ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG Ở BỆNH NHÂN TRÀN DỊCH MÀNG NGOÀI TIM

Abstract

Background: Pericardial effusion is a common clinical condition that can occur in all ages and populations. The clinical presentation of pericardial effusion varies widely, from a clinically irrelevant, incidental finding to life – threatening cardiac tamponade. Data regarding the clinical and subclinical profiles of pericardial effusion in Vietnam are limited. Objectives: To describe clinical and subclinical in patients with pericardial effusion at Cho Ray Hospital. Patients and methods: A retrospective cross – sectional descriptive study. This study included 248 patients with confirmed diagnosis of pericardial effusion treated at Cho Ray hospital in 10 years between 2010 to 2020. Results: For 10 years, there were 285 patients with pericardial effusions, of which 248 patients who met the inclusion criteria in our study. The mean age was 52.3 ± 18, the male:female ratio was 1.61:1. Dyspnea was the most common symptom (77%), followed by chest pain (11%) and fever (4%). There were 7.7% patients with hypotension on admission, jugular venous distension was recorded in 11.3%, muffled heart sounds were 18.6%, and pulsus paradoxus was 1.6%. Circumferential distribution accounted for 95.2%, large effusion accounted for 77.4%, and 23.8% of patients showed signs of cardiac tamponade on echocardiography. Low QRS voltage and electrical alternans were 41.5% and 2%, respectively. There were 248 patients who underwent pericardiocentesis, 98% of the results were exudates. The presence of malignant cells in pericardial fluid cytology results was 12.7%. Pericardial fluid culture was positive 6/232 samples, 3 samples were positive for Staphylococcus aureus. Conclusions: The study revealed that the most common symptom of a pericardial effusion was dyspnea. Muffled heart sounds, hypotension, and jugular venous distension were rarely reported in the study. Circumferential distribution and large effusion were major. The pericardial fluid was mostly exudate, the positive culture rate was very low, and the most recognized agent was Staphylococcus aureus.