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.
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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: when you feel like your heart is racing, pounding or fluttering.
- 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:
Medications
- 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