Massive chronic idiopathic pericardial effusion

  • J. Soler-Soler
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 108)


Pericardial effusion is a common clinical finding now that echocardiography has become a routine tool for the study of patients with cardiac or systemic diseases. Thus, in a consecutive series (1) of 2106 patients pericardial effusion was diagnosed in 178 (8.4%), a prevalence similar to that found by other authors (2). A significant number of pericardial effusions are missed if diagnosis is based on clinical grounds alone (41% and 61% in the two series), as either they are small or do not give rise to clinical suspicion of pericardial disease. By contrast, in some patients pericardial effusion may be the dominant finding because of its great size (massive pericardial effusion), whether or not clinical findings suggesting pericardial disease are present. Occasionally, pericardial effusion persists over years or even decades, thereby constituting the syndrome of chronic pericardial effusion (3–5). This clinical syndrome has multiple etiologies (6–8); in fact, it can be caused by a great number of the disorders that may involve the pericardium.


Pericardial Effusion Cardiac Tamponade Constrictive Pericarditis Pericardial Disease Acute Pericarditis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Berger M, Bobak K, Jelveh M, Goldberg E. Pericardial effusion diagnosed by echo cardiography. Clinical and electrocardiographic findings. Chest 1978; 74:174–179.PubMedCrossRefGoogle Scholar
  2. 2.
    Riba AKK, Morganroth J. Unsuspected pericardial effusion detected by echocardiography. JAMA 1976; 236:2623–2625.PubMedCrossRefGoogle Scholar
  3. 3.
    Barker PS, Johnston FD. Chronic pericarditis with effusion. Circulation 1950; 2:134–138.PubMedGoogle Scholar
  4. 4.
    Bedford DE. Chronic effusive pericarditis. Br Heart J 1964; 26:499–512.PubMedCrossRefGoogle Scholar
  5. 5.
    Brown AK. Chronic idiopathic pericardial effusion. Br Heart J 1966; 28:609–614.PubMedCrossRefGoogle Scholar
  6. 6.
    Saint-Pierre A, Froment R. Epanchements péricardiques chroniques. Diagnostic étiologique. Conduite thérapeutique. In: Froment R, Gonin A, Michaud P, eds. Pathologie péricardique. Paris, Masson & Cie, 1966; 300–320.Google Scholar
  7. 7.
    Marion MML, Le Gall F, Baille Y, Chagnon A, Pierron JR. Les épanchements péricardiques chroniques. Revue générale a propos de 2 observations. Bordeaux Medical 1979; 23:1449–1456.Google Scholar
  8. 8.
    Colombo A, Olson HG, Egan J, Gardin JM. Etiology and prognostic implications of a large pericardial effusion in men. Clin Cardiol 1988; 11:389–394.PubMedCrossRefGoogle Scholar
  9. 9.
    Contro S, De Giuli G, Ragazzini F. Chronic effusive pericarditis. Circulation 1955; 11:844–848.PubMedGoogle Scholar
  10. 10.
    Connolly DC, Dry TJ, Good CA, Clagett OT, Burchell HB. Chronic idiopathic pericardial effusion without tamponade. Circulation 1959; 20:1095–1105.PubMedGoogle Scholar
  11. 11.
    Soulié P, Vernant P, Corone P, Georges R. Epanchement péricardique chronique idiopathique chez des şujets jeunes. Arch Mal Coeur 1960; 53: 1248 – 1256.Google Scholar
  12. 12.
    Wood P. Diseases of the heart and circulation. London, Eyre & Spottiswoode, 1968; 784.Google Scholar
  13. 13.
    Dressler W, Levin EJ, Axelrod M. Huge chronic pericardial effusion of 15 years’s duration. JAMA 1966; 195:188–190.CrossRefGoogle Scholar
  14. 14.
    Gómez Sánchez MA, Fernández Yáñez J, López Gil M, García Martínez J, Saenz de la Calzada C. Derrame pericárdico crónico. Monocardio 1982; 3:24–44.Google Scholar
  15. 15.
    Scheuer J. Chronic idiopathic pericardial effusion. Circulation 1960; 21:41–48.PubMedGoogle Scholar
  16. 16.
    Shabetai R. The pericardium. New York, Grune and Stratton, 1981; 147.Google Scholar
  17. 17.
    Spodick DH. Pericardial diseases. Philadelphia, F.A. Davis Company, 1976.Google Scholar
  18. 18.
    Reddy PA, Leon DF, Shaver JA. Pericardial disease. New York, Raven Press, 1982.Google Scholar
  19. 19.
    Hurst JW. The heart. New York, McGraw-Hill Book Co., 1986.Google Scholar
  20. 20.
    Zimmerman J, Yahalon J, Bar-On, H. Clinical spectrum of pericardial effusion as the presenting feature of hypothyroidism. Am Heart J 1983; 106:770–771.PubMedCrossRefGoogle Scholar
  21. 21.
    Permanyer-Miralda G, Sagristà-Sauleda J, Soler-Soler J. Primary acute pericardial diseases: a prospective series of 231 consecutive patients. Am J Cardiol 1985;56:623 –630.PubMedCrossRefGoogle Scholar
  22. 22.
    Fowler NO. Chronic pericarditis. In: Fowler NO, ed. The pericardium in health and disease. Mount Kisco, Futura Publishing Company, 1985; 231.Google Scholar
  23. 23.
    Mannix EP, Dennis C. The surgical treatment of chronic pericardial effusion and cardiac tamponade. J Thorac Cardiovasc Surg 1955; 29:381–397.Google Scholar
  24. 24.
    Markiewicz W, Borovik R, Ecker S. Cardiac tamponade in medical patients: treatment and prognosis in the echocardiographic era. Am Heart J 1986; 111:1138–1142.PubMedCrossRefGoogle Scholar
  25. 25.
    Spodick DH. The pericardium: structure, function, and disease spectrum. In: Spodick DH, ed. Pericardial disease. Philadelphia, F. A. Davis Company, 1976; 7.Google Scholar
  26. 26.
    Lorell BH, Braunwald E. Pericardial disease. In: Braunwald E, ed. Heart disease. Philadelphia, W. B. Saunders Company, 1988; 1492.Google Scholar
  27. 27.
    Silber EN. Heart disease. New York, MacMillan Publishing Copany, 1987; 1342.Google Scholar
  28. 28.
    Pielher JM, Pluth JR, Schaff HV, Danielson GK, Orszulak TA, Puga FJ. Surgical management of effusive pericardial disease: influence of extent of pericardial resection on clinical course. J Thorac Cardiovasc Surg 1985; 90:506–516.Google Scholar
  29. 29.
    Dunn RP. Primary chylopericardium: a review of the literature and an illustrated case. Am Heart J 1975; 89:369–377.PubMedCrossRefGoogle Scholar
  30. 30.
    Alvarado F, López-Herce J, Matamoros M, Borches D, Castro MC, Ruza F. Quilopericardio idiopàtico en el niño: presentación de un caso y revisión de la literatura. Rev Esp Cardiol 1986; 39(suppl I):81–84.PubMedGoogle Scholar
  31. 31.
    Rosenbaum DL, Yu PN. Idiopathic cholesterol pericarditis with effusion. Am Heart J 1965; 70:515–520.PubMedCrossRefGoogle Scholar
  32. 32.
    Brawley RK, Vasko JS, Morrow AG. Cholesterol pericarditis: considerations of its pathogenesis and treatment. Am J Med 1966; 41:235–248.PubMedCrossRefGoogle Scholar

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© Kluwer Academic Publishers 1990

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  • J. Soler-Soler

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