Why the study?
What factors identify patients at risk for serious causes of pericardial disease?
What factors identify patients at risk for serious causes of pericardial disease?
Clinical and non-invasive findings can correctly identify the cause of pericardial disease in 90% of cases, though anterior pericardiectomy is favored as the diagnostic procedure of choice for high-risk patients.
Answers are grounded in this paper and cite their sources.
Noninvasive assessment may aid etiology identification in pericarditis; leaves open prospective validation before guiding risk stratification.
A retrospective analysis of 133 patients was performed to define the factors identifying those individuals at risk for the more serious causes of pericardial disease. In 90% of the cases, the initial assessment from data obtained without pericardiocentesis or pericardiectomy proved correct. Underlying tuberculous or malignant pericarditis were the most common sources of error on initial assessment. Hemodynamic compromise exclusive of anticoagulants, roentgenographic cardiomegaly, pleural effusion, low voltage on ECG, and large pericardial effusion by echocardiography were more common (P<.05) in tuberculous pericarditis than in acute idiopathic pericarditis. We discuss similar risk factors in patients with chronic idiopathic, rheumatologic, and uremic pericarditis. Anterior pericardiectomy is favored as the diagnostic procedure of choice in patients at risk for the more serious causes of pericarditis because of greater safety, diagnostic sensitivity, and potential therapeutic benefit. (Arch Intern Med139:407-412, 1979)
No takes yet. Share an insight, caveat, or question.
R. Christopher Agner (1979) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: