation of pericardial involvement is pericardial effusion, which is often an incidental finding. Acute pericarditis and constrictive pericarditis are less common presentations of pericardial disease in cancer patients and are often associated with certain cancer treatments like ICIs or radiotherapy. The neoplasms which most frequently produce pericardial involvement are lung cancer (in both sexes) followed by breast cancer, lymphoma, leukemia, gastrointestinal tumors, and melanoma.

• #1 Pericardial effusion in oncological patients: current knowledge and principles of management | Cardio-Oncology | Full Text

  https://cardiooncologyjournal.biomedcentral.com/articles/10.1186/s40959-024-00207-3

  This article provides an up-to-date overview of pericardial effusion in oncological practice and a guidance on its management. Furthermore, it addresses the question of when malignancy should be suspected in case of newly diagnosed pericardial effusion. […] Cancer-related pericardial effusion is commonly the result of localization of lung and breast cancer, melanoma, or lymphoma to the pericardium via direct invasion, lymphatic dissemination, or hematogenous spread. […] The diagnosis of cancer-related pericardial effusion is usually incidental, but cancer accounts for approximately one third of all cardiac tamponades. […] Pericardial effusion is quite a common finding in oncological patients. […] In this narrative review article, we discuss the causes, manifestations, and management of pericardial effusion in cancer patients, with the goal of providing an up-to-date guidance for health care professionals.

• #1 Pericardial effusion in oncological patients: current knowledge and principles of management | Cardio-Oncology | Full Text

  https://cardiooncologyjournal.biomedcentral.com/articles/10.1186/s40959-024-00207-3

  Pericardial effusion is more frequent in males than females with the ratio being 1.3:1. […] The management of pericardial effusion in oncological patients varies depending on the cause and the clinical presentation. […] About 30% of cardiac tamponades are due to malignancy, but the frequency by which, once diagnosed, cancer-related pericardial effusion progresses to tamponade appears to be low in clinical practice. […] Cancer and cancer treatment deserve attention as possible causes of pericardial effusion, even in the general population of patients presenting with a new pericardial effusion.

• #1 Pericardial Disease in Patients with Cancer: Clinical Insights on Diagnosis and Treatment

  https://www.mdpi.com/2072-6694/16/20/3466

  Pericardial effusion is a relatively common incidental finding in cancer patients and entails poor prognosis and an advanced stage of the disease. Malignant pericardial effusions are characterized by a recurrent course, large amounts of fluid, presentation of cardiac tamponade, the absence of response to empirical treatment with NSAIDs, the absence of acute phase reactants, and hematic fluid. Cancer treatment is responsible for about 30% of cases of pericardial effusion, although the percentage could be higher with the increased use of immunotherapy. Neoplastic origin accounts for more than 30% of all pericardial tamponades, and it is estimated that 30–50% of malignant pericardial effusions progress to pericardial tamponade. […] About 5–10% of acute pericarditis may be secondary to an underlying oncologic process, resulting in a poor prognosis of oncologic disease. However, the real prevalence of pericarditis in cancer patients remains uncertain and probably underdiagnosed.

• #1 FF #209 Malignant Pericardial Effusions – Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/malignant-pericardial-effusions/?print=print

  Epidemiology and Prognosis  Approximately 10% of patients with cancer develop cardiac metastases, with ~75% of these affecting the epicardium (1, 2).  Only a third of these, however, will develop clinically significant MPEs (1).  Lung and breast cancers are the most common causes.  MPEs are associated with a poor prognosis.  Studies suggest a median survival of 2-3 months after a MPE is diagnosed, with a mean survival of 5 months for solid tumors and 20 months for hematologic malignancies (3, 4). […] The treatment of MPEs depends on how urgently treatment is needed, the likelihood of the tumor responding to anti-neoplastic treatments, and the anticipated survival of the patient.  A multidisciplinary approach to decision-making, involving input from medical and radiation oncology, cardiology, and thoracic surgery is recommended. Simple pericardiocentesis may be appropriate for patients with short prognoses (<1 month), particularly if their MPE is not expected to re-accumulate in their remaining life-span.  Patients with longer prognoses (>1 month) who are expected to re-accumulate their MPEs will likely benefit most from sclerosis or surgical decompression; there is no clear evidence currently suggesting one strategy is superior to the other.

