248
Views
1
CrossRef citations to date
0
Altmetric
Review

Chronic pericardial effusion: current concepts and emerging trends

, ORCID Icon, , , , & show all
Pages 363-376 | Received 14 Mar 2022, Accepted 05 May 2022, Published online: 15 May 2022

References

  • Adler Y, Charron P, Imazio M, et al., ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 36(42): 2921–2964. 2015.
  • Lazaros G, Imazio M, Brucato A, et al. Untying the Gordian knot of pericardial diseases: A pragmatic approach. Hellenic J Cardiol. 2016;57(5):315–322.
  • Imazio M, Spodick DH, Brucato A, et al. Controversial issues in the management of pericardial diseases. Circulation. 2010;121(7):916–928.
  • Imazio M, Gaita F, LeWinter M. Evaluation and treatment of pericarditis: a systematic review. JAMA. 2015;314(14):1498–1506.
  • Yusuf SW, Hassan SA, Mouhayar E, et al. Pericardial disease: A clinical review. Expert Rev Cardiovasc Ther. 2016;14(4):525–539.
  • Khayata M, Alkharabsheh S, Shah NP, et al. Pericardial cysts: A contemporary comprehensive review. Curr Cardiol Rep. 2019;21(7):64.
  • Khayata M, Alkharabsheh S, Shah NP, et al. Case series, contemporary review and imaging guided diagnostic and management approach of congenital pericardial defects. Open Heart. 2020;7(1):e001103.
  • Lazaros G, Tousoulis D, Vassilopoulos D. Editorial commentary: recurrent pericarditis in the era of interleukin-1 inhibition. Trends Cardiovasc Med. 2021;31(5):275–276.
  • Imazio M, De Ferrari GM. Cardiac tamponade: An educational review. Eur Heart J Acute Cardiovasc Care. 2020 Jul 6;10(1):2048872620939341.
  • Imazio M, Gaido L, Battaglia A, et al. Contemporary management of pericardial effusion: Practical aspects for clinical practice. Postgrad Med. 2017;129(2):178–186.
  • Lazaros G, Lazarou E, Vlachopoulos C, et al. Pericarditis and pericardial effusion: One or two distinct diseases? Minerva Cardiol Angiol. 2022;70(2):207–216.
  • Lazaros G, Vlachopoulos C, Lazarou E, et al. Contemporary management of pericardial effusion. Panminerva Med. 2021;63(3):288–300.
  • Imazio M, Adler Y. Management of pericardial effusion. Eur Heart J. 2013;34(16):1186–1197.
  • Lazaros G, Vlachopoulos C, Lazarou E, et al. New approaches to management of pericardial effusions. Curr Cardiol Rep. 2021;23(8):106.
  • Galluzzo A, Imazio M. Advances in medical therapy for pericardial diseases. Expert Rev Cardiovasc Ther. 2018;16(9):635–643.
  • Lazaros G, Antonopoulos AS, Lazarou E, et al. Long-term outcome of pericardial drainage in cases of chronic, large, hemodynamically insignificant, C-reactive protein negative, idiopathic pericardial effusions. Am J Cardiol. 2020;126:89–93.
  • Tsang TSM, Barnes ME, Gersh BJ, et al. Outcomes of clinically significant idiopathic pericardial effusion requiring intervention. Am J Cardiol. 2003;91(6):704–707.
  • Vogiatzidis K, Zarogiannis SG, Aidonidis I, et al. Physiology of pericardial fluid production and drainage. Front Physiol. 2015;6:62.
  • Peebles CR, Shambrook JS, Harden SP. Pericardial disease–anatomy and function. Br J Radiol. 2011;84:S324-–S337.
  • Imazio M, Biondo A, Ricci D, et al. Contemporary biochemical analysis of normal pericardial fluid. Heart. 2020;106(7):541–544.
  • Natanzon A, Kronzon I. Pericardial and pleural effusions in congestive heart failure-anatomical, pathophysiologic, and clinical considerations. Am J Med Sci. 2009;338(3):211–216.
