Gilbert I, Henning R J
Heart Lung. 1985 Jan;14(1):83-7.
In a patient with cancer, a diagnosis of cardiac tamponade should be considered when there is dyspnea, cough, thready pulse or pulsus paradoxus, low systolic blood pressure, engorged neck veins, an enlarged cardiac silhouette, and total or ventricular electrical alternans. Immediate pericardiocentesis is indicated in such patients to avoid the risk of sudden death. A pericardial window should be created for more prolonged palliation of cardiac tamponade. Cytologic examination of the pericardial fluid often reveals malignant or highly suspect cells. Metastatic carcinomas from the lung and breast are the most common tumors that involve the heart when they spread in a retrograde fashion through the cardiac lymphatic system. Total pericardiectomy for the treatment of cardiac tamponade that is due to cancer is not generally advisable. Radiation therapy in the cardiac area with or without systemic chemotherapy is effective in decreasing the amount and the recurrence of neoplastic pericardial effusion.
对于癌症患者，当出现呼吸困难、咳嗽、脉搏细弱或奇脉、收缩压降低、颈静脉怒张、心脏轮廓增大以及完全性或室性电交替时，应考虑心脏压塞的诊断。此类患者需立即进行心包穿刺以避免猝死风险。应建立心包开窗术以更长期缓解心脏压塞。心包液的细胞学检查常可发现恶性或高度可疑细胞。肺癌和乳腺癌的转移癌是最常见的肿瘤，当它们通过心脏淋巴系统逆行扩散时会累及心脏。因癌症导致的心脏压塞，一般不建议进行全心包切除术。在心脏区域进行放疗，无论是否联合全身化疗，均可有效减少肿瘤性心包积液的量及复发。
