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Ann Thorac Surg 1987;43:653-655
© 1987 The Society of Thoracic Surgeons

Articles

Management of Tuberculous Pericarditis

John M. Quale, M.D.*, Gregg Y. Lipschik, M.D., Albert E. Heurich, M.D.

From the Division of Infectious Diseases, the Medical Intensive Care Unit, and the Pulmonary Disease Division, Department of Medicine, State University of New York, Downstate Medical Center–Kings County Hospital, Brooklyn, NY

Accepted for publication November 3, 1986.

* Address reprint requests to Dr. Quale, Division of Infectious Diseases, Box 56, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203

The cases of 17 patients with tuberculous pericarditis were reviewed. Thirteen patients had effusive pericarditis, and 10 had surgical drainage of the effusion. No deaths were due to pericardial tamponade; this appears to be related to earlier recognition of major pericardial effusions by echocardiography. In 2 patients clinical evidence of pericardial constriction developed while they were on a regimen of therapy, and in another 2 patients, echocardiography revealed pericardial thickening after resolution of the effusion. A pericardial window is recommended for the short-term management of patients suspected of having tuberculous pericarditis with a major pericardial effusion by echocardiography. If a thickened pericardium is found during the window procedure, early pericardiectomy is strongly encouraged.




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