Pericardial effusion secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hafiz M. Ahmed, M.D.[2]
Overview
Secondary prevention of pericardial effusion focuses on preventing recurrence, progression to cardiac tamponade, and complications related to the underlying pericardial disease. Strategies include treatment of the underlying cause, appropriate anti-inflammatory therapy when effusion is associated with active pericarditis, and echocardiographic surveillance for at least moderate-sized effusions when clinically appropriate.
Secondary Prevention
- The underlying cause of pericardial effusion should be identified and treated when possible.
- Inflammatory pericardial effusion without concern for cardiac tamponade should generally be treated with anti-inflammatory therapy before pericardiocentesis is considered.
- Transthoracic echocardiography may be used for surveillance of pericardial effusions that are at least moderate in size.
- Patients with recurrent large pericardial effusion and/or recurrent cardiac tamponade despite prior pericardiocentesis may be considered for surgical pericardial window.
- In rare cases, recurrent effusion despite pericardial window may require consideration of radical pericardiectomy, particularly when medically refractory constrictive pericarditis or recurrent pericarditis is also present.[1]
References
- ↑ Wang TKM, Klein AL, Cremer PC, Imazio M, Kohnstamm S, Luis SA, Mardigyan V, Mukherjee M, Ordovas K, Vakamudi S, Wohlford GF. 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on the Diagnosis and Management of Pericarditis: A Report of the American College of Cardiology Solution Set Oversight Committee. Journal of the American College of Cardiology. 2025;86(25):2691-2719. https://doi.org/10.1016/j.jacc.2025.05.023.