Malignant Pericardial Effusion: Heart-Breaking Tumors

Q: What is the clinical evidence from this study?

Population: malignant pericardial effusion (n=450). Intervention: pericardiocentesis vs. pericardial window. Primary outcome: recurrence rates after management of malignant pericardial effusion (null, 95% CI null, p=null).

Mohammed A. R. Chamsi-Pasha

doi:10.14797/mdcvj.1761

January 1, 2026Methodist DeBakey Cardiovascular JournalOpen Access

Malignant Pericardial Effusion: Heart-Breaking Tumors

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Key result

Extended catheter drainage linked to ~68% lower malignant effusion recurrence versus isolated pericardiocentesis.

null
95% CI null
P null
n=450

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Key Points

To outline the clinical features, diagnostic evaluation, and management strategies for malignant pericardial effusion and complicating cardiac tamponade.
Presented a clinical case of a 71-year-old male undergoing transthoracic echocardiography, urgent pericardiocentesis yielding 800 mL of bloody fluid, cytology, PET-CT, and extended catheter drainage over 2 weeks.
Synthesized findings from published literature, including a cohort of 450 acute pericardial disease patients, a systematic review of 31 observational studies, and a meta-analysis of 41 case reports.
Initial presentation of neoplastic pericardial effusion manifests as cardiac tamponade in approximately one-third of affected patients.
In acute pericardial disease (N=450), large effusions (69.7%) and cardiac tamponade (60.6%) occurred significantly more frequently in malignancy-related cases.
Across 31 observational studies, effusion recurrence rates were 38% for isolated pericardiocentesis, 12% for extended catheter drainage, and < 7% for surgical pericardial window.

Structured PICO

P

Population

1 71-year-old man with a history of prostate cancer, hypertension, and hyperlipidemia presenting with progressive shortness of breath, lower-extremity edema, and a large pericardial effusion with tamponade physiology due to metastatic lung adenocarcinoma.

I

Intervention

Urgent pericardiocentesis with extended catheter drainage over 2 weeks, followed by palliative chemotherapy (carboplatin/pemetrexed).

Main Result

Effect estimate: null (95% CI null)

Absolute Event Rate: 38% vs 7%

p-value: p=null

This case highlights that malignant pericardial effusions frequently present with tamponade and can be effectively managed with extended catheter drainage when surgical options are high-risk.

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Implication

Supports extended catheter drainage for high-risk malignant effusions; extends nonoperative options but remains hypothesis-generating.

Abstract

Pericardial effusion secondary to an underlying neoplasm carries a poor prognosis because it often represents an advanced stage of malignancy. In approximately one-third of affected patients, the initial presentation may be cardiac tamponade.

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Cite This Study

Mohammed A. R. Chamsi-Pasha (2026) studied malignant pericardial effusion (n=450). pericardiocentesis vs. pericardial window was evaluated on recurrence rates after management of malignant pericardial effusion (null, 95% CI null, p=null).

synapsesocial.com/papers/69b3abf602a1e69014ccd4b1 https://doi.org/10.14797/mdcvj.1761

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Malignant Pericardial Effusion: Heart-Breaking Tumors

Figures

Key Points

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Malignant Pericardial Effusion: Heart-Breaking Tumors

Figures

Key Points

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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