[Should we try to determine the specific cause of cardiac tamponade?].
BACKGROUND
The causes of cardiac tamponade vary and it has been suggested that underlying causes should be sought in all cases. The purpose of this study was to determine the causes of cardiac tamponade in our environment, distinguishing between specific and idiopathic causes, and analyzing the proportion and causes in the subgroup of patients with relapsing tamponade.


METHODS
We retrospectively studied all patients who underwent therapeutic pericardiocentesis between 1985 and 2001. The clinical and radiographic features and macroscopic characteristics of the pericardial fluid were analyzed. The final diagnosis in each patient was based on the clinical history, follow-up, pericardial fluid cytology, and pericardial biopsy, if available.


RESULTS
Ninety-six patients were included (52 men/44 women), mean age 56.1 16.1 years. The cause of pericardial effusion was neoplasm in 50 patients (52.1%), 14 idiopathic pericarditis (14.6%), 12 renal failure (12.5%), 7 iatrogenic cases (7.3%), 4 mechanical tamponades (4.2%), 2 tuberculosis (2.1%), and 7 other causes (7.3%). Thirty-five patients had relapsing tamponade; only 2 of them had idiopathic pericarditis (5.7%). We found no significant differences in age, development time, extracted volume or fluid features between tamponade of specific or idiopathic origin.


CONCLUSIONS
Most of the cardiac tamponades in our series had a specific cause. This made it necessary to identify a specific underlying cause in each case, especially in relapsing effusions. However, we did not find any variable suggestive of the cause of the disease.
Oliver Navarrete
Clara
C
Servicio de Cardiología, Hospital General Universitario de Alicante, Spain.
Marín Ortuño
Francisco
F
Pineda Rocamora
Javier
J
Luján Martínez
Juan
J
García Fernández
Amaya
A
Climent Payá
Vicente E
VE
Martínez Martínez
Juan G
JG
Aranda López
Ignacio
I
Sogorb Garri
Francisco
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002305:Cardiac Tamponade / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000473:pathology; D020519:Pericardiocentesis; D010496:Pericardium / Q000473:pathology; D012189:Retrospective Studies