Publication: Perikart efüzyonu olan hastaların klinik ve laboratuvar özellikleri
Abstract
Amaç: Bu çalışmada dört yıllık sürede perikart efüzyonu (PE) tanısı ile takip ettiğimiz hastalarda PE nedenleri, klinik ve laboratuvar özellikler ve tedavi stratejileri geriye dönük olarak incelendi. Çalışma planı: Çalışmada Ağustos 2005 ile Ağustos 2009 tarihleri arasında PE tanısı ile takip edilen 136 hastanın (81 kadın, 55 erkek; ort. yaş 55.8±18.7; dağılım 8-90) kayıtları geriye dönük olarak gözden geçirildi. Perikart efüzyonu tanısı transtorasik ekokardiyografi ile kondu. Hastaların özgeçmiş, fizik muayene, elektrokardiyografi, ekokardiyografi, laboratuvar bulguları ve uygulanan tedavi yöntemleri kaydedildi. Bulgular: Perikart efüzyonu olan hastalarda en sık karşılaşılan yakınma nefes darlığı (%86.8), fizik muayenede en sık bulgu ise jügüler venöz dolgunluk (%47.1) idi. Elektrokardiyografide en sık taşikardi (%47.8), ekokardiyografide ise hafif düzeyde (<1 cm) PE (%63.2) saptandı. Kronik böbrek yetersizliği (%25) ve kanserler (%22.8) PE’nin en sık nedenleriydi, bunları idiyopatik PE (%14) takip etmekteydi. Otuz dört hastada (%25) perikart tamponadı saptandı. Perikart tamponadı gelişen hastaların büyük bölümü (%53) kanser hastalarıydı. Otuz sekiz hastaya (%27.9) girişimsel tedavi (27 perikardiyosentez, 11 cerrahi drenaj) uygulandı; 98 hasta (%72.1) ise medikal tedavi ile takip edildi. Perikart tamponadı gelişen üç hasta takipler sırasında yaşamını yitirdi. Sonuç: Çalışma grubumuzda PE’nin en sık nedeni kronik böbrek yetersizliği ve kanserlerdi. Toplumun yaşlanması ile kanser hastalıklarına bağlı PE sıklığı da artmaktadır. Ekokardiyografi PE tanısı için öncelikle kullanılan tanı yöntemidir.
Objectives: We reviewed patients who were diagnosed to have pericardial effusion (PE) over a four-year period to determine the causes of PE, clinical and laboratory features, and treatment modalities. Study design: Medical records of 136 patients (81 women, 55 men; mean age 55.8±18.7 years; range 8 to 90 years) admitted to our department with PE from August 2005 to August 2009 were reviewed. The diagnosis of PE was made by transthoracic echocardiography. Medical history, physical examination, electrocardiography, echocardiography, and laboratory findings and treatment methods were recorded. Results: The most frequent complaint was dyspnea (86.8%) and the most common physical examination finding was jugular venous distension (47.1%). The most common electrocardiographic and echocardiographic findings were tachycardia (47.8%) and mild PE (<1 cm) (63.2%), respectively. Chronic renal failure and malignant diseases were the primary causes of PE (25% and 22.8% respectively), followed by idiopathic cases (14%). Pericardial tamponade was detected in 34 patients (25%), of which the majority had malignant diseases (53%). Thirty-eight patients (27.9%) underwent interventional treatment (pericardiocentesis in 27, surgical drainage in 11), while 98 patients (72.1%) were followed-up with medical treatment. Mortality occurred in three patients with pericardial tamponade. Conclusion: The most common causes of PE in our cases were chronic renal failure and malignancies. The incidence of malignant PE is on the incline owing to increased life expectancy. Echocardiography is the primary imaging modality for the evaluation of PE.
Objectives: We reviewed patients who were diagnosed to have pericardial effusion (PE) over a four-year period to determine the causes of PE, clinical and laboratory features, and treatment modalities. Study design: Medical records of 136 patients (81 women, 55 men; mean age 55.8±18.7 years; range 8 to 90 years) admitted to our department with PE from August 2005 to August 2009 were reviewed. The diagnosis of PE was made by transthoracic echocardiography. Medical history, physical examination, electrocardiography, echocardiography, and laboratory findings and treatment methods were recorded. Results: The most frequent complaint was dyspnea (86.8%) and the most common physical examination finding was jugular venous distension (47.1%). The most common electrocardiographic and echocardiographic findings were tachycardia (47.8%) and mild PE (<1 cm) (63.2%), respectively. Chronic renal failure and malignant diseases were the primary causes of PE (25% and 22.8% respectively), followed by idiopathic cases (14%). Pericardial tamponade was detected in 34 patients (25%), of which the majority had malignant diseases (53%). Thirty-eight patients (27.9%) underwent interventional treatment (pericardiocentesis in 27, surgical drainage in 11), while 98 patients (72.1%) were followed-up with medical treatment. Mortality occurred in three patients with pericardial tamponade. Conclusion: The most common causes of PE in our cases were chronic renal failure and malignancies. The incidence of malignant PE is on the incline owing to increased life expectancy. Echocardiography is the primary imaging modality for the evaluation of PE.