pericardiocentesis in PH patients

Q: Patients with which Pulmonary Hypertension Group (PH) have the highest chance of mortality from pericardial drainage? - select one

A) Group 1

B) Group 2

C) Group 3

D) Group 4

E) Group 5

Answer: A

One remarkable endeavor in pulmonary hypertension (PH) is its classification into five groups based on underlying pathology.

Group 1: Pulmonary Arterial Hypertension (PAH)

Group 2: PH Due to Left Heart Disease

Group 3: PH Due to Lung Diseases and/or Hypoxia

Group 4: Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

Group 5: PH With Unclear or Multifactorial Mechanisms

Although it is known that any patient with PH has a higher chance of hemodynamic collapse during pericardiocentesis, knowing the patient's underlying pathology may help in clinical decision-making if the situation arises. Patients with Group 1 have higher mortality rates compared with other non-PAH groups during such a procedure, with an adjusted odds ratio (aOR) of 2.35 and a 95% confidence interval (CI) of 1.46-3.80.

Some reports suggest that performing this procedure gradually, under the guidance of a Pulmonary Artery Catheter (PAC/Swan-Ganz), may help.

#pulmonary

#procedures

References:

1. Vasquez MA, Iskander M, Mustafa M, et al. Pericardiocentesis Outcomes in Patients With Pulmonary Hypertension: A Nationwide Analysis from the United States. Am J Cardiol 2024; 210:232.

2. Singh A, Mosarla R, Carroll K, Sulica R, Pashun R, Bangalore S, Yuriditsky E. Pericardiocentesis in Severe Pulmonary Arterial Hypertension Guided by a Pulmonary Artery Catheter. JACC Case Rep. 2024 May 1;29(12):102339. doi: 10.1016/j.jaccas.2024.102339. PMID: 38984206; PMCID: PMC11232420.

3. Cabada-Garcia MJ et.al. Safety of pericardiocentesis in pulmonary arterial hypertension: a systematic review. Front Cardiovasc Med. 2025 Aug 18;12:1610419. doi: 10.3389/fcvm.2025.1610419. PMID: 40901363; PMCID: PMC12400511.