Novel "CHASER" pathway for the management of pericardial disease

Edgar Argulian, Dan G. Halpern, Emad F. Aziz, Seth Uretsky, Farooq Chaudhry, Eyal Herzog

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

The diagnosis and management of pericardial disease are very challenging for clinicians. The evidence base in this field is relatively scarce compared with other disease entities in cardiology. In this article, we outline a unified, stepwise pathway-based approach for the management of pericardial disease. We used the "CHASER" acronym to define the entry points into the pathway. These include chest pain, hypotension or arrest, shortness of breath, echocardiographic or other imaging finding of pericardial effusion, and right-predominant heart failure. We propose a score for the assessment of pericardial effusion that is composed of the following 3 parameters: the etiology of the effusion, the size of the effusion, and the echocardiographic assessment of hemodynamic parameters. The score is applied to clinically stable patients with pericardial effusion to quantify the necessity of pericardial effusion drainage. A stepwise, pathway-based approach to the management of pericardial disease is intended to provide guidance for clinicians in decision-making and a patient-tailored evidence-based approach to medical and surgical therapy for pericardial disease. The pathway for the management of pericardial disease is the ninth project to be incorporated into the "Advanced Cardiac Admission Program" at Saint Luke's Roosevelt Hospital Center of Columbia University in New York. Further studies should focus on the validation of the feasibility, efficacy, and reliability of this pathway.

Original languageEnglish
Pages (from-to)57-63
Number of pages7
JournalCritical Pathways in Cardiology
Volume10
Issue number2
DOIs
Publication statusPublished - Jun 2011
Externally publishedYes

Keywords

  • clinical pathway
  • echocardiogram
  • pericardial disease
  • tamponade

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