• #1 Pericardial Disease Center | UCSF Cardiology

  https://ucsfhealthcardiology.ucsf.edu/patient-care/clinical-services/pericardial-disease-center

  Fluid in the pericardial space is called a pericardial effusion. A pericardial effusion occurs when too much fluid builds up in the sac around the heart, called the pericardium. […] In cancer patients, the most common reason for a pericardial effusion is when cancer spreads to the pericardium. This is called a malignant pericardial effusion. […] Cancer treatments can also cause fluid to build up around the heart. Some chemotherapies can cause this problem, including drugs like anthracyclines, tyrosine kinase inhibitors, busulfan, cytarabine, and cyclophosphamide (among others), particularly when used in high doses or in combination with other cancer therapies. […] Pericardial effusion is often found incidentally (without symptoms) in cancer patients when they have heart or chest scans for other reasons.

• #1 Purulent pericarditis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/purulent-pericarditis-1?lang=us

  Purulent pericarditis is rare nowadays and makes up 1% of pericarditis cases. […] Factors that increase the likelihood of developing purulent pericarditis include cardiac or thoracic surgery, immunosuppression, chronic kidney disease, malignancy, and preexisting pericardial effusion. […] Clinical conditions with which purulent pericarditis has been associated include pneumonia, pleural empyema, and sepsis.

• #1 Pericardial Effusion and Cardiac Tamponade: Etiology and Evolution in the Contemporary Era – International Journal of Cardiovascular Sciences

  https://ijcscardiol.org/article/pericardial-effusion-and-cardiac-tamponade-etiology-and-evolution-in-the-contemporary-era/

  Pericardial effusion is a relatively common finding and can progress to cardiac tamponade; etiological diagnosis is important for guiding treatment decisions. […] A total of 254 patients with a mean age of 53.09 17.9 years were evaluated, 51.2% of whom were female. […] Pericardial tamponade occurred in 44.1% of patients. […] There is an etiological difference between pericardial effusion patients with and without cardiac tamponade. An idiopathic etiology is more common among those without tamponade, while postinterventional/postsurgical is more common among those with tamponade. The tamponade group had a higher mortality rate.

• #1 SciELO Brazil – Pericardial Effusion and Cardiac Tamponade: Etiology and Evolution in the Contemporary Era Pericardial Effusion and Cardiac Tamponade: Etiology and Evolution in the Contemporary Era

  https://www.scielo.br/j/ijcs/a/Mc5PDpXXcsXbX6rLDrYGwsp/

  In the overall sample, idiopathic pericardial effusion was the most frequent etiology (84 patients, 33.1%), followed by postsurgical (49 patients, 19.3%), neoplastic (43 patients, 16.9%), and postprocedural complications (angioplasty, ablation and pacemaker)(22 patients, 8.7%). […] When the groups were compared regarding the need for pericardiocentesis, recurrence, and medication type, the group with tamponade had a significantly higher percentage of pericardiocentesis and death (Table 6). The overall mortality rate was 31.5% (80 patients), being significantly higher in the group with tamponade (42%) than the group without it (23.2%)(P=0.001). […] Our study found that cardiac procedures, such as angioplasty, pacemaker implantation and arrhythmia ablation, are important in the etiology of cardiac tamponade, and these procedures are increasingly performed.

• #1 SciELO Brazil – Pericardial Effusion and Cardiac Tamponade: Etiology and Evolution in the Contemporary Era Pericardial Effusion and Cardiac Tamponade: Etiology and Evolution in the Contemporary Era

  https://www.scielo.br/j/ijcs/a/Mc5PDpXXcsXbX6rLDrYGwsp/

  In evaluating the clinical course of patients, mortality is related to etiology and the presence or absence of tamponade. Our study found an overall mortality of 31.5% during follow-up, with a significantly higher mortality rate in patients with tamponade (42% vs. 23.2% p=0.001). […] In the present study, which was carried out in a tertiary cardiology hospital, the most frequent etiologies were idiopathic, followed by post-cardiac surgery, neoplastic, and as a postprocedural complication. A significant percentage of the patients (44.1%) had cardiac tamponade. Among those without tamponade, the most frequent etiologies were idiopathic, postsurgical, and neoplastic, while among those with tamponade, the most frequent etiologies were postsurgical, post-procedural, idiopathic, and neoplastic. Mortality was high overall (31.5%) and significantly higher in the group with tamponade. Patients with tamponade had shorter survival than those without it.

• #1 Incidence of secondary pericardial effusions associated with different etiologies: a comprehensive review of literature | Journal of Cardiothoracic Surgery | Full Text

  https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-025-03370-5

  More recently, COVID-19 infection and vaccination (specifically mRNA vaccines) have become additional causes of PE. […] It is important to consider the point that in clinical practice, determining the exact cause of pericardial effusion often remains challenging, with many cases ultimately labeled as idiopathic. […] The incidence of pericardial effusions is different in various studies. In one study, PE was seen in 12.9% of patients, with 6.1% and 0.7% being moderate and severe, respectively. […] The presence or absence of PE does not significantly affect the survival rate or complications. […] The mainstay of the treatment of PE due to uremia is initiating dialysis, and more than half of these patients respond to intensive hemodialysis. […] Treatment of pericardial effusion is planned based on the size, consequences, and etiology. […] In 2015, ESC guidelines stated that pericardiocentesis was the class I recommended for moderate to large PEs.

• #1 Asymptomatic Chronic Large Pericardial Effusions: To Drain or to Observe?

  https://www.mdpi.com/2077-0383/13/13/3887

  From an etiological point of view, pericardial effusions may have infectious and non-infectious causes. […] Infections etiologies (mainly viral infections) account for 15–30% of cases and are characterized by the elevation of inflammatory markers such as C-reactive protein, the erythrocyte sedimentation rate, and white blood cells. […] In developing countries, mycobacterium tuberculosis accounts for at least 70% of acute pericarditis cases. […] Notably, in the setting of acute pericarditis, pericardial effusions (newly appearing or increasing in size) are included in the four main diagnostic criteria for acute pericarditis. […] Despite extensive diagnostic work-up, unfortunately half of the cases in the Western world are finally classified as idiopathic, while in the subgroup of chronic, large, asymptomatic, idiopathic, non-inflammatory effusions, the possibility of unveiling a specific etiology is as low as 7%.

• #1 Cardiac Tamponade: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/152083-overview

  The incidence of cardiac tamponade is 5 cases per 10,000 population in the United States. Approximately 2% of penetrating injuries are reported to result in cardiac tamponade. […] In children, cardiac tamponade is more common in boys than in girls, with a male-to-female ratio of 7:3. In adults, cardiac tamponade appears to be slightly more common in men than in women. A male-to-female ratio of 1.25:1 was observed at the author’s referral center, based on the International Classification of Diseases (ICD) code 423.9. However, a male-to-female ratio of 1.7:1 was observed at another level 1 trauma center. […] Cardiac tamponade related to trauma or HIV is more common in young adults, whereas tamponade due to malignancy and/or renal failure occurs more frequently in elderly individuals.

• #1 Pericardial involvement in neoplastic disease: prevalence, clinical picture, diagnosis and treatment

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Pericardial-involvement-in-neoplastic-disease-prevalence-clinical-picture-diagnosis-and-treatment

  Pericardial effusions in the majority of cases are clinically silent and asymptomatic. […] The most common symptoms of pericardial effusion are non-specific, and the slow accumulation of pericardial fluid results in delayed manifestations of signs and symptoms. […] Rapidly accumulating effusions are more likely to cause symptoms. […] Pericardial effusions are difficult to diagnose, as the clinical examination might be essentially normal in haemodynamically stable patients and tachycardia may be the only sign. […] Two-dimensional transthoracic echocardiography is the preferred investigation for pericardial effusion as it can determine the size, location, and haemodynamic significance of a pericardial effusion and is also low cost and easily available. […] Upon detection of the effusion, it is imperative to assess the size of the effusion, look for signs of tamponade and any evidence of associated illness.

• #1 Pericardial involvement in neoplastic disease: prevalence, clinical picture, diagnosis and treatment

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Pericardial-involvement-in-neoplastic-disease-prevalence-clinical-picture-diagnosis-and-treatment

  Though echocardiography is fairly conclusive in diagnosing pericardial effusion, computed tomography (CT) or cardiac magnetic resonance (CMR) imaging is useful in providing a wider field, detecting loculated effusion, thickening of the pericardium, and detecting pericardial and myocardial malignant deposits. […] The clinical severity and the haemodynamic status are determined by the pace of collection and the volume of the pericardial fluid in addition to the compliance of the pericardium and the cardiac chambers. […] In order to improve the diagnostic yield and optimise the management, an integrated approach using different imaging modalities as appropriate should be the ideal strategy. […] However, the analysis of the pericardial fluid and the pericardial biopsy specimen is central to the diagnosis of malignant effusion; the diagnostic yield from the tumour markers in the pericardial fluid remains inconclusive to differentiate malignant and benign pericardial effusion. […] The approach to malignant pericardial disease management is usually based on the type and stage of the primary illness and the general medical condition of the patient.

• #2 Assessment of pericardial effusion – Differential diagnosis of symptoms | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/458

  Pericardial effusion is present when the fluid in the pericardial space exceeds its physiological amount (50 mL). In the clinical setting, pericardial effusion is relatively common. It may be detected incidentally on a cardiac or chest imaging study, or manifest on the background of a cardiac or systemic disease. […] Data from the Framingham cohort suggest that pericardial effusion may be present in up to 6.5% of the general adult population. Prevalence increased with age, from 1% in patients aged 20 to 30 years to more than 15% in patients aged 80 years and over. Most people in the study had small effusions and no recognisable cardiac disease. […] In the clinical setting, the prevalence of pericardial effusion depends on the patient population studied. Over a 6-year period, the mean annual prevalence and incidence of pericardial effusion in an echocardiography laboratory of a large Italian hospital was 3% and 9%, respectively. In high-risk emergency department patients, the prevalence of pericardial effusion has been reported in the range of 13% to 20%. One meta-analysis reported pooled pericardial effusion prevalence of 19.5% across studies that included patients with pulmonary arterial hypertension, chronic heart failure, myocardial infarction, and malignancy.

• #2 Pericardial Effusion: Causes, Symptoms and Treatment | Doctor

  https://patient.info/doctor/pericardial-effusion

  Small pericardial effusions are often asymptomatic and pericardial effusion has been found in 3.4% of general autopsy studies. […] Studies in the pre-highly active antiretroviral therapy (HAART) era reported an incidence of 11% of pericardial effusion in HIV patients. However, post-HAART the incidence is much reduced (only 2 patients in a cohort of 802 in one study). […] 10.7% of autopsies of cancer patients show pericardial effusion.

• #2 Pericardial effusion epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Pericardial_effusion_epidemiology_and_demographics

  Pericardial effusion occurs commonly in fourth or fifth decade of life. However, it can occur in all age groups. Patients with AIDS are at higher risk of developing effusion earlier when compared to general population. […] Malignant pericardial effusion is seen in approximately 50-60% of patients presenting with pericardial effusion who have history of malignancy. […] Among patients presenting with pericarditis or pericardial effusion with no history of malignancy, undiagnosed underlying malignancy was detected in 4-7%. […] Pericardial effusion secondary to HIV and tuberculosis is one of the major cause of acute pericarditis in developing countries. […] The incidence of pericardial effusion in patients with asymptomatic AIDS was 11% per year before the introduction of effective highly active antiretroviral therapy (HAART). The 6 month survival rate of AIDS patients with effusion was significantly shorter (36%) than the survival rate without effusions (93%). This shortened survival rate remained statistically significant after adjustment for lead-time bias and was independent of CD4 count and albumin level.

• #2 The epidemiology and outcomes of pericardial effusion in hospitalized children: a national database analysis – Congenital Heart International Professionals (CHiP) Network

  https://thechipnetwork.org/the-epidemiology-and-outcomes-of-pericardial-effusion-in-hospitalized-children-a-national-database-analysis/

  1) KIDS inpatient database, authors found a prevalence for pericardial effusion of 0.1% in inpatients; pericardial drainage occurred in 12.3% of these patients […] There were 6.26 million patients evaluated and 6417 (0.1%) were diagnosed as having a pericardial effusion. The prevalence was highest in infants (0.28%) and lowest in neonates (0.04%). The prevalence was twice as high in black children (0.15%) compared to white children (0.08%). […] Mortality occurred in 6.8% of children with pericardial effusion. Of those who required pericardial drainage, 10.8% died. Using an adjusted risk for mortality model, the adjusted risk for mortality was lowest in older age groups and highest in neonates.

• #2 Epidemiology of pericardial effusions at a large academic hospital in South Africa | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/epidemiology-of-pericardial-effusions-at-a-large-academic-hospital-in-south-africa/68B0547F33263B73BC7A68428F3FFB7C

  The aim was to establish the prevalence of large pericardial effusions in the Western Cape Province of South Africa, and to determine the incidence of various types of effusions. A total of 233 patients presented with large pericardial effusions. […] Tuberculous pericarditis was the most common cause of pericardial effusions (695%, n=162). It was concluded that tuberculosis (TB) is a leading cause of pericarditis in this province of South Africa. The prevalence of TB confounded by HIV co-infection is steadily increasing, burdening the health-care facilities.

