+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The composition of normal pericardial fluid and its implications for diagnosing pericardial effusions

The composition of normal pericardial fluid and its implications for diagnosing pericardial effusions

American Journal of Medicine 118(6): 636-640

Pericardial fluid obtained at pericardiocentesis is often subjected to biochemical and hematological analysis, and interpreted using criteria borrowed from pleural effusions. However, the validity and diagnostic yield of this approach is uncertain. Moreover, there is little data regarding the normal composition of the physiological pericardial fluid, which could serve as a reference for pathological effusions. Pericardial fluid from 30 patients undergoing elective open heart surgery was collected. Patients were excluded if they had known pericardial disease, had systemic disorders known to be associated with pericardial disease, or if the fluid samples were hemolytic. The biochemical and hematological parameters of the fluid were determined using standard laboratory techniques, and compared with the results obtained for concurrently drawn venous blood. The median age of the study population was 64.5 +/- 10.6 years. Chemistry results of soluble molecules were consistent with the plasma ultrafiltrate nature of the fluid. However, fluid lactate dehydrogenase (LDH) level was unexpectedly high, averaging 2.4 times the serum level, and the mean protein level was 0.6 of the serum level. No correlation was found between comorbidities of patients and fluid characteristics. Fluids contained an average of 1430 leukocytes/muL, with a differential count that was predominated by lymphocytes (53.2 +/- 14%) and monocytes (11.6 +/- 6%). The composition of the physiologic pericardial fluid is remarkable for high LDH and protein content, and for predominance of lymphocytes. Thus, the biochemical criteria useful for diagnosing pleural effusions are probably not applicable for differentiating transudative from exudative pericardial effusions, and lymphocytosis should be interpreted cautiously.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 012640080

Download citation: RISBibTeXText

PMID: 15922695

DOI: 10.1016/j.amjmed.2005.01.066

Related references

Subxiphoid pericardial window. A simple and safe method for diagnosing and treating acute and chronic pericardial effusions. Journal of Thoracic and Cardiovascular Surgery 62(1): 95-97, 1971

Subxiphoid pericardial biopsy and fluid analysis for diagnosis of malignancy or infection in patients with large pericardial effusions. Circulation 80(4 Suppl. 2): II667, 1989

Pericardial window diagnostic and therapeutic effectiveness in chronic pericardial effusions and pericardial tamponade. Medicina Clinica 84(3): 102-103, 1985

Viral genomes in the pericardial fluid and in peri- and epicardial biopsies from a German cohort of patients with large to moderate pericardial effusions. Heart Failure Reviews 18(3): 329-336, 2013

The efficiency of surgical subxiphoid pericardial drainage and percutaneous pericardial drainage in pericardial effusions associated with cardiac tamponade. Chirurgia 108(2): 226-233, 2013

The value of measuring adenosine deaminase activity in pericardial effusion fluid for diagnosing the etiology of pericardial effusion. Pneumonologia i Alergologia Polska 64(Suppl. 2): 174-179, 1996

Preliminary investigation of the clinical value of vascular endothelial growth factor and hypoxia-inducible factor-1alpha in pericardial fluid in diagnosing malignant and tuberculous pericardial effusion. Cardiology 116(1): 37-41, 2010

Clinically silent pericardial effusions in patients on long-term hemodialysis. Pericardial effusions in hemodialysis. Chest 72(6): 744-747, 1977

Video-assisted thoracoscopic pericardial window for diagnosis and management of pericardial effusions. Annals of Thoracic Surgery 80(2): 607-610, 2005

Diagnosis of pericardial pericardial effusions by scintigraphic visualization of the blood content of the heart. Orvosi Hetilap 116(8): 432-434, 1975

Colchicine for postoperative pericardial effusions: not the magic bullet for all kind of pericardial diseases!. Heart 101(21): 1693-1694, 2015

Systemic chemotherapy in combination with pericardial window has better outcomes in malignant pericardial effusions. Journal of Thoracic and Cardiovascular Surgery 148(5): 2288-2293, 2014

Pericardial effusions in the course of thyroid insufficiency. A new case and value of gammagraphy for the diagnosis of pericardial effusion. Annales de Medecine Interne 122(11): 1113-1118, 1971

Video-thoracoscopic pericardial window in the diagnosis and treatment of pericardial effusions. American Journal of Cardiology 82(1): 124-126, 1998

Subxiphoid pericardial window drainage in the management of large pericardial effusions. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae 20(3): 216-219, 1998