Introduction:

The etiology of pericardial effusion is highly variable around the world. The present study describes the clinical features and etiologies of severe pericardial effusion in a series of cases treated at a third-level hospital in Medellín, Colombia.

Material and methods:

Retrospective case series based on clinical records. All patients treated between 2006 and 2018 with severe pericardial effusion requiring intervention for pericardial fluid drainage were included. The exclusion criteria were the absence of more than 50% of the data in the clinical history and the recurrence of the pericardial effusion after its first drainage. Etiology, indications for pericardial drainage and patient comorbidities are described.

Results:

48 patients were included, 50% men with a mean age of 52.4 years (SD 17.5). Non-infectious etiologies were the most common causes of severe pericardial effusion (66.7%), followed by idiopathic (20.8%) and infectious causes (12.5%), being tuberculosis the most important. The main indication for pericardial drainage was to determine its etiology (58.0%) and the most relevant comorbidity was hypertension (40.0%).

Conclusions:

The main causes of severe pericardial effusion were non-infectious, unlike previous reports from developing countries where infectious diseases are considered the most common. Although, the frequency of idiopathic etiology was lower than that reported in other series, it continues to be a representative number of patients in which the etiology cannot be established.