Hemorrhagic Pericardial Effusions (Hemopericardium)- Differential Diagnosis Framework



IATROGENIC DISEASE

Secondary to invasive cardiac procedures



NONIATROGENIC

• Malignancy (e.g., metastatic spread: lung cancer, breast cancer, lymphoma, leukemia, melanoma, sarcomas, and many carcinomas)

• Complications of acute myocardial infarction

• Aortic dissection - proximal

• Hemorrhagic tuberculous pericardial effusions are uncommon - 1 to 2% of patients with pulmonary tuberculosis



OTHER RARE CAUSES

• PRIMARY Cardiac tumors - rare: Angiosarcoma, sarcoma, mesothelioma

• AVM, HHT

• Primary systemic amyloidosis

• Uremia

• Familial Mediterranean fever (FMF)

• Radiation induced

• MCTD, Lupus, GPA, RA, and other CTD



TIP: Cytologic studies of the hemorrhagic fluid may have false negative results in some patients, especially those with lymphoma or mesothelioma. Might likely have to repeat if malignancy is suspected.



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