TY  - JOUR
PY  - 2015//
TI  - Cause and long-term outcome of cardiac tamponade
JO  - American journal of cardiology
A1  - Sánchez-Enrique, Cristina
A1  - Nuñez-Gil, Iván J.
A1  - Viana-Tejedor, Ana
A1  - De Agustín, Alberto
A1  - Vivas, David
A1  - Palacios-Rubio, Julián
A1  - Vilchez, Jean Paul
A1  - Cecconi, Alberto
A1  - Macaya, Carlos
A1  - Fernández-Ortiz, Antonio
SP  - 664
EP  - 669
VL  - 117
IS  - 4
N2  - Cardiac tamponade is a life-threatening condition, whose current specific cause and outcome are unknown. Our purpose was to analyze it. We performed a retrospective observational study with prospective follow-up data including 136 consecutive patients admitted with diagnosis of cardiac tamponade, from 2003 to 2013. We thoroughly recorded variables as clinical features, drainage/pericardiocentesis, fluid characteristics, and long-term events (new cardiac tamponade ± death). The median age was 65 ± 17 years (55% men). In the baseline characteristics, 70% were no smokers, 12% were on anticoagulation, and 13 had suffered a previous myocardial infarction. In the preceding month, 15 patients had undergone a cardiac catheterization, 5 cardiac surgery, and 5 pacemaker insertion. Fever was observed in 16% of patients and 21% displayed other inflammatory symptoms. In 81% of patients, pericardiocentesis was needed. The fluid was hemorrhagic or a transudate in the majority, with positive cytology in 15% and bacteria in 3.7%. Main causes were malignancy (32%), infection (24%), idiopathic (16%), iatrogenic (15%), postmyocardial infarction (7%), uremic (4%), and other causes (2%). After a maximum follow-up of 10.4 years, cardiac tamponade recurred in 10% of the cases (62% in the neoplastic group) and the 48% of patients died (89% in the neoplastic cohort). In conclusion, most cardiac tamponades are due to malignancy, having this specific cause a poorer outcome, probably as a manifestation of an advanced disease. The rest of causes, after an aggressive intensive management, have a good prognosis, especially the iatrogenic.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-9149
UR  - http://dx.doi.org/10.1016/j.amjcard.2015.11.023
ID  - ref1
ER  -