What is pericardial effusion?

Pericardial effusion, sometimes referred to as "fluid around the heart," is the abnormal build-up of excess fluid that develops between the pericardium, the lining of the heart, and the heart itself.

Who is affected by pericardial effusions?

Since pericardial effusions are a result of many different diseases or conditions, anyone who develops one of the many conditions that can produce an effusion may be affected. Pericardial effusions can be acute (comes on quickly) or chronic (lasting more than 3 months).

Is pericardial effusion serious?

The seriousness of the condition depends on the primary cause, size and rate of growth of the effusion — and whether it can be treated effectively. Causes that can be treated or controlled, such as an infection due to a virus or heart failure, allows the patient to be effectively treated and remain free of pericardial effusions.

Pericardial effusion caused by other conditions, such as cancer, is very serious and should be diagnosed and treated promptly.

Additionally, rapid fluid accumulation in the pericardium can cause cardiac tamponade, a severe compression of the heart that impairs its ability to function. Cardiac tamponade resulting from pericardial effusion can be life-threatening.

What are the symptoms of pericardial effusion?

Many patients with a small pericardial effusion have no symptoms. The condition is often discovered on a chest x-ray, CT scan or echocardiogram that was performed for another reason. Initially, the pericardium may stretch to accommodate excess fluid build-up. Therefore, signs and symptoms may not occur until a large amount of fluid has collected over time.If symptoms do occur, they may result from compression of surrounding structures, such as the lung, stomach or phrenic nerve (a nerve that connects to the diaphragm). Symptoms also may occur due to diastolic heart failure (heart failure that occurs because the heart is unable to relax normally between each contraction due to the added compression).Symptoms of pericardial effusion include:

  • Chest pressure or pain
  • Shortness of breath
  • Nausea
  • Abdominal fullness
  • Difficulty in swallowing

Symptoms that pericardial effusion is causing cardiac tamponade include:

  • Blue tinge to the lips and skin
  • Shock
  • Change in mental status

Cardiac tamponade is a severe compression of the heart that impairs its ability to function. Cardiac tamponade resulting from pericardial effusion can be life-threatening and is a medical emergency, requiring urgent drainage of the fluid.

What causes pericardial effusion?

Pericardial effusion, and the possible inflammation of the pericardium resulting from it (called pericarditis), can have many possible causes, including:

  • Infection such as viral, bacterial or tuberculous
  • Inflammatory disorders, such as lupus and rheumatoid arthritis
  • Cancer that has spread (metastasized) to the pericardium
  • Kidney failure with excessive blood levels of nitrogen
  • Heart surgery