Management of malignant pericardial effusion with tetracycline induced pericardiodesis.

Clinically evident cardiac involvement due to malignancy is uncommonly encountered. In autopsy series, however, involvement of the heart has been observed in 5.1% of the patients with advanced cancer. Pericardium is most frequently involved. Pericardial involvement usually presents as pericardial effusion. Depending upon the rapidity of the process, pericardial effusion may remain asymptomatic on one hand or present with lifethreatening cardiac tamponade on the other. Patients presenting with cardiac tamponade require immediate pericardiocentesis which affords rapid relief ofsymptoms. Long term management of these cases, however, is difficult and controversial. We recently had two patients presenting with symptomatic pericardial effusion who after pericardiocentesis underwent tetracycline induced pericardiodesis. On follow-up neither has recurrence of the pericardial effusion.