  • Buoro S, Tombetti E, Ceriotti F, et al. What is the normal composition of pericardial fluid? Heart. 2021;107(19):1584–1590.
  • Imazio M, Mayosi BM, Brucato A, et al. Triage and management of pericardial effusion. J Cardiovasc Med (Hagerstown). 2010;11(12):928–935.
  • Ristić AD, Imazio M, Adler Y, et al., Triage strategy for urgent management of cardiac tamponade: A position statement of the European society of cardiology working group on myocardial and pericardial diseases. Eur Heart J. 35(34): 2279–2284. 2014.
  • Little WC, Freeman GL. Pericardial disease. Circulation. 2006;113(12):1622–1632.
  • Lazaros G, Vlachopoulos C, Stefanadis C. Idiopathic recurrent pericarditis: Searching for Ariadne’s thread. Hellenic J Cardiol. 2009;50(5):345–351.
  • Khandaker MH, Espinosa RE, Nishimura RA, et al. Pericardial disease: Diagnosis and management. Mayo Clin Proc. 2010;85(6):572–593.
  • Mitiku TY, Heidenreich PA. A small pericardial effusion is a marker of increased mortality. Am Heart J. 2011;161(1):152–157.
  • Furqan M, Chetrit M, Cremer P, et al. Misclassification of pericardial disease diagnosis; international classification of diseases-10 coding requires validation. Circulation. 2019;140:A15826.
  • Lazaros G, Antonopoulos AS, Lazarou E, et al. Age- and sex-based differences in patients with acute pericarditis. Eur J Clin Invest. 2021;51(3):e13392.
  • Imazio M, Demichelis B, Parrini I, et al. Day-hospital treatment of acute pericarditis: A management program for outpatient therapy. J Am Coll Cardiol. 2004;43(6):1042–1046.
  • Imazio M, Gaita F. Diagnosis and treatment of pericarditis. Heart. 2015;101(14):1159–1168.
  • Lazaros G, Solomou E, Antonopoulos AS, et al. The landscape of acute pericarditis in Greece: Experience from a tertiary referral center. Hellenic J Cardiol. 2019;60(2):139–140.
  • Vecchié A, Chiabrando JG, Dell MS, et al. Clinical presentation and outcomes of acute pericarditis in a large urban hospital in the United States of America. Chest. 2020;158(6):2556–2567.
  • Sagristà-Sauleda J, Mercé J, Permanyer-Miralda G, et al. Clinical clues to the causes of large pericardial effusions. Am J Med. 2000;109(2):95–101.
  • Corey GR, Campbell PT, Van Trigt P, et al. Etiology of large pericardial effusions. Am J Med. 1993;95(2):209–213.
  • Levy P-Y, Corey R, Berger P, et al. Etiologic diagnosis of 204 pericardial effusions. Medicine (Baltimore). 2003;82(6):385–391.
  • Reuter H, Burgess LJ, Doubell AF. Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect. 2005;133(3):393–399.
  • Ma W, Liu J, Zeng Y, et al. Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients. Herz. 2012;37(2):183–187.
  • Mayosi BM, Burgess LJ, Doubell AF. Tuberculous pericarditis. Circulation. 2005;112(23):3608–3616.
  • Lazaros G, Tousoulis D. Tuberculous pericarditis: A complex puzzle to put together. EBioMedicine. 2015;2(11):1570–1571.
  • Lazaros G, Vlachopoulos C, Stefanadis C. Extensive infectious panel testing for acute pericarditis: A ghost hunt? Cardiology. 2011;119(3):131–133.
  • Lazaros G, Anastassopoulou C, Hatziantoniou S, et al. A case series of acute pericarditis following COVID-19 vaccination in the context of recent reports from Europe and the United States. Vaccine. 2021;39(45):6585–6590.
  • Lazaros G, Klein AL, Hatziantoniou S, et al. The novel platform of mRNA COVID-19 vaccines and myocarditis: clues into the potential underlying mechanism. Vaccine. 2021;39(35):4925–4927.
