Wysięk osierdziowy
Rokowania, prognozy i postęp choroby
Rokowanie w przypadku wysięku osierdziowego jest ściśle związane z jego etiologią, a kluczowym czynnikiem determinującym przebieg kliniczny po perikardiocentezie jest choroba podstawowa. Najczęstszą przyczyną wysięku jest nowotwór (46,3%), a następnie jatrogenne powikłania pooperacyjne (17,4%). Wysięki złośliwe charakteryzują się niekorzystnym rokowaniem, z 12-miesięcznym wskaźnikiem przeżycia około 45%, a mediana czasu przeżycia wynosi 13,7 miesiąca. Czynniki prognostyczne w MPE obejmują echokardiograficzne objawy płynu (HR=2,37, P=0,010), tachykardię zatokową w EKG (HR=1,76, P=0,006) oraz tamponadę serca (HR=3,33, P<0,001). Wysięk osierdziowy jest także istotnym czynnikiem prognostycznym u pacjentów z rakiem płuc i złośliwym wysiękiem opłucnowym, gdzie nomogram uwzględnia m.in. poziomy LDH w płynie opłucnowym oraz objętość wysięku.
Prognostyczne czynniki w wysięku osierdziowym
Rokowanie w przypadku wysięku osierdziowego jest zasadniczo związane z jego etiologią. Podstawowym czynnikiem determinującym przebieg kliniczny po perikardiocentezie jest przyczyna leżąca u podstaw wysięku osierdziowego1. Prawdopodobieństwo nawrotu wysięku oraz przeżycie do wypisu ze szpitala są determinowane przez etiologię wysięku osierdziowego2.
Rokowanie w zależności od etiologii
Rokowanie pacjenta z wysiękiem osierdziowym zależy od choroby podstawowej. Duże wysięki generalnie wskazują na poważniejszy przebieg choroby3. Jeśli przyczyna wywołująca nie zagraża życiu, małe, przewlekłe wysięki są zwykle dobrze tolerowane4.
Wysięki, które pojawiają się z nieznanych przyczyn, mają zazwyczaj dobre rokowanie. Wysięki powstałe w wyniku urazu lub nowotworu częściej powodują powikłania i są trudniejsze w leczeniu5. Wskaźniki przeżycia są gorsze dla osób, których wysięki osierdziowe mają związek z nowotworem lub HIV/AIDS6.
Wysięk osierdziowy w chorobach nowotworowych
Nowotwór jest najczęstszą przyczyną wysięku osierdziowego (46,3%), a na drugim miejscu znajdują się jatrogenne powikłania pooperacyjne (17,4%)7. Wskaźnik przeżycia 12 miesięcy po drenażu złośliwego wysięku osierdziowego wynosi około 45,0%8.
Diagnoza złośliwego wysięku osierdziowego (MPE) jest często związana z niekorzystnym rokowaniem ze względu na złożoność i niespecyficzny charakter objawów klinicznych9. W jednym z badań mediana czasu przeżycia 216 pacjentów z MPE wynosiła 13,7 miesiąca10. Śmiertelność wewnątrzszpitalna wynosiła 9,3% (20/216), a 5-letnia śmiertelność po wypisie wynosiła 46,8% (101/216)11.
Czynniki ryzyka wpływające na rokowanie
Czynniki wpływające na rokowanie w złośliwym wysięku osierdziowym obejmują echokardiograficzne objawy płynu (HR=2,37, P=0,010), elektrokardiograficzne dowody tachykardii zatokowej (HR=1,76, P=0,006) oraz echokardiograficzne dowody tamponady serca (HR=3,33, P<0,001)1213. Wszystkie te czynniki są niezależnymi czynnikami wpływającymi na przeżycie pacjentów.
W przypadku pacjentów z rakiem płuc i złośliwym wysiękiem opłucnowym (MPE), obecność wysięku osierdziowego jest jednym z kluczowych czynników wpływających na rokowanie14. Nomogram opracowany dla tych pacjentów uwzględnia pięć zmiennych: poziomy dehydrogenazy mleczanowej (LDH) w płynie opłucnowym, przejrzystość wysięku opłucnowego, schemat leczenia, obecność wysięku osierdziowego oraz całkowitą objętość wysięku opłucnowego15.
