Pericardial Effusion

The heart is surrounded by a double-layered sac called the pericardium. Between these two layers, there is a space known as the pericardial cavity. The pericardial cavity normally contains a small amount of pericardial fluid. This fluid prevents friction between the two layers and helps your heart move easier within the sac. If too much fluid accumulates between the pericardium and the heart itself, the condition is known as pericardial effusion.

Pericardial effusions may develop rapidly (acute) or more gradually (chronic). A normal pericardium can stretch to accommodate increases in pericardial volume, with the stretch amount related to how quickly the effusion develops. Regardless, ongoing accumulation of pericardial fluid into a closed space will eventually lead to an increase of the intra-pericardial pressure. When the intra-pericardial pressure becomes too high, cardiac function becomes impaired and a condition called cardiac tamponade occurs.

Pericardial Effusion

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Causes of Pericardial Effusion

Pericardial effusion is caused by the excess accumulation of fluid in between the two layers of the pericardium (pericardial cavity).

Other conditions that contribute to the development of pericardial effusion

  • Malignancy “cancerous” spread
  • End-stage renal disease: a condition in which your kidneys have stopped working well and your body retains fluid.
  • Viral, bacterial, fungal or parasitic infections
  • Idiopathic “no known cause” pericarditis
  • Sharp or blunt chest trauma
  • Thyroid disease: a condition that is caused by the over or under function of the thyroid gland. The thyroid gland is an essential organ for producing thyroid hormones, which maintains the body’s metabolism.
  • Autoimmune disease: a condition in which your immune system mistakenly attacks your body (e.g. lupus, rheumatoid arthritis and scleroderma).
  • Inflammation of the pericardium following heart surgery or a heart attack.
  • Invasive heart/lung surgical procedures
  • Rupture of an aortic aneurysm

Symptoms of Pericardial Effusion

Common symptoms of pericardial effusion include:

  • Chest pain or pressure
  • Shortness of breath
  • Heart palpitations
  • Lightheadedness/Fainting
  • Confused or impaired thinking
  • Nausea and/or vomiting
  • Decreased urine output
  • Anxiety
  • Swelling of the legs or abdomen

Diagnosis of Pericardial Effusion

The clinical diagnosis of pericardial effusion is usually based on the patient’s medical history and physical examination findings. After that, you have:

Diagnostic tests and procedures

Treatment of Pericardial Effusion

Treatment for pericardial effusion will depend on the amount and speed of fluid accumulation, what's causing the effusion and whether you have or are likely to develop cardiac tamponade. Small ones that don’t have symptoms and are due to known causes (kidney failure) require no special treatment. Treatment options include:


  • Anti-inflammatory medications will help reduce inflammation and relief pain.
  • Aspirin will treat pain, fever, inflammation and reduce risk of heart attack.

Medical and surgical procedures

Saint Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
(973) 322-5000
Monmouth Medical Center
300 Second Avenue
Long Branch, NJ 07740
(732) 222-5200
Monmouth Medical Center Southern Campus
600 River Avenue
Lakewood, NJ 08701
(732) 363-1900
Clara Maass Medical Center
1 Clara Maass Drive
Belleville, NJ 07109
(973) 450-2000
Community Medical Center
99 Highway 37 West
Toms River, NJ 08755
(732) 557-8000
Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
RWJ University Hospital Hamilton
1 Hamilton Health Place
Hamilton, NJ 08690
(609) 586-7900
Robert Wood Johnson University Hospital
1 Robert Wood Johnson Place
New Brunswick, NJ 08901
(732) 828-3000
RWJ University Hospital Rahway
865 Stone Street
Rahway, NJ 07065
(732) 381-4200
RWJ University Hospital Somerset
110 Rehill Avenue
Somerville, NJ 08876
(908) 685-2200

Pericardial Effusion Treatment & Care

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