BACKGROUND: A large idiopathic @entity60182 can be defined as a collection of pericardial fluid that persists for more than three months and has no apparent cause. We conducted a prospective study of the natural history and treatment of this disorder. METHODS: Between 1977 and 1992, we prospectively evaluated and enrolled @entity1 with large idiopathic @entity60182 . We performed pericardiocentesis in most of the @entity1 . We performed pericardiectomy when large @entity2294 reappeared after pericardiocentesis. Follow-up ranged from 18 months to 20 years (median, 7 years). RESULTS: During the study period, we evaluated a total of 1108 @entity1 with @entity2396 , 461 of whom had large @entity2294 . Twenty-eight of these @entity1 (age range, 7 to 85 years; median, 61) had large idiopathic chronic effusion and were included in the study. The duration of effusion ranged from 6 months to 15 years (median, 3 years). At the initial evaluation, 13 @entity1 were asymptomatic. Overt tamponade was found in eight @entity1 (29 percent). Therapeutic pericardiocentesis, performed in 24 @entity1 , was followed by the disappearance of or marked reduction in the effusion in 8. Five of the 24 @entity1 underwent early pericardiectomy, and in 11 large @entity2294 reappeared. Cardiac catheterization, performed in 16 @entity1 , showed elevated intrapericardial pressure (4.75+/-3.79 mm Hg) and reduced transmural pressure (1.0+/-2.50 mm Hg) before pericardiocentesis. Both of these abnormalities in pressure improved significantly after pericardiocentesis. Pericardiectomy, performed in 20 @entity1 , yielded excellent long-term results. At the end of the follow-up period, 10 @entity1 had died, but none had died from @entity66 . CONCLUSIONS: Large idiopathic @entity60182 is well tolerated for long periods in most @entity1 , but severe tamponade can develop unexpectedly at any time. Pericardiocentesis alone frequently results in the resolution of large effusions, but recurrence is common and pericardiectomy should be considered whenever a large effusion recurs after pericardiocentesis.

Long-term follow-up of idiopathic XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity66 :: ('MESH:D004194', 'Disease') :: ['pericardial disease'] @entity2294 :: ('MESH:D010490', 'Disease') :: ['pericardial effusion'] @entity2396 :: ('MESH:D010493', 'Disease') :: ['pericarditis'] @entity60182 :: ('MESH:C564895', 'Disease') :: ['chronic pericardial effusion']
@entity60182 :: (MESH:C564895,Disease) :: ['chronic pericardial effusion']
