Information
Most malignant pericardial effusions result from direct malignant involvement with the pericardium. Other, rarer causes of effusions in cancer patients include radiation-induced pericarditis or chemotherapy-induced pericarditis associated with agents such as Doxorubicin or Cyclophosphamide.
Most common symptoms are dyspnoea, fatigue, cough and chest pain. Signs include elevated JVP, tachycardia, hypotension, pulsus paradoxus, Kussmauls’s sign.
M.A, K.E & J.W. 12-2-26
Who to refer:
All patients with a suspected malignant pericardial effusion should be referred via hospital medical teams in first instance, as this often requires direct cardiology input.
Who not to refer:
If in doubt please do not hesitate to call Edinburgh Cancer Centre Acute Oncology team on 07798774842 or 0131 537 1000. You may be advised to refer via medical team
How to refer:
Refer via Flow Centre 03000134000
All patients on or within six weeks of treatment should be encouraged to monitor symptoms and call The Cancer Treatment Helpline (CTH; 08009177711) with any treatment-related concerns. Please note, the CTH is a call operator service provided by NHS 24, who then refer on to an acute care specialist. They cannot give specialist advice.
If the patient has been assessed by a healthcare practitioner in Primary Care, and Oncology advice/input is felt to be required, the Primary Care clinician should call the Acute Oncology team at the Edinburgh Cancer Centre (based in the WGH) and discuss directly. The Acute Oncology team can be contacted during working hours (Mon-Fri 9-5) on 07798774842; If out of hours, please discuss with the Oncology Registrar On-Call via NHS Lothian Switchboard (0131 537 1000).
If the primary care clinician requires any further guidance on the suitability of referral to Acute Oncology, they can consult Pg 10 of the The UKONS Oncology/Haematology 24 Hour Triage Toolkit.
Note if a patient has presented to primary care for assessment, the patient should NOT be advised to call the CTH themselves to pass on this information or seek further advice.
Link to Acute Oncology Initial Management Guidelines:
UKONS | Acute Oncology Initial Management Guidelines (sundownsolutions.co.uk)
