From the Guidelines
Pericardial fluid analysis tests contain cytology, polymerase chain reaction (PCR) for TB, and microbiology tests including Mycobacterium cultures, aerobic and anaerobic cultures. The analysis of pericardial fluid is crucial in evaluating the fluid surrounding the heart and guiding appropriate treatment. According to the most recent and highest quality study 1, the main analyses to be performed on pericardial fluid include:
- Cytology: ratio >0.6, blood cell count, centrifugation, and rapid analysis improve diagnostic yield
- Polymerase chain reaction (PCR): PCR for TB
- Microbiology: Mycobacterium cultures, aerobic and anaerobic cultures
These components help differentiate between infectious, inflammatory, malignant, and other causes of pericardial effusion. While other studies, such as 1, provide additional information on the diagnosis and management of pericardial diseases, the most recent and highest quality study 1 prioritizes the above-mentioned tests for pericardial fluid analysis. The inclusion of cytology, PCR, and microbiology tests in pericardial fluid analysis is essential for establishing an accurate diagnosis and guiding treatment.
From the Research
Pericardial Fluid Analysis Test Contents
The pericardial fluid analysis test contains various components that help in determining the etiology of pericardial effusion. These components include:
- Physical characteristics of the fluid, such as appearance and specific gravity 2
- Chemical characteristics, including lactate dehydrogenase levels, protein levels, and glucose levels 2, 3
- Cellular characteristics, such as cell count and cytologic studies 4, 2
- Microbiological characteristics, including Gram's stain and microbial cultures 2
- Tumor markers and adenosine deaminase levels, which can help in diagnosing malignant effusions and tuberculous pericarditis, respectively 5, 6
Diagnostic Value of Pericardial Fluid Analysis
The diagnostic value of pericardial fluid analysis lies in its ability to distinguish between different causes of pericardial effusion. However, the analysis of pericardial fluid biochemical and cell-count composition is generally not helpful for the diagnosis of most pericardial effusions 3. Certain parameters, such as adenosine deaminase levels, can be useful in diagnosing specific conditions like tuberculous pericarditis 5, but may not be specific in all cases 6.
Components of Pericardial Fluid Analysis
The components of pericardial fluid analysis can be summarized as follows: