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.
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 (PArch Intern Med139:407-412, 1979)
R. Christopher Agner (Sun,) studied this question.
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