(1) 원인
1 Breast and lung cancer
2 Melanoma, Leukemia, Lymphoma
3 Rtx.나 CTx.의 complication
(2) 증상
1 Accumulation rate와 volume에 따라 증상이 달라짐
→ 다량의 effusion이라도 점진적으로 증가하면 tolerable함.
2 Dyspnea, Orthopnea, Chest pain, Dysphagia, Hoarseness, Hiccups
3 Physical finding - Distant cardiac sound, Jugular venous distention, Pulsus paradoxus
4 Cardiac tamponade Sudden increase of effusion
→ Tachycardia, Hypotension, Narrowed pulse pressure
(3) 진단
1 Low voltage QRS complex, Electrical alternans (Large amount)
2 Cardiomegaly on chest x-ray
3 Echocardiography : Diagnostic tool of choice
(4) 치료
1 증상이 없는 effusion : 처치 필요치 않음, underlying cause treatment.
2 Emergency pericardiocentesis
3 CTx. 나 RTx. 동안 fluid restriction
4 Intrapericardial chemotherapy
5 Pericardial window or partial pericardial resection : 예방적으로 시행 가능
6 Indwelling intrapericardial catheter도 고려 가능함
