Abstract
RATIONALE: Recurrent pericardial effusion increases patient discomfort and the frequency of hospital readmissions. As effusion progresses, patients may experience cardiac tamponade, a condition where fluid builds up around the heart, making it difficult for the heart to pump blood, which can be life-threatening. In elderly patients, managing recurrent pericardial effusion can be challenging owing to multiple comorbidities. Reports on the efficacy of low-dose colchicine in elderly patients with recurrent pericardial effusion are limited. This paper presents 3 cases of low-dose colchicine treatment for recurrent pericardial effusion in elderly patients (≥80 years) and reviews the literature. PATIENT CONCERNS: The first patient (Case 1) was hospitalized several times due to recurrent shortness of breath and edema. The second patient (Case 2) presented with complete atrioventricular block as a complication of acute ST-segment elevation myocardial infarction (inferior wall) and was experiencing recurrent pericardial effusion related to perforation of the electrode after removal of the temporary pacemaker. The third patient (Case 3) presented with a rare case of pericardial effusion characterized mainly by dizziness and syncope. DIAGNOSES: These 3 cases of pericardial effusion were seen at Putuo Hospital within the past year. Moderate to severe pericardial effusion were confirmed by chest computed tomography and/or pericardial ultrasound. INTERVENTIONS: Low-dose colchicine (0.5 mg) was administered to each patient once a day for at least 3 months, in addition to prompt pericardiocentesis drainage, to address recurrent pericardial effusion. During colchicine treatment, liver and kidney function and routine blood test results were closely monitored for side effects. OUTCOMES: After 1 to 2 months of treatment, the recurrent pericardial effusion in all 3 patients was largely absorbed, their symptoms were greatly improved, and no side effects were observed. During colchicine treatment, liver and kidney function, myocardial enzyme levels, and routine blood tests showed no abnormalities. LESSONS: More cases and longer follow-up periods are needed to confirm the efficacy and safety of low-dose colchicine for recurrent pericardial effusion in elderly patients. Interactions between colchicine and other medications also require further study, especially in elderly patients (≥80 years) with chronic diseases.