Understanding Disease of pericardium: Causes, Symptoms, and Management

What is it?

Pericardial effusion is an abnormal accumulation of excess fluid that develops between the pericardium - the sac-like bilayer structure around the heart. The space between these layers typically contains a thin layer of fluid. But for some reasons, like disease or injury to the pericardium, that resulting inflammation can lead to excess fluid. Fluid can also build up around the heart without inflammation, such as from bleeding, related to cancer or after chest trauma.
Rapid accumulation of fluid in the pericardium can cause severe compression on the heart that impairs its ability to function. This condition is called cardiac tamponade and can be life-threatening.
The fluid may accumulate rapidly and then is known as acute pericardial effusion. Pericardial effusion can develop slowly and then is known as subacute pericardial effusion, or even chronic pericardial effusion if it happens more than once over time.

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Additional names

This group contains additional names:
- Pericardial effusion

Signs & symptoms

Many patients with a small pericardial effusion have no symptoms. Signs and symptoms may occur when a large amount of fluid has accumulated over time. The symptoms may result from compression of surrounding structures, and diastolic heart failure due to abnormal relaxation between each contraction due to increased compression on the heart. Symptoms may include shortness of breath, chest pain, chest or abdomen fullness, nausea. If the effusion is very severe, it can also lead to very low blood pressure, and even cause symptoms of shock.

Diagnosis

The diagnosis of pericardial effusion is based on a medical history and physical exam, which includes listening to the heart using a stethoscope.
Imaging tests such as a chest X-ray, CT scan, or MRI may check the size and shape of the heart. Signs of an enlarged heart can be seen if the effusion is large.
Tests to diagnose or confirm pericardial effusion may include an echocardiogram to look for fluid around the heart and heart movement, and ECG to analyze the heart’s electrical rhythm.

Treatment

Treatment for pericardial effusion depends on the amount of fluid buildup, the cause of the pericardial effusion, and the presence or the risk of cardiac tamponade. Medication therapy is an option if you don't have cardiac tamponade. Aspirin, steroids, NSAIDs, and colchicine can treat inflammation of the pericardium. If the medications do not help or the amount of the fluid is large, the treatment should be draining of the pericardial effusion by fluid drainage or even surgery.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital