Pericardial effusion

The pericardial effusion consists of the accumulation of fluid, which can be plasma or blood, in the membrane that surrounds the heart, and can cause a cardiac tamponade that is a serious situation that can lead to death.

Pericardial effusion is curable if its diagnosis and treatment are performed early to prevent fatal complications of the heart.

Treatment of pericardial effusion

The treatment of pericardial effusion depends on the cause of the effusion, the amount of fluid accumulated and the consequence it can bring to the functioning of the heart.

In mild pericardial effusion, there is no impairment of cardiac function. Treatment consists of the use of medications such as aspirin, non-steroidal anti-inflammatory drugs such as ibuprofen or corticosteroids such as prednisolone, which decrease inflammation and the symptoms of the disease.

However, if there is a risk of heart problems, withdrawal of this liquid may be required by:

• Pericardiocentesis: procedure consisting of the introduction of a needle and a catheter into the pericardial space to drain the accumulated fluid;
• Surgery: used to drain fluid and repair pericardial lesions that cause the effusion;
• Pericardiectomy: consists of the removal, through surgery, of part or all of the pericardium, used mainly in the treatment of recurrent pericardial effusions.

The cardiologist is the specialist for the diagnosis and treatment of pericardial effusion.

Cause of pericardial effusion

The cause of the pericardial effusion is often related to pericarditis because the effusion is usually a consequence of this inflammation in the membranes of the heart. Some causes that can lead to this inflammation are:

• Bacterial, viral or fungal infections;
• Autoimmune diseases such as rheumatoid arthritis or lupus;
• Accumulation of urea in the blood as a consequence of renal insufficiency;
• Hypothyroidism;
• Metastases of lung, breast, or leukemia cancer;
• Cancer in the heart;
• Heart injury or trauma;
• Acute myocardial infarction;
• Medications for high blood pressure such as hydralazine.

Identifying the cause is important for the treatment, so during the diagnosis the doctor can request tests.

Symptoms of pericardial effusion

The symptoms of pericardial effusion vary according to the severity of the disease and the amount of fluid accumulated in the pericardial space, which can be:

• Difficulty breathing;
• Worsening of tiredness when lying down;
• Pain in the chest, usually behind the sternum or on the left side of the chest;
• Cough;
• Low fever;
• Increased heart rate.

Diagnosis of pericardial effusion may be made through physical examination through cardiac auscultation, observation of symptoms, and may be confirmed by examination such as chest x-ray, electrocardiogram, or echocardiogram.

Useful links:

• Pericarditis
• Cardiac tamponade