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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 3, May/June 2015
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AFRICA
used much earlier as a rule-out test for TB pericarditis and an
alternative cause could have been sought earlier.
Inmost cases that are treated as TB pericarditis in sub-Saharan
Africa, the clinical criteria are used to make a decision to treat.
In the majority of patients, this is the correct decision, but it
is that occasional patient such as the one described, where the
special tests to make a definitive diagnosis would have clinched
the alternative diagnosis earlier.
This patient illustrates the need to be aware of the rarer causes
of fibrinous pericardial effusion and the need to perform more
tests, such as CT or MRI scans and pericardial biopsy to make
a definitive diagnosis, even in our setting of high TB prevalence.
Unfortunately however, most cases of angiosarcoma present
with metastatic deposits and the options for therapy may not
be available, as it was for this patient. The prognosis tends to be
poor.
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