Hydroperikard hos katt : patofysiologi, diagnos och behandling

Abstract: Hydropericardium or pericardial effusion (PE) is the accumulation of fluid in the pericardial sac and is often secondary to pericardial diseases or diseases related to the heart. It is unusual with clinically relevant pericardial diseases in cats but pericardial effusion is the most common one. Since PE causes serious symptoms and may lead to death it is important with a quick diagnosis and treatment. PE can be acute and cause cardiac tamponade, which gives severe clinical signs. Cardiac tamponade needs to be treated immediately or else the cat will die from cardiogenic chock. More common is chronic PE where the fluid accumulates during a longer period of time and the pericardial sac stretches. In this case the pressure slowly leads to right heart failure and clinical signs of ascites or hydrothorax occur. In cats the result is more often hydrothorax, which shows as clinical signs of respiratory disease. The best method to diagnose PE is radiography and echocardiography in combination. Pericardiocentesis is the best and easiest treatment and when performed properly it is a safe method that both relieves the symptoms quickly and produces samples to analyse. During pericardiocentesis it is also possible to do a pneumopericardium to exam the pericardium and look for neoplastic disease or pericarditis. Hydropericardium can be treated with good prognosis, but depending on the underlying disease causing the effusion the long-time prognosis may differ. In some cases pericardiocentesis needs to be redone several times and it may be necessary to perform pericardiectomy. In cats hydropericardium is most often associated with congestive heart failure (CHF) due to hypertrophic cardiomyopathy (HCM) or neoplasia but other causes are also identified.