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Year : 2018  |  Volume : 4  |  Issue : 2  |  Page : 160-168

Standardized approach to pericardial effusion management

1 Department of Surgery, Summa Health, Akron, OH, USA
2 Summa Health Medical Group, Cardiothoracic Surgery Specialists, Akron, OH, USA

Correspondence Address:
Dr. Sarah Eapen
525 East Market Street, Akron, Ohio 44304
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJAM.IJAM_91_17

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The purpose of this review is to provide evidence-based, standardized recommendations on intervention for pericardial effusions. The appropriate management strategy is determined by effusion etiology. Pericardiocentesis under echocardiographic or fluoroscopic guidance is recommended for acute viral or idiopathic pericardial effusions. Due to recurrence risk, indwelling pericardial catheter placement is recommended for malignant pericardial effusions. Intrapericardial instillation of sclerosing or antineoplastic agents and percutaneous balloon pericardiotomy are alternative strategies. If less invasive options are not feasible or successful, pericardiotomy may be considered. Wide anterior pericardiectomy is indicated for relapse after repeated drainage. Potential procedural risks and therapeutic benefits are considered in determining the approach to intervention. The following core competencies are addressed in this article: Practice-based learning and improvement, Medical knowledge, and Patient care.

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