  • Kermani-Alghoraishi M, Pouramini A, Kafi F, et al. Coronavirus disease 2019 (COVID-19) and severe pericardial effusion: from pathogenesis to management: a case report based systematic review. Curr Probl Cardiol. 2022;47(2):100933.
  • Buckley BJR, Harrison SL, Fazio-Eynullayeva E, et al. Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients. Eur J Clin Invest. 2021;51(11):e13679.
  • Imazio M, Cooper LT. Management of myopericarditis. Expert Rev Cardiovasc Ther. 2013;11(2):193–201.
  • Imazio M, Brucato A, Barbieri A, et al. Good prognosis for pericarditis with and without myocardial involvement: Results from a multicenter, prospective cohort study. Circulation. 2013;128(1):42–49.
  • Serati L, Carnovale C, Maestroni S, et al. Management of acute and recurrent pericarditis in pregnancy. Panminerva Med. 2021;63(3):276–287.
  • Fröhlich GM, Keller P, Schmid F, et al. Haemodynamically irrelevant pericardial effusion is associated with increased mortality in patients with chronic heart failure. Eur Heart J. 2013;34(19):1414–1423.
  • Lazaros G, Vlachopoulos C, Lazarou E, et al. Acute idiopathic pericarditis: is it actually always idiopathic? J Am Coll Cardiol. 2021;77(11):1484–1485.
  • Imazio M, Brucato A, Maestroni S, et al., Y. risk of constrictive pericarditis after acute pericarditis. Circulation. 124(11): 1270–1275. 2011.
  • Cremer PC, Kumar A, Kontzias A, et al., Complicated pericarditis: understanding risk factors and pathophysiology to inform imaging and treatment. J Am Coll Cardiol. 68(21): 2311–2328. 2016.
  • Chiabrando JG, Bonaventura A, Vecchié A, et al. Management of acute and recurrent pericarditis: JACC state-of-the-art review. J Am Coll Cardiol. 2020;75(1):76–92.
  • Chetrit M, Xu B, Kwon DH, et al. Imaging-guided therapies for pericardial diseases. JACC Cardiovasc Imaging. 2020;13(6):1422–1437.
  • Klein AL, Abbara S, Agler DA, et al. American society of echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: Endorsed by the society for cardiovascular magnetic resonance and society of cardiovascular computed tomography. J Am Soc Echocardiogr. 2013;26(9):965–1012.e15.
  • Cosyns B, Plein S, Nihoyanopoulos P, et al. European Association of Cardiovascular Imaging (EACVI) position paper: multimodality imaging in pericardial disease. Eur Heart J Cardiovasc Imaging. 2015;16(1):12–31.
  • Verhaert D, Gabriel RS, Johnston D, et al., The role of multimodality imaging in the management of pericardial disease. Circ Cardiovasc Imaging. 3(3): 333–343. 2010.
  • Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349(7):684–690.
  • Roy CL, Minor MA, Brookhart MA, et al. Does this patient with a pericardial effusion have cardiac tamponade? JAMA. 2007;297(16):1810–1818.
  • Shabetai R. Pericardial effusion: Haemodynamic spectrum. Heart. 2004;90(3):255–256.
  • Lazaros G, Vlachopoulos C. Acute pericarditis clinical features and outcome: an update on the latest evidence. Chest. 2020;158(6):2262–2263.
  • Spodick DH. Pericarditis, pericardial effusion, cardiac tamponade, and constriction. Crit Care Clin. 1989;5(3):455–476.
  • Lazarou E, Lazaros G, Antonopoulos AS, et al., A risk score for pericarditis recurrence. Eur J Clin Invest. 51(11): e13602. 2021.
  • Imazio M, Andreis A, Lubian M, et al. The torino pericarditis score: A new-risk stratification tool to predict complicated pericarditis. Intern Emerg Med. 2021;16(7):1921–1926.
  • Eisenberg MJ, Dunn MM, Kanth N, et al. Diagnostic value of chest radiography for pericardial effusion. J Am Coll Cardiol. 1993;22(2):588–593.
