How do you approach the risk/benefit ratio of pericardiocentesis as opposed to close observation with serial TTEs in a hemodynamically stable elderly patient on anticoagulation with a large circumferential pericardial effusion?

Core principle: balance the diagnostic and therapeutic benefits of drainage against procedural risks heightened by anticoagulation and patient frailty.

Key Considerations: Indication for pericardial drainage:

Diagnostic: uncertainty regarding malignancy, infection, or hemopericardium.

Therapeutic:...