Rokowanie w nadciśnieniu płucnym
Wysięk osierdziowy (PE) jest skorelowany z wynikami u pacjentów z tętniczym nadciśnieniem płucnym (PAH)16. Po medianie 376 dni obserwacji, odsetek zdarzeń związanych z PAH, zgonów z wszystkich przyczyn i ponownych hospitalizacji wzrastał wraz z ilością wysięku osierdziowego i występował u 29,8%, 19,7% i 25,2% pacjentów z PE, w porównaniu do 3,4%, 3,4% i 6,8% pacjentów bez PE (odpowiednio p = 0,034, p = 0,041 i p = 0,039)17.
Obecność wysięku osierdziowego była związana z mniejszą redukcją ciśnienia w tętnicy płucnej (PAP)18. Wielkość wysięku osierdziowego była jedynym predyktorem wyniku klinicznego po denerwacji tętnicy płucnej (PADN)19. PADN prowadziło do znacznego zmniejszenia PE, z następującym zmniejszeniem zdarzeń związanych z PAH, zgonów z wszystkich przyczyn i pogorszenia PAH20.
Rokowanie w innych schorzeniach sercowo-naczyniowych
Najniższe wskaźniki przeżycia do wypisu obserwowano wśród pacjentów z ostrym zespołem aorty wstępującej (rozwarstwienia aorty lub pęknięcia tętniaka aorty wstępującej) oraz pęknięciem wolnej ściany komory po ostrym zawale mięśnia sercowego21.
Znaczenie monitorowania i interwencji
O tym, czy wysięk osierdziowy stanowi zagrożenie dla życia, decyduje jego przyczyna, ilość płynu oraz szybkość wypełniania osierdzia22. Gdy wysięk powstaje w wyniku urazów lub problemów z sercem i układem krążenia (lub z jakiegokolwiek powodu, który może powodować szybki rozwój wysięku), wymaga szybkiego leczenia, aby uniknąć niebezpiecznych powikłań, takich jak tamponada serca23.
Biorąc pod uwagę wartość prognostyczną wysięku osierdziowego, brak lub ustąpienie PE po zastosowaniu nowej terapii powinno sugerować lepsze rokowanie24. W przypadku nowotworów i zakażenia HIV/AIDS, wczesne postawienie diagnozy i odpowiednie leczenie mogą poprawić rokowanie, choć pozostaje ono niepomyślne w porównaniu z innymi przyczynami wysięku osierdziowego.
Monitoring echokardiograficzny jest niezbędny do oceny progresji wysięku osierdziowego i wczesnego wykrywania tamponady serca, która jest poważnym czynnikiem ryzyka wpływającym na rokowanie2526.
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Materiały źródłowe
- #1 Causes and prognosis of symptomatic pericardial effusions treated by pericardiocentesis in an Asian academic medical centrehttps://pmc.ncbi.nlm.nih.gov/articles/PMC7905117/
Of 149 patients who underwent pericardiocentesis, malignancy (46.3%) was the most common cause of pericardial effusions, followed by iatrogenic postsurgical complications (17.4%). […] Likelihood of effusion recurrence and survival to discharge was determined by the aetiology of the pericardial effusion. […] The survival rate 12 months after drainage of a malignant pericardial effusion was 45.0%. […] Prognosis and clinical course after pericardiocentesis are determined by the underlying cause of the pericardial effusion. […] The prognosis of pericardial effusion is essentially related to its aetiology. […] This is consistent with the 45.0% survival rate at 12 months in our patients. […] Survival to discharge was closely related to aetiology, with the lowest survival rates seen among patients with acute ascending aortic syndrome (aortic dissections or rupture of ascending aortic aneurysms) and ventricular free wall rupture following acute myocardial infarctions. […] In conclusion, cancer and iatrogenic complications are the most common causes of pericardial effusion in this large cohort of Singapore patients.
- #2 Causes and prognosis of symptomatic pericardial effusions treated by pericardiocentesis in an Asian academic medical centrehttps://pmc.ncbi.nlm.nih.gov/articles/PMC7905117/
Of 149 patients who underwent pericardiocentesis, malignancy (46.3%) was the most common cause of pericardial effusions, followed by iatrogenic postsurgical complications (17.4%). […] Likelihood of effusion recurrence and survival to discharge was determined by the aetiology of the pericardial effusion. […] The survival rate 12 months after drainage of a malignant pericardial effusion was 45.0%. […] Prognosis and clinical course after pericardiocentesis are determined by the underlying cause of the pericardial effusion. […] The prognosis of pericardial effusion is essentially related to its aetiology. […] This is consistent with the 45.0% survival rate at 12 months in our patients. […] Survival to discharge was closely related to aetiology, with the lowest survival rates seen among patients with acute ascending aortic syndrome (aortic dissections or rupture of ascending aortic aneurysms) and ventricular free wall rupture following acute myocardial infarctions. […] In conclusion, cancer and iatrogenic complications are the most common causes of pericardial effusion in this large cohort of Singapore patients.
- #3 Pericardial Effusion: Causes, Symptoms and Treatment | Doctorhttps://patient.info/doctor/pericardial-effusion
The prognosis for a patient with a pericardial effusion will depend on the underlying cause. Large effusions generally indicate more serious disease. […] If the precipitating cause is not life-threatening, small, chronic effusions are usually well tolerated.
- #4 Pericardial Effusion: Causes, Symptoms and Treatment | Doctorhttps://patient.info/doctor/pericardial-effusion
The prognosis for a patient with a pericardial effusion will depend on the underlying cause. Large effusions generally indicate more serious disease. […] If the precipitating cause is not life-threatening, small, chronic effusions are usually well tolerated.
- #5 Pericardial Effusion: Symptoms & Causeshttps://my.clevelandclinic.org/health/diseases/17351-pericardial-effusion
Pericardial effusion is usually a significant condition. But it isnt always a medical emergency. Whether or not its a life-threatening emergency depends on what caused it, the amount of fluid involved and how fast that fluid fills your pericardium. […] One factor that determines if a pericardial effusion is serious is why it happened in the first place. When it happens because of injuries or heart and circulatory problems (or any reason that can cause an effusion to develop quickly), pericardial effusion needs quick treatment to avoid dangerous complications like cardiac tamponade. […] Overall, effusions that happen for unknown reasons tend to have a good prognosis. Effusions that happen because of trauma or cancer are more likely to have complications and are usually harder to treat. Survival rates are poor for people whose pericardial effusions have a link to cancer or HIV/AIDS.
- #6 Pericardial Effusion: Symptoms & Causeshttps://my.clevelandclinic.org/health/diseases/17351-pericardial-effusion
Pericardial effusion is usually a significant condition. But it isnt always a medical emergency. Whether or not its a life-threatening emergency depends on what caused it, the amount of fluid involved and how fast that fluid fills your pericardium. […] One factor that determines if a pericardial effusion is serious is why it happened in the first place. When it happens because of injuries or heart and circulatory problems (or any reason that can cause an effusion to develop quickly), pericardial effusion needs quick treatment to avoid dangerous complications like cardiac tamponade. […] Overall, effusions that happen for unknown reasons tend to have a good prognosis. Effusions that happen because of trauma or cancer are more likely to have complications and are usually harder to treat. Survival rates are poor for people whose pericardial effusions have a link to cancer or HIV/AIDS.
- #7 Causes and prognosis of symptomatic pericardial effusions treated by pericardiocentesis in an Asian academic medical centrehttps://pmc.ncbi.nlm.nih.gov/articles/PMC7905117/
Of 149 patients who underwent pericardiocentesis, malignancy (46.3%) was the most common cause of pericardial effusions, followed by iatrogenic postsurgical complications (17.4%). […] Likelihood of effusion recurrence and survival to discharge was determined by the aetiology of the pericardial effusion. […] The survival rate 12 months after drainage of a malignant pericardial effusion was 45.0%. […] Prognosis and clinical course after pericardiocentesis are determined by the underlying cause of the pericardial effusion. […] The prognosis of pericardial effusion is essentially related to its aetiology. […] This is consistent with the 45.0% survival rate at 12 months in our patients. […] Survival to discharge was closely related to aetiology, with the lowest survival rates seen among patients with acute ascending aortic syndrome (aortic dissections or rupture of ascending aortic aneurysms) and ventricular free wall rupture following acute myocardial infarctions. […] In conclusion, cancer and iatrogenic complications are the most common causes of pericardial effusion in this large cohort of Singapore patients.
