Key result
Among 23 hospitalized systemic sclerosis patients with symptomatic pericardial effusions, 78% received medical therapy and 22% underwent a surgical procedure.
Why the study?
What are the clinical characteristics and management strategies for clinically symptomatic pericardial effusions in hospitalized systemic sclerosis patients?
Observational (n=23)
No
What are the clinical characteristics and management strategies for clinically symptomatic pericardial effusions in hospitalized systemic sclerosis patients?
Absolute Event Rate: 78% vs 22%
Clinically symptomatic pericardial effusion is a rare cause of hospital admission in systemic sclerosis, frequently associated with pulmonary arterial hypertension, and is predominantly managed with medical therapy.
Symptomatic pericardial effusions remain uncommon in SSc admissions with frequent PAH overlap; leaves open optimal medical versus surgical selection pending prospective data.
BACKGROUND: Pericardial effusions in systemic sclerosis (SSc) may present as acute or chronic with or without clinical symptoms. Best treatment is unknown and whether patients receive medical therapy or a surgical procedure is clinician-dependent. OBJECTIVE: To describe the clinical characteristics, treatment, and outcomes of patients with SSc and clinically symptomatic pericardial effusions treated in the inpatient setting. METHODS: We evaluated all SSc admissions over a 10-year period to a tertiary care hospital which has a dedicated SSc clinic. Patients who had a clinically symptomatic pericardial effusion were evaluated based on their demographics, disease pattern, and medical or surgical management. RESULTS: From January 2005 till October 2015, there were 462 SSc admissions with 32 (6.9%) of them being for a clinically symptomatic pericardial effusion in 23 unique patients. Eleven (47%) of these patients had right heart failure, seventeen (74%) had pulmonary arterial hypertension (PAH), and 4 (17%) had tamponade physiology. Five (22%) patients were treated by a surgical procedure, while eighteen (78%) patients had medical therapy. Patients who received medical therapy tended to be older, have a lower serum Cr level, and more likely have right heart failure. CONCLUSION: Clinically symptomatic pericardial effusion is a rare cause for hospital admissions in SSc, with a high percentage of these patients having PAH. Medical therapy tends to be reserved for older patients with right heart failure, while surgical therapy was more likely in patients with higher serum Cr levels.
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Hosoya et al. (2018) conducted an observational in Systemic sclerosis with clinically symptomatic pericardial effusions (n=23). Medical therapy vs. Surgical procedure was evaluated on Treatment modality (medical vs surgical). Among 23 hospitalized systemic sclerosis patients with symptomatic pericardial effusions, 78% received medical therapy and 22% underwent a surgical procedure.
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