What is the role of lab tests in the workup of pericardial effusion?

Updated: Nov 28, 2018
  • Author: William J Strimel, DO, FACP; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

The following lab studies may be performed in patients with suspected pericardial effusion:

  • Electrolytes - To assess for metabolic abnormalities (eg, renal failure)

  • Complete blood count (CBC) with differential - Leukocytosis for evidence of infection, as well as cytopenias, as signs of underlying chronic disease (eg, cancer, HIV)

  • Cardiac biomarkers

  • Other markers of inflammation, such as erythrocyte sedimentation rate and C-Reactive protein - While these do not aid in identifying specifics, they can be used to potentially assess the need for anti-inflammatory agents (ie, corticosteroids, colchicine, NSAIDs), especially in the setting of recurrent effusions. [12]

  • Thyroid-stimulating hormone - Thyroid-stimulating hormone screen for hypothyroidism [13]

  • Blood cultures in the presence of systemic inflammatory response syndrome (SIRS) or fever; in general, specific viral studies are low yield and therefore not recommended [14]

  • Rheumatoid factor, immunoglobulin complexes, antinuclear antibody test (ANA), and complement levels (which would be diminished) - In suspected rheumatologic causes

  • Specific infectious disease testing, based upon clinical suspicion, such as (1) tuberculin skin testing or QuantiFERON-TB assay; (2) rickettsial antibodies if there is a high index of suspicion for tick-borne disease; and HIV serology


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