Pericarditis in malignancy epidemiology and demographics


 * Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Epidemiology and Demographics
In developed countries malignancy is the leading cause of cardiac tamponade secondary to pericardial effusion. Malignant pericardial effusion is seen in approximately 50-60% of patients presenting with pericardial effusion who have history of malignancy. Among patients presenting with pericarditis or pericardial effusion with no history of malignancy, undiagnosed underlying malignancy was detected in 4-7%.

Carcinoma of the lung is the most common cause for pericardial effusion in malignancy accounting for approximately 40%. Another 40% of cases could be due to breast carcinoma and lymphomas. Carcinoma of GI tract, melanoma, sarcomas, and other neoplastic diseases are less common.

Kaposi sarcoma and lymphomas associated with HIV were other neoplastic causes of pericardial effusion which accounted for 5% and 7% respectively in one study and 15% together in another series. However, with the use of antiretroviral agents, the incidence of Kaposi carcinoma and subsequent pericardial effusion has considerably decreased.

In regions where tuberculosis is not highly prevalent, malignancy may be the most common cause of a hemorrhagic effusion

Sex
Higher incidence of the pericardial effusion related to malignancy is observed among males with ratio of 7:3 as reported in a series