Definition

What is pericardial effusion?

Pericardial effusion is the accumulation of too much fluid in the double-layered, sac-like structure around the heart (pericardium).

The space between the layers normally contains a thin layer of fluid. But if the pericardium is diseased or injured, the resulting inflammation can lead to excess fluid. Fluid can also build up around the heart without inflammation, such as from bleeding after a chest trauma.

Pericardial effusion puts pressure on the heart, affecting the heart’s function. If untreated, it can lead to heart failure or death.

How common is pericardial effusion?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of pericardial effusion?

The common symptoms of pericardial effusion are:

  • Shortness of breath or difficulty breathing (dyspnea)
  • Discomfort when breathing while lying down (orthopnea)
  • Chest pain, usually behind the breastbone or on the left side of the chest
  • Chest fullness

However, you can have significant pericardial effusion without signs or symptoms, particularly if the fluid has increased slowly.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • Chest pain that lasts more than a few minutes
  • Difficult or painfulbreathing
  • Unexplained fainting spell
  • Shortness of breath.

Causes

What causes pericardial effusion?

Pericardial effusion can result from inflammation of the pericardium (pericarditis) in response to illness or injury. Pericardial effusion can also occur when the flow of pericardial fluids is blocked or when blood accumulates within the pericardium, such as from a chest trauma.

Sometimes the cause can’t be determined (idiopathic pericarditis).

Causes of pericardial effusion can include:

  • Inflammation of the pericardium following heart surgery or a heart attack
  • Autoimmune disorders, such as rheumatoid arthritis or lupus
  • 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, such as doxorubicin (Doxil) and cyclophosphamide
  • Waste products in the blood due to kidney failure (uremia)
  • Underactive thyroid (hypothyroidism)
  • Viral, bacterial, fungal or parasitic infections
  • Trauma or puncture wound near the heart
  • Certain prescription drugs, including hydralazine, a medication for high blood pressure; isoniazid, a tuberculosis drug; and phenytoin (Dilantin, Phenytek, others), a medication for epileptic seizures

Risk factors

What increases my risk for pericardial effusion?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is pericardial effusion diagnosed?

Because these often cause no symptoms, they’re frequently discovered after the results of routine tests are abnormal. These tests can include:

  • Physical examination: A doctor may hear abnormal sounds over the heart that can suggest inflammation. However, pericardial effusions usually can’t be found through a physical.
  • Electrocardiogram (EKG): Electrodes placed on your chest trace the heart’s electrical activity. Certain patterns on an EKG can signal a pericardial effusion or the inflammation that leads to it.
  • Chest X-ray film: The heart’s silhouette on one may be enlarged. That’s a sign of a pericardial effusion.

If one is suspected, the best test to confirm it is an echocardiogram (ultrasound of the heart) because your doctor would easily see any excess fluid.

Once the effusion is identified, its size and severity are figured out. Most times, it’s small and causes no serious problems. If it’s large, it can compress your heart and hamper its ability to pump blood. This condition, called cardiac tamponade, is potentially life-threatening.

To find the cause of a pericardial effusion, your doctor may take a sample of the pericardial fluid. In this procedure, called pericardiocentesis, a doctor inserts a needle through your chest, into your pericardial effusion, and takes some fluid.

How is pericardial effusion treated?

It depends on its severity and cause. Small ones that don’t have symptoms and are due to known causes (for example, kidney failure) require no special treatment.

For pericardial effusions due to inflammation of the sac, treating the inflammation also treats the effusion.

In that case, you may be given:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), like Aleve, Indocin, and Motrin
  • Corticosteroids, like prednisone and Solu-Medrol
  • Colchicine (Colcrys)

If a severe infection or heart impairment (cardiac tamponade) exists, the extra fluid must be drained immediately. Drainage is done in two ways:

  • Pericardiocentesis: A doctor inserts a needle through the chest into the pericardial effusion. A catheter is put into the fluid, and it’s suctioned out.
  • Pericardiectomy or pericardial window: A surgeon makes an incision in the chest, reaches in, and cuts away part of the pericardium. This drains the pericardial effusion and usually prevents it from coming back. The procedure requires general anesthesia and is riskier than pericardiocentesis.

Pericardial effusions that are 3 months old or older are called chronic. Often, no cause is known. They’re monitored without treatment. If there are symptoms or your heart is being harmed, drainage is usually done.

Some medical conditions can cause pericardial effusions, like:

In these cases, treating the underlying medical condition will often help treat the effusion.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage pericardial effusion?

The following lifestyles and home remedies might help you cope with pericardial effusion:

Please discuss with your doctor for further information.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 28, 2017 | Last Modified: August 28, 2017

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