What is Pericardial Effusion

Pericardial effusion is a buildup of fluid around the heart. The heart is surrounded by a thin, double-layered sac (pericardium). When fluid builds up in this sac, it can put pressure on the heart and cause problems.

When fluid builds up in the pericardial sac and pressure on the heart increases, it becomes harder for the heart to pump blood. The fluid can prevent the heart from pumping enough blood (cardiac tamponade). This can be life-threatening.

What are the causes?

Often, the cause of pericardial effusion is not known (idiopathic effusion). In some cases, the condition may be caused by:

• Infections from a virus, fungus, parasite, or bacteria.
• Damage to the pericardium from heart surgery or a heart attack.
• Inflammatory diseases, such as rheumatoid arthritis or lupus.
• Kidney disease.
• Thyroid disease.
• Cancer or treatment for cancer, including radiation or chemotherapy.
• Certain medicines, including medicines for tuberculosis or seizures.
• Chest injury.

What are the signs or symptoms?

Pericardial effusion may not cause symptoms at first, especially if the fluid builds up slowly. In time, pressure on the heart may cause:

• Chest pain.
• Trouble with breathing.
• Pain and shortness of breath that get worse when lying down.
• Dizziness.
• Fainting.
• Cough.
• Hiccups.
• Skipped heartbeats (palpitations).
• Anxiety and confusion.
• A bluish skin color (cyanosis).
• Swollen legs and ankles.
• A feeling of fullness in the chest.

How is this diagnosed?

This condition is diagnosed based on your symptoms and testing, which may include:

• A test that creates ultrasound images of your heart (echocardiogram).
• A test to examine the electrical functions of your heart (electrocardiogram, ECG).
• Chest X-ray.
• CT scan.
• MRI.
• Blood tests.

How is this treated?

Treatment for this condition depends on the cause of your condition and how severe your symptoms are. Treatment may include:

• Medicines, such as:
  • NSAIDs or other anti-inflammatory medicines such as steroids.
  • Antibiotic medicine.
  • Antifungal medicine.
• Hospital treatment. This may be necessary for cardiac tamponade. Treatment in the hospital may include:
  • IV fluids.
  • Breathing support.
• Surgery. This may be needed in severe cases. Surgery may include:
  • A procedure to remove fluid from the pericardium by placing a needle into it (pericardiocentesis).
  • A procedure to make a permanent opening in the pericardium (pericardial window).
  • Open heart surgery.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Rest as told by your health care provider. Ask your health care provider what activities are safe for you.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a cough or hiccups that do not go away.
• You have severe swelling in your legs or ankles.

Get help right away if:

• You have fast or irregular heartbeats (palpitations).
• You feel dizzy or light-headed.
• You faint.
• You have chest pain.
• You have trouble breathing.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Pericardial effusion is a buildup of fluid around the heart. The fluid can eventually prevent the heart from pumping enough blood (cardiac tamponade), which can be life-threatening.
• Pericardial effusion may not cause symptoms at first.
• Treatment for pericardial effusion depends on the cause of your condition and how severe your symptoms are. In severe cases, hospital treatment or surgery may be required.
• Rest as told by your health care provider. Ask your health care provider what activities are safe for you.