Evaluation of Etiology and Causes of Massive
Pericardial Effusion in Patients with
Tamponade, in Mazandaran Heart Center and
Shafa Hospital, Sari, Iran

Shervin Ziabakhsh Tabary, MD, FCTS*

Background: Pericardial effusion is diagnosed as an echo-free space around the

heart. This fluid collection follows the anatomic landmarks of the pericardium,

covering both ventricles and most of the right atrium, whereas a small portion of

the LA wall is surrounded by pericardium. Pericardial effusion should be

differentiated from left pleural effusion, an echo free space that extends posterior

to the descending aorta, and from increased pericardial fat content, of typical

granular appearance, that does not deserve medical attention.

Aim: Aim of this issue is to find the presentation by which the patients have come

to the hospital that at last the diagnosis was massive pericardial effusion and

finding the laboratory and pathologic causes of this clinical problem.

Materials and Methods: We reviewed the patients who had been admitted in

Mazandaran Heart Center and Shafa hospital between Sept 2009 and Jan 2013

with diagnosis of pericardial effusion which were made by echocardiography.

Results: Among these patients there was a history of viral infection including

cough, fever, weakness in previous month in 32 (37%) patients and a history of

diagnosed malignancy in 15 patients (1%7) who at least had a course of

chemotherapy in their drug history and history of trauma in one patient, there

was history of chronic renal failure and repeated dialysis in 12(14%) but there

was no previous disease in the other patients (36%). There was a history of

previous surgery for tamponade in 3 of them (3%).After admission the diagnosis

of massive pericardial effusion had been made and in 48 (55%) of them, there

was echocardiographic signs of RA collapse and RV collapse.

Discussion: Most pericardial effusions are caused by inflammation of the

pericardium, a condition called pericarditis. As the pericardium becomes

inflamed, extra fluid is produced, leading to a pericardial effusion. Viral infections

are one of the main causes of pericarditis and pericardial effusions. in laboratory

and pathologic findings of specimen obtained from pericardial fluid and biopsy

specimen there was nothing specific to show the exact cause of effusion.

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