Clinical and pathologic features of metastatic neoplasms of the pericardium.

Of 60 cases with pericardial metastatic disease, 26 had significant effects on the cardiovascular system. Pericardial metastases were suspected in 18 of these cases before death. The most common features reported were dyspnea on exertion and pleural effusion. While these were nonspecific for circulatory disturbance, ECG features of ST-T changes and low voltage QRS complexes were helpful in suspecting pericardial metastases. Thoracic roentgenograms were not helpful unless there was a large pericardial effusion. Echocardiography reported in one case promises a higher incidence of suspicion in the future.