Cardiac tamponade in medical patients: a 10-year follow-up survey.
OBJECTIVE
Cardiac tamponade represents a life-threatening condition that may complicate almost any cause of pericarditis. We conducted a 10-year prospective survey on patients with cardiac tamponade requiring an emergency drainage.


METHODS
From 1996 to 2005, 114 consecutive patients were admitted to the University Hospital of Brest for medical cardiac tamponade. Data on medical history, and volume, characteristics and histology of the pericardial fluid as well as short- and long-term follow-up data were collected.


RESULTS
Malignant disease was the primary cause of medical tamponade (74 patients; 65%), followed by viral history (11; 10%) and intra-pericardial bleeding due to anti-coagulation treatment (4; 3%). In 12 cases, aetiology remained unknown (10%). Pericardiocentesis was immediately performed in 80 cases and surgical pericardiotomy in 34. The mean volume drained was 593 +/- 313 ml. In-hospital mortality was 10% without any difference between malignant and non-malignant diseases (p = 0.8). One-year mortality was 76.5% in patients with malignant disease and 13.3% in those without malignant disease (p < 0.0001). Median survival in case of malignant disease was 150 days.


CONCLUSIONS
Compared to previously published data, our survey shows a decrease in some historical causes of tamponade such as tuberculosis, myxoedema or uraemia. The leading cause is currently malignant disease, which carries a very poor prognosis.
Cornily
Jean-Christophe
JC
Department of Cardiology, Brest University Hospital, Brest, France.
Pennec
Pierre-Yves
PY
Castellant
Philippe
P
Bezon
Eric
E
Le Gal
Grégoire
G
Gilard
Martine
M
Jobic
Yannick
Y
Boschat
Jacques
J
Blanc
Jean-Jacques
JJ
D000368:Aged; D002305:Cardiac Tamponade / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010490:Pericardial Effusion / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D010492:Pericardiectomy; D020519:Pericardiocentesis; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome