Management of Malignant Pericardial Effusion and Tamponade
- Oliver W. Press, MD, PhD;
- Robert Livingston, MD
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
THE OPTIMAL management of neoplastic cardiac tamponade has been controversial, with ardent proponents of pericardiocentesis (with or without sclerotherapy),1-3 surgical decompression,4-8 and radiation therapy9-11 as primary therapeutic modalities. In the eight years since this oncologic emergency was last reviewed in this journal,12 several informative therapeutic trials have been reported that warrant a reappraisal of the recommended interventions for this condition.
Epidemiology Although neoplastic involvement of the heart is commonly regarded as a rare condition, a compilation of autopsy series suggests that 3.4% (642/19130) of general autopsies13-18 and 11.6% (1280/11078) of cancer autopsies13-21 demonstrate cardiac metastatic disease. Of 770 cases of cardiac metastases for which adequate information was reported, 533 (69.2%) had involvement of the pericardium.13-16,19,21 The majority of cases were clinically insignificant; however, 29% of such patients developed symptoms referable to pericardial metastases and 16% developed cardiac tamponade.22 Pericardial lesions were either
Footnotes
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Reprint requests to the Division of Medical Oncology, Department of Medicine, RG-08, University of Washington School of Medicine, Pacific Avenue, Seattle, WA 98195 (Dr Press).
