Pericardial Disease Associated with Malignancy

Ryan Schusler, Shari Lynn Meyerson*

*Corresponding author for this work

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Purpose of Review: Pericardial effusion is commonly associated with malignancy. The goals of treatment should include optimizing symptom relief, minimizing repeat interventions, and restoring as much functional status as possible. Recent Findings: Pericardiocentesis should be the first intervention but has high recurrence rates (30–60%). For patients with recurrence, repeat pericardiocentesis is indicated in those with limited expected lifespans. Extended pericardial drainage decreases recurrence to 10–20%. The addition of sclerosing agents decreases recurrence slightly but creates significant pain and can lead to pericardial constriction and therefore has fallen out of favor. Summary: Most patients with symptomatic pericardial disease have a short median survival time due to their underlying disease. In patients with a longer life expectancy, surgical drainage offers the lowest recurrence rate. Surgical approach is based on effusion location and clinical condition. Subxiphoid and thoracoscopic approaches lead to similar outcomes. Thoracotomy should be avoided as it increases morbidity without improving outcomes.

Original languageEnglish (US)
Article number92
JournalCurrent Cardiology Reports
Volume20
Issue number10
DOIs
StatePublished - Oct 1 2018

Fingerprint

Recurrence
Pericardiocentesis
Neoplasms
Drainage
Sclerosing Solutions
Pericardial Effusion
Thoracotomy
Life Expectancy
Constriction
Morbidity
Pain
Survival
Therapeutics

Keywords

  • Cardiac tamponade
  • Malignancy
  • Pericardial disease (including epidemiology, clinical presentation, pathogenesis, detection, treatment, prognosis)
  • Pericardial effusion
  • Pericardial window
  • Pericardiocentesis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Schusler, Ryan ; Meyerson, Shari Lynn. / Pericardial Disease Associated with Malignancy. In: Current Cardiology Reports. 2018 ; Vol. 20, No. 10.
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abstract = "Purpose of Review: Pericardial effusion is commonly associated with malignancy. The goals of treatment should include optimizing symptom relief, minimizing repeat interventions, and restoring as much functional status as possible. Recent Findings: Pericardiocentesis should be the first intervention but has high recurrence rates (30–60{\%}). For patients with recurrence, repeat pericardiocentesis is indicated in those with limited expected lifespans. Extended pericardial drainage decreases recurrence to 10–20{\%}. The addition of sclerosing agents decreases recurrence slightly but creates significant pain and can lead to pericardial constriction and therefore has fallen out of favor. Summary: Most patients with symptomatic pericardial disease have a short median survival time due to their underlying disease. In patients with a longer life expectancy, surgical drainage offers the lowest recurrence rate. Surgical approach is based on effusion location and clinical condition. Subxiphoid and thoracoscopic approaches lead to similar outcomes. Thoracotomy should be avoided as it increases morbidity without improving outcomes.",
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Pericardial Disease Associated with Malignancy. / Schusler, Ryan; Meyerson, Shari Lynn.

In: Current Cardiology Reports, Vol. 20, No. 10, 92, 01.10.2018.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Pericardial Disease Associated with Malignancy

AU - Schusler, Ryan

AU - Meyerson, Shari Lynn

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Purpose of Review: Pericardial effusion is commonly associated with malignancy. The goals of treatment should include optimizing symptom relief, minimizing repeat interventions, and restoring as much functional status as possible. Recent Findings: Pericardiocentesis should be the first intervention but has high recurrence rates (30–60%). For patients with recurrence, repeat pericardiocentesis is indicated in those with limited expected lifespans. Extended pericardial drainage decreases recurrence to 10–20%. The addition of sclerosing agents decreases recurrence slightly but creates significant pain and can lead to pericardial constriction and therefore has fallen out of favor. Summary: Most patients with symptomatic pericardial disease have a short median survival time due to their underlying disease. In patients with a longer life expectancy, surgical drainage offers the lowest recurrence rate. Surgical approach is based on effusion location and clinical condition. Subxiphoid and thoracoscopic approaches lead to similar outcomes. Thoracotomy should be avoided as it increases morbidity without improving outcomes.

AB - Purpose of Review: Pericardial effusion is commonly associated with malignancy. The goals of treatment should include optimizing symptom relief, minimizing repeat interventions, and restoring as much functional status as possible. Recent Findings: Pericardiocentesis should be the first intervention but has high recurrence rates (30–60%). For patients with recurrence, repeat pericardiocentesis is indicated in those with limited expected lifespans. Extended pericardial drainage decreases recurrence to 10–20%. The addition of sclerosing agents decreases recurrence slightly but creates significant pain and can lead to pericardial constriction and therefore has fallen out of favor. Summary: Most patients with symptomatic pericardial disease have a short median survival time due to their underlying disease. In patients with a longer life expectancy, surgical drainage offers the lowest recurrence rate. Surgical approach is based on effusion location and clinical condition. Subxiphoid and thoracoscopic approaches lead to similar outcomes. Thoracotomy should be avoided as it increases morbidity without improving outcomes.

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KW - Pericardial effusion

KW - Pericardial window

KW - Pericardiocentesis

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