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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should Thoracocentesis Be Done For Pericardiac Effusion?

Hi , my father had an MI anterior wall, 2 weeks ago, he was noted to have pericardiac effusion last week and a thoracentesis was performed ,but 2 days ago he was noted to have declining H and H and was transfused and the fluid is back upon C scan, he is 83 years old and my mom , feels that no more aggressive management shold be done, but he is suffering and he is unable to rest due to increased dyspnea, my question is it worth for the thoracentecis to be done , and what are the long term management for it , will diuretics work?He is in the philippines and i am here and i feel useless .
Mon, 18 Jan 2016
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Pulmonologist,  's  Response
Thanks for your question on Health Care Magic.
I can understand your concern.
In my he is having recurrent pericardial effusion.
And his pericardial effusion consume blood, so he is requiring blood transfusion.
Common causes for such recurrent pericardial effusion are infection like tuberculosis and malignancy.
If we don't treat underlying pathology, this fluid will accumulate and may endanger life.
So better to get done repeat thoracocentesis and get done fluid reports for tuberculosis and malignancy.
If it is tubercular then anti tubercular drugs will cure him.
But if it is malignant then he will need pigtail catheter insertion in pericardium.
Diuretic works only in transudative fluid.
So better to consult cardiologist and rule out tuberculosis and malignancy.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.
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Should Thoracocentesis Be Done For Pericardiac Effusion?

Thanks for your question on Health Care Magic. I can understand your concern. In my he is having recurrent pericardial effusion. And his pericardial effusion consume blood, so he is requiring blood transfusion. Common causes for such recurrent pericardial effusion are infection like tuberculosis and malignancy. If we don t treat underlying pathology, this fluid will accumulate and may endanger life. So better to get done repeat thoracocentesis and get done fluid reports for tuberculosis and malignancy. If it is tubercular then anti tubercular drugs will cure him. But if it is malignant then he will need pigtail catheter insertion in pericardium. Diuretic works only in transudative fluid. So better to consult cardiologist and rule out tuberculosis and malignancy. Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.