Massive chronic idiopathic pericardial effusion

Abstract

Pericardial effusion is a common clinical finding now that echocardiography has become a routine tool for the study of patients with cardiac or systemic diseases. Thus, in a consecutive series (1) of 2106 patients pericardial effusion was diagnosed in 178 (8.4%), a prevalence similar to that found by other authors (2). A significant number of pericardial effusions are missed if diagnosis is based on clinical grounds alone (41% and 61% in the two series), as either they are small or do not give rise to clinical suspicion of pericardial disease. By contrast, in some patients pericardial effusion may be the dominant finding because of its great size (massive pericardial effusion), whether or not clinical findings suggesting pericardial disease are present. Occasionally, pericardial effusion persists over years or even decades, thereby constituting the syndrome of chronic pericardial effusion (3–5). This clinical syndrome has multiple etiologies (6–8); in fact, it can be caused by a great number of the disorders that may involve the pericardium.