Derrame Pericárdico y Taponamiento Cardíaco Flashcards
¿Cuáles son las causas más frecuentes de Derrame Pericárdico?
Países desarrollados
Idiopático 50 %
Cáncer 10-25 %
Infecciones 15-30 %
Iatrogénico 15-20 %
Enfermedades del tejido conectivo (5-15 %)
En países en vías de desarrollo endémicos para Tuberculosis suele ser la causa hasta en el 60 %
Yehuda Adler, Arsen D. Ristic, Massimo Imazio et al. Cardiac Tamponade: Nature Reviews Disease Primers. DOI: https://doi.org/10.1038/s41572-023-00446-1
¿Cuáles son los tipos de cáncer que más frecuentemente pueden ocasionar un derrame pericárdico y profesión a Taponamiento?
Cardiac tamponade can occur in the presence of solid tumours (most commonly lung and breast cancers, adenocarcinoma, oesophageal squamous cell carcinoma, melanoma, thymic carcinoma and, rarely, germ cell, renal, or bladder cancer and Ewing sarcoma) or haematological malignancy (usually leukaemia and non-Hodgkin and Hodgkin lymphomas and, rarely, acute and chronic myeloid leukaemia and myelodysplastic syndrome).
Yehuda Adler, Arsen D. Ristic, Massimo Imazio et al. Cardiac Tamponade: Nature Reviews Disease Primers. DOI: https://doi.org/10.1038/s41572-023-00446-1
¿Cuál es la dosis de quimioterapia con antraciclinas y la dosis de radiación asociada con daño cardíaco que podría llevar a derrame pericárdico y taponamiento?
Radiation‐induced cardiovascular diseases, among which are pericardial syndromes, are well described as a late effect in patients with cancer treated with radiation therapy. Exposure to ≥250 mg/m2 of anthracyclines increased the relative hazard twofold to fivefold, while cardiac radiation expo- sure of ≥1,500 cGy increased the relative hazard by twofold to sixfold compared with survivors that had not undergone radiation therapy.
Radiation therapy is known to be associated with acute pericarditis and, subsequently, with pericardial effusion leading to cardiac tamponade.
Yehuda Adler, Arsen D. Ristic, Massimo Imazio et al. Cardiac Tamponade: Nature Reviews Disease Primers. DOI: https://doi.org/10.1038/s41572-023-00446-1
¿Cuál es la incidencia de Pericarditis post IAM y progresión a Taponamiento Cardíaco?
Post-myocardial infarction pericarditis occurs with an incidence of <5% in developed countries and may present as early infarct-associated pericarditis (within 5 days after an acute event) or late post-myocardial infarction pericarditis (also known as Dressler syndrome; presents 2–8 weeks after infarction).
Delayed angioplasty is a major risk factor for pericarditis. Cardiac tamponade is a rare complication in both.
Yehuda Adler, Arsen D. Ristic, Massimo Imazio et al. Cardiac Tamponade: Nature Reviews Disease Primers. DOI: https://doi.org/10.1038/s41572-023-00446-1
¿Cuál es la frecuencia de derrame pericárdico y taponamiento cardíaco en Disección Aórtica?
The incidence of cardiac tamponade has been reported to be 8–31% in patients with acute aortic dissection.
However, many of these patients die before reaching hospital and before a diagnosis can be made. In the large cohort of the International Registry of Acute Aor- tic Dissection, 18.7% of 674 patients (mean age 61.8 years) had cardiac tamponade as a life-threatening complication of acute type A aortic dissection. Tamponade complicating aortic dissection was associated with poor in-hospital outcomes and significantly increased mortality.
Yehuda Adler, Arsen D. Ristic, Massimo Imazio et al. Cardiac Tamponade: Nature Reviews Disease Primers. DOI: https://doi.org/10.1038/s41572-023-00446-1
¿Se recomienda usar los criterios de Light en líquido pericárdico?
The Light criteria, which were originally developed for pleural effusions, have traditionally been used to characterize pericardial effusions in transudates and exudates. However, we do not recommend the use of the Light criteria to interpret pericardial fluid as they are not validated in this setting. In fact, according to these criteria, normal pericardial fluid would almost always be erroneously interpreted as an inflammatory exudate. Speculatively, lactate dehydrogenase in particular could be released by mesothelial cells, which are abundant in normal pericardial fluid.
Yehuda Adler, Arsen D. Ristic, Massimo Imazio et al. Cardiac Tamponade: Nature Reviews Disease Primers. DOI: https://doi.org/10.1038/s41572-023-00446-1
¿Cuál es la sensibilidad y especificidad de la Triada de Beck para el diagnóstico de Taponamientos Cardíaco?
Existen reportes con sensibilidad alrededor de 20 % y especificidad de 50 % (rango 28-72 %).
Yehuda Adler, Arsen D. Ristic, Massimo Imazio et al. Cardiac Tamponade: Nature Reviews Disease Primers. DOI: https://doi.org/10.1038/s41572-023-00446-1
