Trends in Etiological Profile of Patients with Massive Pericardial Effusion with Signs of Tamponade Presenting to a Tertiary Care Hospital

Virtually any disease that can cause pericarditis can cause an effusion. About 20 % of large, symptomatic effusions without an obvious etiology following routine evaluation constitute the initial presentation of a cancer. This study is a prospective study including patients presenting with pericardial effusion and features of tamponade to NRI medical college from Nov 2017 to May 2019. The diagnosis of pericardial effusion was established by echocardiography, seen as a echo free space (representing pericardial fluid) surrounding the heart, more than 10 mm. Evaluation for the cause of PE included complete blood count with ESR, blood urea, serum creatinine, tuberculin skin test, chest X-ray, ECG, thyroid profile, ANA, rheumatoid factor, CT chest/MRI and pericardiocentesis. Pericardial fluid was analysed for cells, proteins, LDH, malignant cells, ADA, PCR (for mycobacterium tuberculosis), gram staining, AFB staining and cultures, CT-Chest with contrast. Most common cause for pericardial effusion in our study was tuberculosis (65.1 %), followed by malignancy (20.9 %), hypothyroidism (9.3 %), chronic kidney disease (CKD) (2.3 %), pyogenic (2.3 %). Out of malignant aetiologies, most common was lung malignancy followed by breast malignancy. Tuberculosis was the most common cause in our study and this differed from western literature where malignancy was leading.