Diagnosis and management of chronic pericardial effusions

Chronic pericardial effusions are a major cause of morbidity in some clinic al settings. Although the treatment of choice for acute symptomatic pericar dial effusions (tamponade) is pericardiocentesis, the long-term management of symptomatic chronic pericardial effusions provides a greater challenge. The aim of this review is to provide insight into the presentation, diagnos is, and different treatment options available to patients with chronic symp tomatic pericardial effusions, with emphasis on malignant pericardial effus ions. Pericardiocentesis with sclerosing agents, radiation therapy, percuta neous, and surgical pericardiotomy and other surgical techniques are partic ularly efficacious, depending on the underlying cause and the patient's pro gnosis.