DOI: https://doi.org/10.53350/pjmhs221651450 ORIGINAL ARTICLE 1450 P J M H S Vol. 16, No. 05, May 2022 Pericardial Effusionin Patients Admitted in Emergency Department: Frequency and Causes BAKHT UMAR KHAN 1 , FAYAZ AHMED MEMON 2 , MUHAMMAD SHEHRAM 3 , MUHAMMAD SHAHID 4 , FAHAD KHALID 5 , NAYYAR ARIF 6 1 Medical Officer Cardiology Type-D Hospital Baffa, Distt. Mansehra, KPK. 2 Professor Department of Medicine, Muhammed Medical College & Hospital, Mirpurkhas, Sindh. 3 MBBS, FCPS Cardiology. District Specialist, Paharpur Hospital, D. I. Khan. 4 Head of Department, Associate Professor of Cardiology DHQ/Teaching Hospital, Gujranwala Medical College Gujranwala 5 Registrar Cardiology Deptt. FGPC (Federal Govt. Polyclinic Hospital) Islamabad , 6 MBBS,FCPS ( cardiology), Cardiologist DHQ hospital Bagh ,AJK. Corresponding author: Fayaz Ahmed Memon, Email: memonfayaz625@gmail.com, Cell: 03333987196 ABSTRACT Objective:A study of pericardial effusions in individuals with dyspnea was conducted to evaluate the prevalence and aetiology. Study Design:Prospective/Observational Study Place and Duration: Multicenteric study conducted at DHQ Hospital Bagh AJK/ Federal Govt. Polyclinic Hospital Islamabad and DHQ Teaching Hospital Gujranwala Medical College, Gujranwala. Duration was six months from 1st Oct 2021 to 31st March 2022. Methods:There were 135 patients of both genders had ages 18-75 years were presented in this study. Patients with dyspnea were admitted to emergency department. After obtaining informed written consent, we compiled detailed demographic information on all enrolled patients.Pericardial effusion was detected in all cases using echocardiography.The causes of pericardial effusion have been studied." SPSS 22.0 was used to analyze the data. Results: There were 75 (55.6%) males and 60 (44.4%) females in this study. Mean age of the patients was 58.16±10.79 years and had mean BMI 23.9±10.45 kg/m 2 . Majority of the patients were illiterate 90 (66.7%) and 45 (33.3%) were literate. We found frequency of pericardial effusions among 26 (19.3%) cases. Majority were males 17 (65.4%) and 9 (34.6%) were females. Most common cause of pericardial effusions were neoplastic diseases 10 (38.5%), idiopathic found in 8 (30.8%) cases, 3 (11.4%) had uremia, bacterial infections in 2 (7.7%) cases, frequency of HIV cases was 2 (7.7%) and 1 (3.8%) had other causes. Among 26 patients of pericardial effusions, small size effusion found in 14 (53.8%) cases, moderate size in 8 (30.8%) cases and large size in 4 (15.4%) cases. Conclusion: According to this study,patients with unexplained dyspnea had an increased risk of developing pericardial effusion,. The most prevalent cause of pericardial effusion was a neoplastic disease. Keywords:Electrocardiogram, Causes, Pericardial Effusion, Frequency, Dyspnea INTRODUCTION An examination of the heart is routine in today's emergency rooms (ED). More than a decade ago, it was realised that life-threatening processes like cardiac tamponade might be swiftly detected in the ED environment, and that's when emergency echocardiography was first reported. [1,2] Focused abdominal sonography for trauma (FAST) includes a quick assessment of the heart. [3] Ultrasound examinations of the heart in an emergency department (ED) are often used to detect an effusion in one's heart chambers. Patients who do not get prompt treatment for pericardial effusions are at risk of mortality. [4] Distended jugular veins, pulsusparadoxus, and electrical alternans, on the other hand, are rare and only show late in the course of the condition. [5,6] When a patient is rushed to the ER, the reason of their dyspnea might be several. Emergency doctors (EPs) often find that dyspnea is caused by a variety of conditions, including reactive airways disease, lung infections, mental illness, cardiac disease, anaemia, heart failure, and pulmonary embolism. However, some individuals still have a diagnosis of unexplained dyspnea even if pathology is ruled out. Pericardial effusion should be considered as an alternative diagnosis for patients with unexplained dyspnea, even if it seems implausible to the EP. [7,8] Pericardial effusions are one of the most common reasons for urgent cardiac ultrasonography in the emergency department. Patients who do not get prompt treatment for pericardial effusions are at risk of mortality. However, signs such as dilated jugular veins, pulsusparadoxus, or electrical alternans are few and show late in the illness progression. [10] There are various possible causes of pericardial effusion, including malignant and nonmalignant conditions. [11] Numerous etiologies for pericardial effusions, including neoplasia (infection), congestive heart failure (iatrogenicity, radiation), trauma, connective tissue illnesses, pericardial damage, and metabolic reasons such uremia and hypothyroidism, are recognised. [12,13] In cases of symptomatic or substantial pericardial effusion, pericardiocentesis (a procedure that removes fluid from the heart) might reveal the specific cause [14]. Tamponade and/or an unknown source of the effusion are other indicators... The gold standard for determining the cause of pericardial effusion is pericardiocentesis. [15] It was the purpose of this research to investigate the prevalence of pericardial effusion and its related causes in individuals with unexplained breathlessness.. MATERIAL AND METHODS This Prospective/Observational multicenteric study was conducted at DHQ Hospital Bagh AJK/ Federal Govt. Polyclinic Hospital Islamabad and DHQ Teaching Hospital Gujranwala Medical College, Gujranwala. Duration was six months from 1st Oct 2021 to 31st March 2022 and comprised of 135 patients.After obtaining informed written consent, we compiled detailed demographic information on all enrolled patients. Excluded were those with surgical drainage or those under the age of 18. Laboratory testing was completed on all patients. All of the patients had their chests x-rayed and ultrasounded. We performed a series of tests to determine whether or not the patient had pericardial effusion. It was considered tiny if the fluid stripe was less than 10 mm in length. Measurements of moderate-sized effusions ranged from 10 to 15 mm in diameter. Large effusions have a diameter of at least 15 mm. ' Some of the causes of pericardial effusion were studied, including neoplasms, idiopathic viral infection and collagen vascular disease. In SPSS 22, all the data was examined. RESULTS There were 75 (55.6%) males and 60 (44.4%) females in this study. Mean age of the patients was 58.16±10.79 years and had mean BMI 23.9±10.45 kg/m 2 . Majority of the patients were illiterate 90 (66.7%) and 45 (33.3%) were literate.(table 1) We found frequency of pericardial effusions among 26 (19.3%) cases.(fig 1)