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Pericardial Effusion

What is pericardial effusion?

A 2-layered, sac-like structure, referred to as the pericardium, surrounds your heart. Between the pericardium and the heart there is normally a very small quantity of fluid. When an excessive amount of this fluid accumulates, it is called pericardial effusion.

How does pericardial effusion affect my health?

When too much liquid accumulates in the pericardial space, the excess liquid puts increased pressure on the heart, impairing heart function.

What causes pericardial effusion?

Pericardial effusion often is related to inflammation of the pericardium brought about by disease (or injury—delete); nonetheless, pericardial effusion may occur without any inflammation. On occasion, pericardial effusion is caused an accumulation of blood following a surgical procedure, an injury, or renal failure.

(If the flow of pericardial fluids becomes blocked or if blood accumulates within the pericardium, pericardial effusion can occur—delete). It is unclear how certain diseases contribute to pericardial effusion formation. On occasion its cause cannot be determined.  Specific causes of pericardial effusion may include: fungal, bacterial, viral, or parasitic infections; (inflammation of the pericardium due to unknown cause—delete); inflammation of the pericardium following heart surgery or a heart attack(Dressler’s syndrome); autoimmune disorders, such as rheumatoid arthritis or lupus; waste products in the blood due to kidney failure (uremia); underactive thyroid (hypothyroidism);  HIV/AIDS; spread of cancer (metastasis), particularly lung cancer, breast cancer, melanoma, leukemia, non-Hodgkin’s lymphoma or Hodgkin’s disease; cancer of the pericardium or heart; radiation therapy for cancer if the heart was within the field of radiation; chemotherapy treatment for cancer;  and trauma or puncture wound near the heart. Certain prescription drugs for high blood pressure, tuberculosis and epileptic seizures can bring about a pericardial effusion.

What are the symptoms of a pericardial effusion?        

Major pericardial effusion is possible without the display of any signs or symptoms, especially if the fluid has accumulated gradually over time. When signs and symptoms are apparent, they may include: fainting (syncope) or dizziness; shortness of breath or difficulty breathing ; rapid heart rate; low-grade fever; a feeling of anxiety; shortness of breath when lying down; chest pain, usually behind the breastbone or on the left side of the chest which is more painful when you breathe and feels better when you are sitting up rather than lying down; coughing; painful breathing, especially when inhaling or lying down.

Is pericardial effusion dangerous?

Pericardial effusion can cause heart failure or death if left untreated.

What complications may be brought about if I have pericardial effusion?

Only a limited quantity of fluid can be contained within the pericardium. An accumulation of too much causes problems. The pericardium’s inner layer of single cells adheres to the heart. The thicker outer layer is only slightly elastic. When excess liquid accumulates, the pericardium is forced to expand inwardly, putting pressure on the heart. Under this abnormal pressure, the heart’s pumping chambers cannot fill completely, possibly causing one or more chambers to collapse partially. The result is an inadequate supply of oxygen-rich blood to the body, a life-threatening condition when left untreated.

What should I do if I think I have pericardial effusion?

It is essential that you call 911 or your local emergency number if you feel chest pain lasting more than a few minutes, if breathing is difficult or painful, or following an unexplained fainting spell. Be sure to see your doctor if you experience shortness of breath, fatigue or other symptoms of pericardial effusion.

How is pericardial effusion most commonly diagnosed?

Frequently, tests to diagnose pericardial effusion include: chest x-ray; computed tomography (CT) scan of the chest; and echocardiogram to look at the heart. Another procedure, pericardiocentesis, employs a needle to extract fluid from the pericardium; thereafter, the fluid can be tested to sometimes identify the effusion’s cause.

How is a pericardial effusion treated?

Treatment for pericardial effusion is varied. They include: non-steroidal anti-inflammatory medications; diuretics and other heart failure medications. When pericardial effusion can be associated with the presence of cancer, treatment may include radiation therapy, chemotherapy, or medication infused within the chest. Various medical procedures include: ultrasound-guided removal of excess fluid from the pericardium; video-assisted thoracoscopic surgery; and a pericardial window, the creation of a small opening to drain the excess fluid.

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