Baqi Abdul, Ahmed Intisar
Cardiology, Aga Khan University Hospital, Karachi, PAK.
Cureus. 2020 Aug 28;12(8):e10102. doi: 10.7759/cureus.10102.
Pericardiocentesis is crucial for the diagnosis and management of diseases responsible for significant pericardial effusions. Pericardiocentesis was performed the first time by Riolanus for cardiac tamponade. He described the process of trephination of the sternum to remove the abnormally accumulated fluid from the pericardial space. However, with the advancement of expertise in echocardiography assisted procedures, echocardiography-guided diagnostic and therapeutic pericardiocentesis is now considered standard clinical practice in the treatment of pericardial effusions.
We aim to study different causes of pericardial effusion and indications of pericardiocentesis as well as complications associated with it in our population.
This is a retrospective observational study done at Aga Khan University Hospital, Karachi. We reviewed hospital record files of 66 patients admitted to Aga Khan University Hospital from January 2010 to December 2019 who underwent pericardiocentesis.
Out of 66 patients, 43 (65.2%) were male. The mean age of the study population was 48.59±18.9 years and 41 (62.1%) of them had underlying active malignancy with hematological malignancies being most common followed by lung carcinoma. In the majority of patients (71.2%), pericardiocentesis was performed at the bedside, and the rest of them (28.8%) underwent pericardiocentesis in the cardiac catheterization laboratory. Of all the patients, 46 (69.7%) underwent pericardiocentesis under echocardiography guidance and 18 (27.3%) required fluoroscopy. Successful pericardiocentesis was performed in 65 (98.5%) of the patients, two (3%) patients developed access site infection and only one (1.5%) patient became hemodynamically unstable while undergoing pericardiocentesis Conclusion: Malignancy, predominantly lymphoma, is the most common cause of pericardial effusion requiring pericardiocentesis. Dyspnea is the most common symptom of presentation with cardiac tamponade. Echocardiography is the commonly used imaging modality for pericardiocentesis. Bedside setting is the most common setting used for pericardiocentesis. Imaging guided pericardiocentesis has a very high success and low complication rate.
心包穿刺术对于诊断和处理导致大量心包积液的疾病至关重要。里奥兰努斯首次为心脏压塞患者实施了心包穿刺术。他描述了胸骨环钻术的过程，以清除心包腔内异常积聚的液体。然而，随着超声心动图辅助操作技术的进步，超声心动图引导下的心包穿刺诊断和治疗现已被视为心包积液治疗的标准临床实践。
我们旨在研究心包积液的不同病因、心包穿刺术的适应证以及在我们的研究人群中与之相关的并发症。
这是一项在卡拉奇阿迦汗大学医院进行的回顾性观察研究。我们回顾了2010年1月至2019年12月期间入住阿迦汗大学医院并接受心包穿刺术的66例患者的医院病历档案。
66例患者中，43例（65.2%）为男性。研究人群的平均年龄为48.59±18.9岁，其中41例（62.1%）患有潜在的活动性恶性肿瘤，血液系统恶性肿瘤最为常见，其次是肺癌。大多数患者（71.2%）在床边进行心包穿刺术，其余患者（28.8%）在心脏导管实验室进行心包穿刺术。所有患者中，46例（69.7%）在超声心动图引导下进行心包穿刺术，18例（27.3%）需要透视。65例（98.5%）患者成功进行了心包穿刺术，2例（3%）患者发生穿刺部位感染，只有1例（1.5%）患者在进行心包穿刺术时出现血流动力学不稳定。结论：恶性肿瘤，主要是淋巴瘤，是需要心包穿刺术的心包积液最常见的病因。呼吸困难是心脏压塞最常见的症状表现。超声心动图是心包穿刺术常用的影像学检查方法。床边操作是心包穿刺术最常用的操作环境。影像学引导下心包穿刺术成功率很高且并发症发生率低。
