[Tumor-associated significant pericardiac effusions: analysis of 18 cases]. / Derrames pericárdicos significativos asociados a tumores: análisis de 18 casos.

Metastatic infiltration is most frequent than primary pericardiac tumors. Most frequent tumors are adenocarcinoma and lymphomas. A retrospective analysis of 18 oncological patients with significant pericardiac effusion (SPE) is carried out. The conclusions of the study are: SPE can be the first manifestation of a neoplasm; frequently, pericardiac tamponade (PT) has a neoplastic origin; thorax is the most frequent localization of the primary tumor; pericardiac fluid (PF) cytology analysis has low diagnostic yield; most useful diagnostic tests are thoracocentesis, thorax computerized tomography (CT) and bronchoscopy; SPE in a neoplasm suggest poor short-term prognosis; poor prognosis variables in this series were primary tumor unfavorable histology, advanced tumor disease and (probably) presentation as PT.

Derrames pericárdicos significativos asociados a tumores: análisis de 18 casos / Tumor-associated significant pericardiac effusions: analysis of 18 cases

La afectación neoplásica del pericardio es poco frecuente. La infiltración metastásica es más frecuente que los tumores pericárdicos primarios. Predomina la histología de adenocarcinoma y linfomas. Se realiza un análisis retrospectivo de 18 pacientes oncológicos con derrame pericárdico significativo (DPS). Del estudio realizado se extraen las conclusiones siguientes: el DPS puede ser la primera manifestación de una neoplasia; frecuentemente el taponamiento pericárdico (TP) es de causa tumoral; la localización más frecuente del tumor primario es el tórax; la citología en líquido pericárdico (LP) tiene rentabilidad diagnóstica baja; las pruebas diagnósticas más rentables fueron: toracocentesis, tomografía computarizada (TC) de tórax y broncoscopia; el DPS en una neoplasia indica mal pronóstico a corto plazo; los factores de mal pronóstico en esta serie fueron: histología desfavorable del tumor primario, enfermedad tumoral avanzada y (probablemente) presentación como TP (AU)

[Analysis of 73 cases of significant pericardiac effusion]. / Análisis de 73 casos de derrame pericárdico significativo.

Seventy-three patients with significant pericardiac effusion (SPE) are analyzed retrospectively. The results concerning etiology, clinical findings, evolution, echocardiography findings and pericardiac effusion (PE) findings are summarized. Conclusions drawn are: 1) the pericardiac effusion (PE) is a difficult diagnosis without the assistance of the echocardiogram; 2) the echocardiogram signs of hemodynamic alterations have prognostic value; 3) the most frequent causes of SPE are: tumors, idiopathic acute pericarditis, and iatrogenesis; 4) in an important percentage of DPS patients the cause is not identified; 5) the clinical presentation as pericardiac tamponade (PT) is most frequent in the tumors; 6) the analysis of the PE has a low yield, which means that diagnostic pericardicentesis is not justified in all patients with SPE; 7) the pericardiac biopsy hasa low diagnostic yield; 8) the predictive mortality factors are: presentation as PT and tumor etiology, and 9) because of the dynamic character of the SPE, it is important to carry out a progress follow-up of it.

[Electrocardiographic changes in hypoglycemia]. / Alteraciones electrocardiográficas en la hipoglucemia.

Several electrocardiographic anomalies have been described in association with hypoglycaemia. We report the case of a 70-year-old woman with hypoglycaemic coma whose electrocardiogram showed significant conduction anomalies, including atrioventricular block and intraventricular conduction disturbances, and repolarization abnormalities. These electrocardiographic changes disappeared after intravenous glucose administration.