- #8 Causes and prognosis of symptomatic pericardial effusions treated by pericardiocentesis in an Asian academic medical centrehttps://pmc.ncbi.nlm.nih.gov/articles/PMC7905117/
Of 149 patients who underwent pericardiocentesis, malignancy (46.3%) was the most common cause of pericardial effusions, followed by iatrogenic postsurgical complications (17.4%). […] Likelihood of effusion recurrence and survival to discharge was determined by the aetiology of the pericardial effusion. […] The survival rate 12 months after drainage of a malignant pericardial effusion was 45.0%. […] Prognosis and clinical course after pericardiocentesis are determined by the underlying cause of the pericardial effusion. […] The prognosis of pericardial effusion is essentially related to its aetiology. […] This is consistent with the 45.0% survival rate at 12 months in our patients. […] Survival to discharge was closely related to aetiology, with the lowest survival rates seen among patients with acute ascending aortic syndrome (aortic dissections or rupture of ascending aortic aneurysms) and ventricular free wall rupture following acute myocardial infarctions. […] In conclusion, cancer and iatrogenic complications are the most common causes of pericardial effusion in this large cohort of Singapore patients.
- #9 Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China | BMC Cardiovascular Disorders | Full Texthttps://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02331-9
The diagnosis of malignant pericardial effusion (MPE) is often associated with a poor prognosis, but due to the complexity and unspecific nature of MPE patients’ clinical manifestations, imaging often performs an essential role in diagnosis and prognosis. […] The median survival time of the 216 patients with MPE was 13.7 months. The factors affecting prognosis were echocardiographic fluid signs (HR=2.37, P=0.010), electrocardiographic evidence of sinus tachycardia (HR=1.76, P=0.006) and echocardiographic evidence of cardiac tamponade (HR=3.33, P0.001). […] MPE has complex clinical manifestations and an unsatisfactory prognosis. Echocardiographic fluid signs, electrocardiographic evidence of sinus tachycardia, and echocardiographic evidence of cardiac tamponade are independent risk factors affecting prognosis.
- #10 Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China | BMC Cardiovascular Disorders | Full Texthttps://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02331-9
The diagnosis of malignant pericardial effusion (MPE) is often associated with a poor prognosis, but due to the complexity and unspecific nature of MPE patients’ clinical manifestations, imaging often performs an essential role in diagnosis and prognosis. […] The median survival time of the 216 patients with MPE was 13.7 months. The factors affecting prognosis were echocardiographic fluid signs (HR=2.37, P=0.010), electrocardiographic evidence of sinus tachycardia (HR=1.76, P=0.006) and echocardiographic evidence of cardiac tamponade (HR=3.33, P0.001). […] MPE has complex clinical manifestations and an unsatisfactory prognosis. Echocardiographic fluid signs, electrocardiographic evidence of sinus tachycardia, and echocardiographic evidence of cardiac tamponade are independent risk factors affecting prognosis.
- #11 Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China | BMC Cardiovascular Disorders | Full Texthttps://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02331-9
This study confirmed the unsatisfactory prognosis of MPE. The in-hospital mortality rate was 9.3% (20/216), and the 5-year mortality rate after discharge was 46.8% (101/216). The Cox regression results showed that echocardiographic fluid signs (HR=2.37, P=0.010), electrocardiographic evidence of sinus tachycardia (HR=1.76, P=0.006) and echocardiographic evidence of cardiac tamponade (HR=3.33, P=0.001) had a significant relationship with patient survival. Moreover, they were all independent factors influencing the survival of patients.
- #12 Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China | BMC Cardiovascular Disorders | Full Texthttps://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02331-9
The diagnosis of malignant pericardial effusion (MPE) is often associated with a poor prognosis, but due to the complexity and unspecific nature of MPE patients’ clinical manifestations, imaging often performs an essential role in diagnosis and prognosis. […] The median survival time of the 216 patients with MPE was 13.7 months. The factors affecting prognosis were echocardiographic fluid signs (HR=2.37, P=0.010), electrocardiographic evidence of sinus tachycardia (HR=1.76, P=0.006) and echocardiographic evidence of cardiac tamponade (HR=3.33, P0.001). […] MPE has complex clinical manifestations and an unsatisfactory prognosis. Echocardiographic fluid signs, electrocardiographic evidence of sinus tachycardia, and echocardiographic evidence of cardiac tamponade are independent risk factors affecting prognosis.
- #13 Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China | BMC Cardiovascular Disorders | Full Texthttps://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02331-9
This study confirmed the unsatisfactory prognosis of MPE. The in-hospital mortality rate was 9.3% (20/216), and the 5-year mortality rate after discharge was 46.8% (101/216). The Cox regression results showed that echocardiographic fluid signs (HR=2.37, P=0.010), electrocardiographic evidence of sinus tachycardia (HR=1.76, P=0.006) and echocardiographic evidence of cardiac tamponade (HR=3.33, P=0.001) had a significant relationship with patient survival. Moreover, they were all independent factors influencing the survival of patients.
- #14 Exploring prognostic precision: a nomogram approach for malignant pleural effusion in lung cancer | BMC Cancer | Full Texthttps://bmccancer.biomedcentral.com/articles/10.1186/s12885-025-13632-z
Patients with lung cancer and malignant pleural effusion (MPE) often have poor prognoses. Accurate prognostic tools are needed to guide interventions and improve outcomes. […] The final nomogram included five variables: Lactate Dehydrogenase (LDH) levels in pleural fluid, clarity of pleural effusion, treatment regimen, presence of pericardial effusion, and total volume of pleural effusion. […] Our nomogram accurately predicts the prognosis of lung cancer patients with MPE at initial diagnosis, incorporating key variables such as LDH levels in pleural fluid, clarity of pleural effusion, treatment regimen, pericardial effusion, and total volume of pleural effusion. […] These factors were found to be closely associated with patient prognosis. […] The developed nomograms accurately predicted MPE prognosis at lung cancer diagnosis. […] This study introduces a clinical features-based nomogram for MPE prognostic assessment at lung cancer diagnosis. It holds promise for early prognosis determination, aiding prompt intervention for patients with poor prognoses.
- #15 Exploring prognostic precision: a nomogram approach for malignant pleural effusion in lung cancer | BMC Cancer | Full Texthttps://bmccancer.biomedcentral.com/articles/10.1186/s12885-025-13632-z
Patients with lung cancer and malignant pleural effusion (MPE) often have poor prognoses. Accurate prognostic tools are needed to guide interventions and improve outcomes. […] The final nomogram included five variables: Lactate Dehydrogenase (LDH) levels in pleural fluid, clarity of pleural effusion, treatment regimen, presence of pericardial effusion, and total volume of pleural effusion. […] Our nomogram accurately predicts the prognosis of lung cancer patients with MPE at initial diagnosis, incorporating key variables such as LDH levels in pleural fluid, clarity of pleural effusion, treatment regimen, pericardial effusion, and total volume of pleural effusion. […] These factors were found to be closely associated with patient prognosis. […] The developed nomograms accurately predicted MPE prognosis at lung cancer diagnosis. […] This study introduces a clinical features-based nomogram for MPE prognostic assessment at lung cancer diagnosis. It holds promise for early prognosis determination, aiding prompt intervention for patients with poor prognoses.
- #16 Pericardial effusion is correlated with clinical outcome after pulmonary artery denervation for pulmonary arterial hypertension | Oncotargethttps://www.oncotarget.com/article/14031/text/
Pericardial effusion (PE) is correlated with outcomes in patients with pulmonary arterial hypertension (PAH). The present study aimed to analyze the prognostic value of PE for outcomes after PADN in patients with WHO Group I, Group II and Group IV PAH. […] After a median of 376 days follow-up, the rate of PAH-related event, all-cause death and rehospitalization increased over the PE amount and occurred in 29.8%, 19.7% and 25.2% of patients with PE, different to 3.4%, 3.4% and 6.8% of patients without PE (p = 0.034, p = 0.041 and p = 0.039, respectively). […] PE is associated with increased PAH-related event after PADN. […] The presence of PE was associated with less reduction of PAP. […] The current study for the first time reports the correlation of baseline pericardial effusion with clinical outcome after PADN in patients with different etiologies of PAH.
- #17 Pericardial effusion is correlated with clinical outcome after pulmonary artery denervation for pulmonary arterial hypertension | Oncotargethttps://www.oncotarget.com/article/14031/text/
Pericardial effusion (PE) is correlated with outcomes in patients with pulmonary arterial hypertension (PAH). The present study aimed to analyze the prognostic value of PE for outcomes after PADN in patients with WHO Group I, Group II and Group IV PAH. […] After a median of 376 days follow-up, the rate of PAH-related event, all-cause death and rehospitalization increased over the PE amount and occurred in 29.8%, 19.7% and 25.2% of patients with PE, different to 3.4%, 3.4% and 6.8% of patients without PE (p = 0.034, p = 0.041 and p = 0.039, respectively). […] PE is associated with increased PAH-related event after PADN. […] The presence of PE was associated with less reduction of PAP. […] The current study for the first time reports the correlation of baseline pericardial effusion with clinical outcome after PADN in patients with different etiologies of PAH.
- #18 Pericardial effusion is correlated with clinical outcome after pulmonary artery denervation for pulmonary arterial hypertension | Oncotargethttps://www.oncotarget.com/article/14031/text/
Pericardial effusion (PE) is correlated with outcomes in patients with pulmonary arterial hypertension (PAH). The present study aimed to analyze the prognostic value of PE for outcomes after PADN in patients with WHO Group I, Group II and Group IV PAH. […] After a median of 376 days follow-up, the rate of PAH-related event, all-cause death and rehospitalization increased over the PE amount and occurred in 29.8%, 19.7% and 25.2% of patients with PE, different to 3.4%, 3.4% and 6.8% of patients without PE (p = 0.034, p = 0.041 and p = 0.039, respectively). […] PE is associated with increased PAH-related event after PADN. […] The presence of PE was associated with less reduction of PAP. […] The current study for the first time reports the correlation of baseline pericardial effusion with clinical outcome after PADN in patients with different etiologies of PAH.
- #19 Pericardial effusion is correlated with clinical outcome after pulmonary artery denervation for pulmonary arterial hypertension | Oncotargethttps://www.oncotarget.com/article/14031/text/
PADN led to significant reduction of PE, with subsequent less PAH-related event, all-cause death and worsening of PAH. […] Given the prognostic value of PE, the absence or resolution of PE with novel therapy should have suggested better prognosis. […] Our data clearly showed that size of PE was the only predictor of clinical outcome after PADN.
- #20 Pericardial effusion is correlated with clinical outcome after pulmonary artery denervation for pulmonary arterial hypertension | Oncotargethttps://www.oncotarget.com/article/14031/text/
PADN led to significant reduction of PE, with subsequent less PAH-related event, all-cause death and worsening of PAH. […] Given the prognostic value of PE, the absence or resolution of PE with novel therapy should have suggested better prognosis. […] Our data clearly showed that size of PE was the only predictor of clinical outcome after PADN.
- #21 Causes and prognosis of symptomatic pericardial effusions treated by pericardiocentesis in an Asian academic medical centrehttps://pmc.ncbi.nlm.nih.gov/articles/PMC7905117/
Of 149 patients who underwent pericardiocentesis, malignancy (46.3%) was the most common cause of pericardial effusions, followed by iatrogenic postsurgical complications (17.4%). […] Likelihood of effusion recurrence and survival to discharge was determined by the aetiology of the pericardial effusion. […] The survival rate 12 months after drainage of a malignant pericardial effusion was 45.0%. […] Prognosis and clinical course after pericardiocentesis are determined by the underlying cause of the pericardial effusion. […] The prognosis of pericardial effusion is essentially related to its aetiology. […] This is consistent with the 45.0% survival rate at 12 months in our patients. […] Survival to discharge was closely related to aetiology, with the lowest survival rates seen among patients with acute ascending aortic syndrome (aortic dissections or rupture of ascending aortic aneurysms) and ventricular free wall rupture following acute myocardial infarctions. […] In conclusion, cancer and iatrogenic complications are the most common causes of pericardial effusion in this large cohort of Singapore patients.
- #22 Pericardial Effusion: Symptoms & Causeshttps://my.clevelandclinic.org/health/diseases/17351-pericardial-effusion
Pericardial effusion is usually a significant condition. But it isnt always a medical emergency. Whether or not its a life-threatening emergency depends on what caused it, the amount of fluid involved and how fast that fluid fills your pericardium. […] One factor that determines if a pericardial effusion is serious is why it happened in the first place. When it happens because of injuries or heart and circulatory problems (or any reason that can cause an effusion to develop quickly), pericardial effusion needs quick treatment to avoid dangerous complications like cardiac tamponade. […] Overall, effusions that happen for unknown reasons tend to have a good prognosis. Effusions that happen because of trauma or cancer are more likely to have complications and are usually harder to treat. Survival rates are poor for people whose pericardial effusions have a link to cancer or HIV/AIDS.
- #23 Pericardial Effusion: Symptoms & Causeshttps://my.clevelandclinic.org/health/diseases/17351-pericardial-effusion
Pericardial effusion is usually a significant condition. But it isnt always a medical emergency. Whether or not its a life-threatening emergency depends on what caused it, the amount of fluid involved and how fast that fluid fills your pericardium. […] One factor that determines if a pericardial effusion is serious is why it happened in the first place. When it happens because of injuries or heart and circulatory problems (or any reason that can cause an effusion to develop quickly), pericardial effusion needs quick treatment to avoid dangerous complications like cardiac tamponade. […] Overall, effusions that happen for unknown reasons tend to have a good prognosis. Effusions that happen because of trauma or cancer are more likely to have complications and are usually harder to treat. Survival rates are poor for people whose pericardial effusions have a link to cancer or HIV/AIDS.
- #24 Pericardial effusion is correlated with clinical outcome after pulmonary artery denervation for pulmonary arterial hypertension | Oncotargethttps://www.oncotarget.com/article/14031/text/
PADN led to significant reduction of PE, with subsequent less PAH-related event, all-cause death and worsening of PAH. […] Given the prognostic value of PE, the absence or resolution of PE with novel therapy should have suggested better prognosis. […] Our data clearly showed that size of PE was the only predictor of clinical outcome after PADN.
- #25 Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China | BMC Cardiovascular Disorders | Full Texthttps://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02331-9
The diagnosis of malignant pericardial effusion (MPE) is often associated with a poor prognosis, but due to the complexity and unspecific nature of MPE patients’ clinical manifestations, imaging often performs an essential role in diagnosis and prognosis. […] The median survival time of the 216 patients with MPE was 13.7 months. The factors affecting prognosis were echocardiographic fluid signs (HR=2.37, P=0.010), electrocardiographic evidence of sinus tachycardia (HR=1.76, P=0.006) and echocardiographic evidence of cardiac tamponade (HR=3.33, P0.001). […] MPE has complex clinical manifestations and an unsatisfactory prognosis. Echocardiographic fluid signs, electrocardiographic evidence of sinus tachycardia, and echocardiographic evidence of cardiac tamponade are independent risk factors affecting prognosis.
- #26 Prognosis and role of clinical and imaging features in patients with malignant pericardial effusion: a single-center study in China | BMC Cardiovascular Disorders | Full Texthttps://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02331-9
This study confirmed the unsatisfactory prognosis of MPE. The in-hospital mortality rate was 9.3% (20/216), and the 5-year mortality rate after discharge was 46.8% (101/216). The Cox regression results showed that echocardiographic fluid signs (HR=2.37, P=0.010), electrocardiographic evidence of sinus tachycardia (HR=1.76, P=0.006) and echocardiographic evidence of cardiac tamponade (HR=3.33, P=0.001) had a significant relationship with patient survival. Moreover, they were all independent factors influencing the survival of patients.