• #2 Incidence of secondary pericardial effusions associated with different etiologies: a comprehensive review of literature | Journal of Cardiothoracic Surgery | Full Text

  https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-025-03370-5

  More recently, COVID-19 infection and vaccination (specifically mRNA vaccines) have become additional causes of PE. […] It is important to consider the point that in clinical practice, determining the exact cause of pericardial effusion often remains challenging, with many cases ultimately labeled as idiopathic. […] The incidence of pericardial effusions is different in various studies. In one study, PE was seen in 12.9% of patients, with 6.1% and 0.7% being moderate and severe, respectively. […] The presence or absence of PE does not significantly affect the survival rate or complications. […] The mainstay of the treatment of PE due to uremia is initiating dialysis, and more than half of these patients respond to intensive hemodialysis. […] Treatment of pericardial effusion is planned based on the size, consequences, and etiology. […] In 2015, ESC guidelines stated that pericardiocentesis was the class I recommended for moderate to large PEs.

• #2 FF #209 Malignant Pericardial Effusions | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/malignant-pericardial-effusions/

  Malignant pericardial effusions (MPEs) are a rare complication of advanced cancer, but are associated with high morbidity and mortality. This Fast Fact discusses the diagnosis and management of MPEs. […] Approximately 10% of patients with cancer develop cardiac metastases, with ~75% of these affecting the epicardium. Only a third of these, however, will develop clinically significant MPEs. Lung and breast cancers are the most common causes. MPEs are associated with a poor prognosis. Studies suggest a median survival of 2-3 months after a MPE is diagnosed, with a mean survival of 5 months for solid tumors and 20 months for hematologic malignancies.

• #2 Pericardial Effusion: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/157325-overview

  Patients with HIV, with or without acquired immunodeficiency syndrome (AIDS), are also found to have an increased prevalence of pericardial effusion. Studies have shown the prevalence of pericardial effusion in these patients to range from 5-43%, depending on the inclusion criteria, with 13% having moderate to severe effusion. The incidence of pericardial effusion in patients infected with HIV has been estimated at 11%; however, it appears that highly active antiretroviral therapy (HAART) may have reduced the incidence of HIV-associated effusions. […] No consistent difference among races is reported in the literature. AIDS patients with pericardial effusion are more likely to be white. […] Pericardial effusion is observed in all age groups. The mean occurrence is in the fourth or fifth decades, although it is earlier than this in patients with HIV.

• #2 SciELO Brazil – Pericardial Effusion and Cardiac Tamponade: Etiology and Evolution in the Contemporary Era Pericardial Effusion and Cardiac Tamponade: Etiology and Evolution in the Contemporary Era

  https://www.scielo.br/j/ijcs/a/Mc5PDpXXcsXbX6rLDrYGwsp/

  In the overall sample, idiopathic pericardial effusion was the most frequent etiology (84 patients, 33.1%), followed by postsurgical (49 patients, 19.3%), neoplastic (43 patients, 16.9%), and postprocedural complications (angioplasty, ablation and pacemaker)(22 patients, 8.7%). […] When the groups were compared regarding the need for pericardiocentesis, recurrence, and medication type, the group with tamponade had a significantly higher percentage of pericardiocentesis and death (Table 6). The overall mortality rate was 31.5% (80 patients), being significantly higher in the group with tamponade (42%) than the group without it (23.2%)(P=0.001). […] Our study found that cardiac procedures, such as angioplasty, pacemaker implantation and arrhythmia ablation, are important in the etiology of cardiac tamponade, and these procedures are increasingly performed.

• #3 Pericarditis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Pericarditis_epidemiology_and_demographics

  The incidence of acute pericarditis is approximately 27.7 per 100,000 individuals annually. […] The recurrence of pericarditis is seen in almost 30% of patients after first episode of disease. […] The mortality rate of acute pericarditis is approximately 1.1% in developed countries. […] In developing countries pericarditis is usually secondary to tuberculosis or HIV infection. […] Tuberculous pericarditis, caused by Mycobacterium tuberculosis, is found in approximately 1% of all autopsied cases of TB and in 1% to 2% of instances of pulmonary TB. […] The incidence and prevalence of viral pericarditis vary with season and region. […] It accounted for 69.5% (162 of 233) of cases referred for diagnostic pericardiocentesis in a study in Western Cape Province of South Africa, while the same accounts for 4% of cases in developed countries.

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