Characteristics of Significant Pericardial Effusion and Outcomes of Pericardiocentesis: A 4-year Retrospective Data Review

Abstract

Introduction: Pericardial effusion can lead to severe complications such as cardiac tamponade, necessitating immediate intervention. Various causes and prevalence vary according to the region. To the best of our knowledge, there is limited data from the Middle East region about pericardial effusion and outcomes of pericardiocentesis. Methods: This retrospective observational study was conducted at Heart Hospital, the only tertiary cardiology center in Qatar, to assess the clinical and echocardiographic characteristics of pericardial effusion and the impact of pericardiocentesis. Patients admitted to the cardiac intensive care unit between January 2017 and February 2021 with significant pericardial effusion confirmed either by large amount using transthoracic echocardiography (TTE), clinical signs, or echocardiographic signs suggestive of tamponade were included. The study evaluated clinical outcomes, including complications of pericardiocentesis and laboratory parameters before and after the procedure. Results: A total of 114 patients were included in our retrospective analysis. The most common etiology of pericardial effusion in the study was idiopathic (31.6%), followed by malignancy (25.4%), viral infection (13.2%), and tuberculosis (12.3%). Most patients (95%) had moderate to large effusions by TTE. Pericardiocentesis was successfully performed in 82.5% of patients. After pericardiocentesis, heart rate significantly decreased from 105 to 95 bpm (P < 0.001), and laboratory results showed significant improvement in renal and liver function, including serum creatinine, alanine transaminase, aspartate aminotransferase, and bilirubin levels. There were no pericardiocentesis-related deaths, but 6.38% of patients died within 28 days due to advanced primary diseases. Conclusion: Idiopathic causes were the most common, followed by malignancy. Pericardiocentesis, performed in an ICU setting with TTE guidance, was safe, with a 100% survival rate and low complication risk. Patients with impaired kidney and liver functions experienced significant improvement postprocedure. These findings offer valuable insights into pericardial effusion in Qatar and allow for comparisons with neighboring Middle Eastern countries.

Keywords

• cardiac tamponade
• echocardiographic-guided pericardiocentesis
• pericardial effusion
• pericardiocentesis
• right ventricular injury postpericardiocentesis