  • Lazaros G, Antonopoulos AS, Imazio M, et al. Clinical significance of pleural effusions and association with outcome in patients hospitalized with a first episode of acute pericarditis. Intern Emerg Med. 2019;14(5):745–751.
  • Imazio M, Brucato A, Mayosi BM, et al. Medical therapy of pericardial diseases: Part II: noninfectious pericarditis, pericardial effusion and constrictive pericarditis. J Cardiovasc Med (Hagerstown). 2010;11(10):785–794.
  • Low TT, Tan VSR, Teo S-G, et al. ECGs with small QRS voltages. Singapore Med J. 2012;53(5):299–303.
  • Brucato A, Brambilla G, Adler Y, et al. Colchicine for recurrent acute pericarditis. Arch Intern Med. 2006;166(6):696.
  • Imazio M, Pedrotti P, Quattrocchi G, et al. Multimodality imaging of pericardial diseases. J Cardiovasc Med (Hagerstown). 2016;17(11):774–782.
  • Lazaros G, Imazio M, Tousoulis D. Percutaneous pericardiocentesis: Safety first! Cardiology. 2015;130(1):34–36.
  • Maggiolini S, Gentile G, Farina A, et al. Safety, efficacy, and complications of pericardiocentesis by real-time echo-monitored procedure. Am J Cardiol. 2016;117(8):1369–1374.
  • Adi O, Fong CP, Ahmad AH, et al. Pericardial decompression syndrome: A complication of pericardiocentesis. Am J Emerg Med. 2021;45:688.e3–688.e7.
  • Prabhakar Y, Goyal A, Khalid N, et al. Pericardial decompression syndrome: A comprehensive review. World J Cardiol. 2019;11(12):282–291.
  • Imazio M. Pericardial decompression syndrome: A rare but potentially fatal complication of pericardial drainage to be recognized and prevented. Eur Heart J Acute Cardiovasc Care. 2015;4(2):121–123.
  • Imazio M, Belli R, Beqaraj F, et al. DROP investigators. DRainage or pericardiocentesis alone for recurrent nonmalignant, nonbacterial pericardial effusions requiring intervention: Rationale and design of the DROP trial, a randomized, open-label, multicenter study. J Cardiovasc Med (Hagerstown). 2014;15(6):510–514.
  • Lazaros G, Oikonomou V, Oikonomou E, et al. Recurrence of pericardial effusion after pericardiocentesis: does catheter-induced acute pericardial inflammation play a role? Am J Med Sci. 2021;361(5):676–678.
  • Yadav S, Singh M, Singh P, et al. Cytological evaluation of pericardial fluids: A 5 years experience in tertiary care center. Indian J Pathol Microbiol. 2019;62(2):270–273.
  • Meyers DG, Meyers RE, Prendergast TW. The usefulness of diagnostic tests on pericardial fluid. Chest. 1997;111(5):1213–1221.
  • Atar S, Chiu J, Forrester JS, et al. Bloody pericardial effusion in patients with cardiac tamponade: Is the cause cancerous, tuberculous, or iatrogenic in the 1990s? Chest. 1999;116(6):1564–1569.
  • Avondo S, Andreis A, Casula M, et al. Update on diagnosis and management of neoplastic pericardial disease. Expert Rev Cardiovasc Ther. 2020;18(9):615–623.
  • Burazor I, Aviel-Ronen S, Imazio M, et al. Primary malignancies of the heart and pericardium. Clin Cardiol. 2014;37(9):582–588.
  • Burazor I, Imazio M, Markel G, et al. Malignant pericardial effusion. Cardiology. 2013;124(4):224–232.
  • Imazio M, Colopi M, De Ferrari GM. Pericardial diseases in patients with cancer: Contemporary prevalence, management and outcomes. Heart. 2020;106(8):569–574.
  • Maisch B, Seferović PM, Ristić AD, et al. Task force on the diagnosis and management of pricardial diseases of the European society of cardiology. guidelines on the diagnosis and management of pericardial diseases executive summary; the task force on the diagnosis and management of pericardial diseases of the European society of cardiology. Eur Heart J. 2004;25(7):587–610.
