ABSTRACT
La mayoría de los pacientes con derrame pericárdico crónico son mujeres y mayores de 50 años. En esta presentación se describe el caso de una paciente de 63 años con derrame pericárdico crónico grave, con antecedente de carcinoma de mama izquierda irradiado, diagnóstico presuntivo no confirmado de tuberculosis pulmonar e hipotiroidea sustituida. Ante la recurrencia del derrame luego de pericardiocentesis y el fracaso del tratamiento antiinflamatorio con AINE se decidió realizar una ventana pericárdica percutánea, sin que se presentaran complicaciones técnicas. Se inició tratamiento con colchicina y se evaluaron las posibles causas: tuberculosa, oncológica, secundaria a hipotiroidismo o por radiación. Por exclusión se llegó a la etiología radiante. Al mes de la realización de la ventana pericárdica no se observaba derrame pericárdico en el ecocardiograma.
Most patients with chronic pericardial effusion are women aged 50 years or older. This presentation describes a 63- year old female patient with severe chronic pericardial effusion; she had received radiotherapy for cancer of the left breast, had a history an unconfirmed presumptive diagnosis of pulmonary tuberculosis and was under treatment for hypothyroidism. A pericardiocentesis was performed; nevertheless the patient presented recurrence of the pericardial effusion and was treated with NSAIDs. As this therapy failed, she underwent a percutaneous pericardial window with no adverse outcomes. The patient started treatment with colchicine. The potential causes of the pericardial effusion were tuberculosis, malignant neoplasms, hypothyroidism or radiotherapy. The latter etiology was considered as the most probable once the others had been excluded. An echocardiogram performed one month after the procedure showed no signs of pericardial effusion.