Profile of cardiac tamponade in the medical emergency ward of a North Indian hospital

OBJECTIVE: To determine the profile of patients presenting to the medical e mergency ward with cardiac tamponade. DESIGN: Retrospective observational study. SETTING: Tertiary care hospital in North India. PATIENTS: Thirty patients (19 men and 11 women) presenting to the medical e mergency ward with cardiac tamponade from March 1, 1995 to March 31, 1997. MAIN RESULTS: The mean age was 36.5+/-7.6 years for the men and 34+/-12.4 y ears for the women, Breathlessness, fever, cough, chest pain and easy fatig ability were present in 97%, 90%, 70%, 57% and 37% of patients, respectivel y. Etiologically, tuberculosis accounted for 60%, malignant disease for 33% and hypothyroidism for 7% of cases of cardiac tamponade. Echocardiographic ally guided pericardiocentesis was carried out in all patients without any complications. Six patients underwent catheter pericardial drainage and, of these, four required pericardiostomy. CONCLUSIONS: Tuberculosis ranked as the most common cause of cardiac tampon ade in Northern India, followed by malignancy. Therapeutically, echocardiog raphically guided pericardiocentesis for cardiac tamponade is a safe and ef fective procedure. For those with recurrent pericardial effusions, catheter pericardial drainage is a safe option until the underlying cause can be tr eated or surgery planned.