Amber Ashraf, Saadia Ashraf, Mukhtiar Zaman, Abdul Samad.
Etiology, management and outcome of patients with Pericardial and Pleuro-Pericardial effusions.
J Med Sci Jan ;13(2):96-100.

Background: Patients with pericardial or pleuro pericardial effusions can be very unwell at presentation. These patients are treated with pericardiocentesis and/or pleural aspiration which itself is associated with morbidity & mortality. The aim of this descriptive study was to determine the etiology, management and outcome of patients with pericardial or pleuro-pericardial effusions. Research Methodology: Patients with pericardial / pleuro pericardial effusion presented to cardiology / pulmonology unit KTH, Peshawar between February 2001 to December 2003 were included in the study. Diagnostic and therapeutic pericardiocentesis/ pleural biopsy was performed, patients managed and followed up for subsequent outcome. Results: In total of 53 patients (28 males, 25 females, mean age of 36 yrs; range 19 to 65 years), 35 had pericardial and 18 had pleuro-pericardial effusion. Twenty patients underwent pericardiocentesis for diagnostic or therapeutic purpose while pleural biopsy was performed in 16 patients. Twenty patients (38%) turned up with confirmed Tuberculosis (T.B), (bacteriologically or histopathologically proven) and twelve (22.6%) had clinical diagnosis of TB (Positive history of contact and or chest X-ray finding). Pyogenic effusion was present in 3 (6%) of patients. Uraemia, malignancy, rheumatic heart disease (RHD), connective tissue disease (CTD), dressler syndrome and idiopathic group were much less in number, pointing to the fact that the T.B was the commonest etiology, affecting younger age group, with positive history of T.B contact in 15%. TB patients received treatment for 8 months, with 83.3% cure rate. Total of 12 patients lost follow-up. Conclusion: In our setup, TB is the commonest underlying diagnosis in patients with pericardial/ pleuropericardial effusion. Percutaneous pericardiocentesis and pleural biopsy remains an effective diagnostic tool. Regular follow up leads to successful outcome in these patients depending on the underlying condition.

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