Purpose of Review

Pericardial effusion is a challenging pericardial syndrome and a cause of serious concern for physicians and patients due to its potential progression to life-threatening cardiac tamponade. In this review, we summarize the contemporary evidence of the etiology; diagnostic work-up, with particular emphasis on the contribution of multimodality imaging; therapeutic options; and short- and long-term outcomes of these patients.

Recent Findings

In recent years, an important piece of information has contributed to put together several missing parts of the puzzle of pericardial effusion. The most recent 2015 guidelines of the European Society of Cardiology for the diagnosis and management of pericardial diseases are a valuable aid for a tailored approach to this condition. Actually, current guidelines suggest a 4-step treatment algorithm depending on the presence or absence of hemodynamic impairment; the elevation of inflammatory markers; the presence of a known or first-diagnosed underlying condition, possibly related to pericardial effusion; and finally the duration and size of the effusion. In contrast to earlier perceptions, based on the most recent evidence, it seems that in the subgroup of asymptomatic patients with large (> 2-cm end-diastolic diameter), chronic (> 3 months) C-reactive protein negative, idiopathic (without an apparent cause) pericardial effusion, a conservative approach is the most reasonable option.

Summary

At present there is an increasing interest in the pericardial syndromes in general and pericardial effusions in specific, which has consistently expanded our knowledge in this “hazy landscape.” Apart from general recommendations applied to all cases, an individualized, etiologically driven treatment is of paramount importance.

中文翻译：

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管理心包积液的新方法

审查目的

心包积液是一种具有挑战性的心包综合征，由于其可能发展为危及生命的心脏压塞，因此引起了医生和患者的严重关注。在这篇综述中，我们总结了病因的当代证据；诊断检查，特别强调多模态成像的贡献；治疗选择；以及这些患者的短期和长期结果。

最近的发现

近年来，一项重要的信息有助于拼凑心包积液之谜的几个缺失部分。欧洲心脏病学会 2015 年最新的心包疾病诊断和管理指南是针对这种情况量身定制的方法的宝贵帮助。实际上，目前的指南建议根据血流动力学障碍的存在或不存在采用 4 步治疗算法；炎症标志物的升高；存在已知或首次诊断出的潜在疾病，可能与心包积液有关；最后是积液的持续时间和大小。与早期的看法相反，根据最新证据，似乎在无症状患者亚组中，大（> 2 cm 舒张末期直径）、慢性（>

概括

目前，人们对一般的心包综合征和具体的心包积液越来越感兴趣，这一直在扩大我们对这个“朦胧景观”的认识。除了适用于所有病例的一般建议外，个性化的、病因驱动的治疗至关重要。