Objective: To study etiology, morbidity and mortality of pericardial disease and frequency of constrictive pericarditis with long term follow up of ten years. Methodology:This descriptive study was conducted at Cardiology Unit Lady Reading Hospital Peshawar. All serial cases with moderate and large pericardial effusions presenting to Echo Room were enrolled in the study after fulfilling the inclusion and exclusion criteria. The cases were worked-up etiologically for the causes of pericardial effusion and planned to be followed up for ten years. Results: 102 cases of moderate and large pericardial effusions were studied etiology wise in detail and were followed up for ten years. End points were death or 10 years of follow-up. On work-up it was observed that 36% were having proven tuberculous, another 26% cases were highly suggestive of tuberculosis. Contribution of other etiologies was pyogenic 8%, idiopathic 8%, rheumatic heart disease 5%, cardiomyopathies 5%, malignancy 4%, uremia 3%, rheumatoid arthritis 2%, pneumonia 1%, Dressler 1%, post cardiotomy 1%. Follow-up revealed that over all mortality was 21.56% at one year. Mortality and constriction was most common in the group with proven tuberculosis 30% and 27% respectively. Similarly malignant and uremic pericardial effusions had also a worst prognosis soon after the diagnosis. Mortality after one year and followup was not found to be related to the initial disease process. Conclusion: Pericardial constriction mostly occurred in the group with proven tuberculosis so was the mortality. After the initial one year period, none developed constriction in the 10 years period.
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