Evaluation and management of radiation-induced pericardial effusion.

Pericardial effusion is an uncommon clinical manifestation of Hodgkin's disease although recognized with some frequency postmortem (1–3). However, the occurrence of pericardial effusion after mediastinal irradiation for Hodgkin's disease is of significant frequency to merit discussion of its treatment (4, 5). Since 1965 seven of our patients have undergone pericardiectomy. The mediastinum of these patients was irradiated through anterior fields with doses of 3,000 to 4,000 rads delivered to the mid chest in four to six weeks. The dose to the anterior cardiac region varied from 5,000 to 7,000 rads depending on the anteroposterior diameter of the chest wall and the dose delivered to the mid chest. The diagnosis of pericardial effusion in our patients is based largely on the enlarging cardiac silhouette on the roentgenogram. Cardiac scan with technetium albumin has confirmed the diagnosis of pericardial effusion when suggested by the serial chest films. Elevated venous or right atrial pressures, dyspnea, or ...