Complications
Recurrence of the effusion will be determined by the underlying etiology. If the underlying disease is managed appropriately, the risk of recurrence is much less.
Pericardiocentesis, windows, and traditional surgical drainage may all close and allow reaccumulation of fluid. The recurrence rate is about 50% after pericardiocentesis, and about 10% to 20% after surgical drainage in patients with malignant effusions.[20][53]
Without prompt diagnosis and urgent intervention, cardiac tamponade can progress to cardiovascular collapse, ultimately resulting in cardiac arrest.
In severe hemodynamic collapse, patients may present in cardiogenic shock.[2] Renal failure may develop secondary to organ hypoperfusion.
Following pericardial drainage, patients must be monitored (preferably in the intensive care unit) for PDS: a rare, but life-threatening complication of pericardial drainage that results in paradoxical hemodynamic instability and/or pulmonary edema.[47]
In-hospital mortality rates have been most closely associated with the causative disease: acute myocardial infarction (70% to 100%), aortic dissection (65%), bleeding/anticoagulation (40%), malignancy (16%), iatrogenic (10%), infectious/inflammatory (8%).[10][20]
Malignancy-related cardiac tamponade has a poor prognosis with around 80% mortality at 12 months.[58]
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