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Pericardial Disease Associated with Malignancy

  • Cardio-Oncology (SA Francis and RB Morgan, Section Editors)
  • Published:
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Abstract

Purpose of Review

Pericardial effusion is commonly associated with malignancy. The goals of treatment should include optimizing symptom relief, minimizing repeat interventions, and restoring as much functional status as possible.

Recent Findings

Pericardiocentesis should be the first intervention but has high recurrence rates (30–60%). For patients with recurrence, repeat pericardiocentesis is indicated in those with limited expected lifespans. Extended pericardial drainage decreases recurrence to 10–20%. The addition of sclerosing agents decreases recurrence slightly but creates significant pain and can lead to pericardial constriction and therefore has fallen out of favor.

Summary

Most patients with symptomatic pericardial disease have a short median survival time due to their underlying disease. In patients with a longer life expectancy, surgical drainage offers the lowest recurrence rate. Surgical approach is based on effusion location and clinical condition. Subxiphoid and thoracoscopic approaches lead to similar outcomes. Thoracotomy should be avoided as it increases morbidity without improving outcomes.

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Authors and Affiliations

  1. Department of Surgery, Northwestern University, Chicago, IL, USA

    Ryan Schusler & Shari L. Meyerson

  2. Northwestern University Feinberg School of Medicine, 676 N. Saint Clair St., Suite 650, Chicago, IL, 60611, USA

    Shari L. Meyerson

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  1. Ryan Schusler
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Schusler, R., Meyerson, S.L. Pericardial Disease Associated with Malignancy. Curr Cardiol Rep 20, 92 (2018). https://doi.org/10.1007/s11886-018-1040-5

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