The Role of Vital Signs in Predicting Cardiac Tamponade in Asymptomatic Patients with Malignancy: Associated Pericardial Effusion

Takeshi Saraya*, Saori Takata, Masachika Fujiwara, Manabu Ishida, Miku Oda, Kosuke Ohkuma, Takayasu Watanabe, Yukari Ogawa, Naoki Tsujimoto, Masaki Tamura, Takuma Yokoyama, Daisuke Kurai, Haruyuki Ishii and Hajime Takizawa

The Role of Vital Signs in Predicting Cardiac Tamponade in Asymptomatic Patients with Malignancy: Associated Pericardial Effusion.

Cardiac tamponade is a potentially life-threatening complication in patients with advanced lung cancer or other metastatic malignant diseases. However, few reports described how to assess the risk for developing cardiac tamponade in asymptomatic patients with pericardial effusion.

Vital signs such as heart rate (HR), SBP, diastolic blood pressure, pulse pressure, and cardiothoracic ratio (CTR) determined on chest radiography were assessed at the time of the diagnosis of malignancy or cardiac tamponade and the time of the first recognition of pericardial effusion on computed tomography (CT), if the data are available. ΔHR and ΔCTR were defined as
absolute value for each timing between the first recognition of pericardial effusion on CT and cardiac tamponade diagnosis. This study additionally focused on seven patients with MPCE
who successfully observed the process of cardiac tamponade from the phase of first recognition of pericardial effusion. In the seven patients, we evaluated the relevance between the vital signs such as ΔHR and ΔCTR. The Kaplan–Meier overall survival curve was also evaluated in 17 cases after diagnosis with cardiac tamponade.

Lung cancer is one of the most common causes of MPCE, with effusion volume as less as 50 mL often detected incidentally on CT. However, few reports described how to assess the risk for
developing cardiac tamponade or to evaluate the vital signs in their management, particularly in patients with asymptomatic MPCE.

Pulm Res Respir Med Open J. 2016; SE(1): S3-S7.doi: 10.17140/PRRMOJ-SE-1-102