  • El Haddad D, Iliescu C, Yusuf SW, et al. Outcomes of cancer patients undergoing percutaneous pericardiocentesis for pericardial effusion. J Am Coll Cardiol. 2015;66(10):1119–1128.
  • Firooz N, Albert DA, Wallace DJ, et al. High-sensitivity C-reactive protein and erythrocyte sedimentation rate in systemic lupus erythematosus. Lupus. 2011;20(6):588–597.
  • Narasimhan B, Turagam MK, Garg J, et al. Role of immunosuppressive therapy in the management refractory postprocedural pericarditis. J Cardiovasc Electrophysiol. 2021 Aug;32(8):2165–2170.
  • Brucato A, Imazio M, Gattorno M, et al. Effect of anakinra on recurrent pericarditis among patients with colchicine resistance and corticosteroid dependence: the AIRTRIP randomized clinical trial. JAMA. 2016;316(18):1906–1912.
  • Klein AL, Imazio M, Cremer P, et al. RHAPSODY investigators. phase 3 trial of interleukin-1 trap rilonacept in recurrent pericarditis. N Engl J Med. 2021;384(1):31–41.
  • Lazaros G, Antonatou K, Vassilopoulos D. The therapeutic role of interleukin-1 inhibition in idiopathic recurrent pericarditis: current evidence and future challenges. Front Med (Lausanne). 2017;4:78.
  • Brucato A, Imazio M, Cremer PC, et al. Recurrent pericarditis: Still idiopathic? The pros and cons of a well-honoured term. Intern Emerg Med. 2018;13(6):839–844.
  • Lazaros G, Antonopoulos AS, Antonatou K, et al. Hydroxychloroquine for colchicine-resistant glucocorticoid-dependent idiopathic recurrent pericarditis: A pilot observational prospective study. Int J Cardiol. 2020;311:77–82.
  • Sagristà-Sauleda J, Angel J, Permanyer-Miralda G, et al. Long-term follow-up of idiopathic chronic pericardial effusion. N Engl J Med. 1999;341(27):2054–2059.
  • Imazio M, Lazaros G, Valenti A, et al. Outcomes of idiopathic chronic large pericardial effusion. Heart. 2019;105(6):477–481.
  • Kytö V, Sipilä J, Rautava P. Clinical profile and influences on outcomes in patients hospitalized for acute pericarditis. Circulation. 2014;130(18):1601–1606.
  • Søgaard KK, Farkas DK, Ehrenstein V, et al. Pericarditis as a marker of occult cancer and a prognostic factor for cancer mortality. Circulation. 2017;136(11):996–1006.
  • Imazio M, Lazaros G, Picardi E, et al. Incidence and prognostic significance of new onset atrial fibrillation/flutter in acute pericarditis. Heart. 2015;101(18):1463–1467.
  • De Filippo O, Gatti P, Rettegno S, et al. Is pericardial effusion a negative prognostic marker? Meta-analysis of outcomes of pericardial effusion. J Cardiovasc Med (Hagerstown). 2019;20(1):39–45.
  • Bizzi E, Picchi C, Mastrangelo G, et al. Recent advances in pericarditis. Eur J Intern Med. 2022;95:24–31.
  • Al-Khadra Y, Sattar Y, Ullah W, et al. Predictors and risk factors of short-term readmission of acute pericarditis. Expert Rev Cardiovasc Ther. 2021;19(3):261–268.
  • Lazaros G, Aznaouridis K, Lazarou E, et al. The prognostic impact of the 2015 European society of cardiology pericarditis guidelines implementation in clinical practice. Hellenic J Cardiol. 2022;64:97–98.
  • Maisch B. European society of cardiology. progress or regress or both? ESC guidelines on pericardial diseases 2015. Herz. 2015;40(8):1061–1069.
  • Mauro AG, Bonaventura A, Vecchié A, et al., The role of NLRP3 inflammasome in pericarditis: potential for therapeutic approaches. JACC Basic Transl Sci. 6(2): 137–150. 2021.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.