What is pericardial effusion?

Pericardial Effusion

Pericardial effusion

Pericardial effusion is a buildup of fluid in the space between the heart and the sac around the heart (pericardium).

The extra fluid can be caused by many things. Some causes are pericarditis (inflammation of the sac), heart attack, surgery, kidney failure, infection, some cancers, and certain diseases such as lupus. Sometimes the cause is not known.

If the fluid buildup is gradual and the heart is tolerating the increased fluid around it, treatment of the underlying cause may be tried first. In some cases, the fluid might need to be drained.

What happens when you have pericardial effusion?

How long it takes for the amount of fluid in your pericardium to get back to normal will depend on what caused the extra fluid and what treatment you have.

If a lot of fluid builds up, it can cause increased pressure on your heart. This pressure is called cardiac tamponade. It is an emergency that can reduce the heart's ability to pump blood.

In some people, pericardial effusion comes back and must be treated again.

What are the symptoms of pericardial effusion?

Symptoms depend on how much fluid there is and how fast the fluid builds up.

Symptoms may include:

  • Chest pain.
  • Trouble breathing.

Some people have no symptoms.

How is pericardial effusion treated?

If there is only a small amount of extra fluid in your pericardium, you may not need treatment. The extra fluid may go away on its own.

Treatment depends on the cause of the extra fluid, the amount of fluid, and your symptoms. Options include:

  • Medicine to treat the cause of the effusion, if the cause is known.
  • Pericardiocentesis. This is a procedure that uses a needle and a tube to drain the fluid. You will get a shot of anesthetic to numb the skin and deeper tissues. You will be awake for the procedure.
  • Surgery to open a section of the pericardium to drain the fluid. You may get anesthesia that makes you sleep during the surgery.

How is pericardial effusion diagnosed?

You will have an echocardiogram ("echo"). This is a test that lets your doctor see how much fluid is in your pericardium and how your heart is working. You also may have tests such as a chest X-ray, EKG, or CT scan.

Your doctor may want to take a small sample of the fluid around your heart for testing. This may help find the cause of the extra fluid.

How can you care for yourself when you have pericardial effusion?

Follow a heart-healthy lifestyle, take medicines as prescribed, and watch for changes in your symptoms. A heart-healthy lifestyle includes eating heart-healthy foods. Limit alcohol, sodium, and sugar. Be active. Stay at a weight that's healthy for you. If you smoke or vape, try to quit. And try to get enough sleep.

Pericardial effusion

Normal heart and heart with pericardial effusion

In a normal heart, a thin layer called the pericardium surrounds and protects the heart. There is a small amount of fluid between the pericardium and the heart. This fluid helps cushion the heart.

But sometimes too much fluid builds up in this space around the heart. This is called pericardial effusion. This extra fluid puts pressure on the heart and can cause chest pain and serious heart problems.

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