Chronic Pericardial Effusion: Diagnostic and Therapeutic Methods

Chronic Pericardial Effusion: Diagnostic and Therapeutic Methods Chronic pericardial effusion is a very important clinical situation that can cause morbidity and mortality. In parallel with having many different etiological factors, there are important differences in diagnostic and treatment methods of this problem. A good knowledge of clinical presentation of pericardial effusions, diagnostic methods, and different therapeutic approaches is very important. In this study, our aim is to look over the diagnostic and therapeutic approaches by searching the latest literature. According to these, in acute symptomatic effusions the method of therapeutic choice should be pericardiosynthesis with the guidance of echocardiography. The etiology plays a crucial role in the treatment of chronic effusions. In malignant effusions, pericardiocentesis, sclerosing therapy, and radiotherapy are the choice of treatments. In chronic recurrent effusions balloon pericardiotomy and in purulent and tuberculosis pericardial effusions surgery are the appropriate approaches. The latest studies are mostly based on the application of new therapeutic methods on pericardial pathologies. Especially, in patients who do not have the chance of percutaneous and surgical revascularization, the use of intrapericardial basic fibroblast growth factor to stimulate collateral revascularization is promising. (Türk Kardiyol Dern Arş 2004; 32: 581-590)