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September 1974

Management of Uremic Pericarditis With Tamponade

Author Affiliations

From the Renal Division, Department of Medicine, and the Department of Surgery, Indiana University School of Medicine, Indianapolis. Dr. de Quesada is now at the University of South Florida College of Medicine, Tampa.

Arch Intern Med. 1974;134(3):488-490. doi:10.1001/archinte.1974.00320210098013

Uremic pericarditis that is unresponsive to intensive hemodialysis may culminate in pericardial tamponade. This complication occurred in 15 of 179 patients in long-term hemodialysis. Echocardiography was employed in 14 of 15 patients and proved to be the single most helpful diagnostic procedure. All were managed surgically, some with generous pericardiectomy, others with "pericardial window." All patients tolerated these surgical procedures well, and there were no deaths related to the surgery. Follow-up done up to four years later demonstrated that a "pericardial window" has the same efficacy as a more extensive procedure. There have been no long-term complications.