Pericardial Effusion

Written By Randy Wu

What is Pericardial Effusion?

Pericardial effusion is the buildup of excess fluid in the pericardium (sac surrounding the heart), which will put pressure on the heart and affect how well it functions. Normally, there should be a small amount of fluid in the pericardium to reduce the friction as the heart beats. When the buildup becomes severe, it can cause cardiac tamponade, where the heart is critically compressed and can’t properly fill or pump blood.

Why is Pericardial Effusion Important?

  • Pericardial effusion could be asymptomatic or have subtle symptoms at first and quickly transform into a life-threatening emergency. As little as 100-150 mL of fluid can cause your heart to stop, reducing blood flow to the body and potentially leading to heart failure or shock

  • Early detection and treatments can prevent serious complications and lead to discoveries of hidden infections, undiagnosed cancers, and autoimmune flare-ups

Causes of Pericardial Effusion:

Pericardial effusion is commonly caused by the inflammation or injury to the pericardium, but these are other causes of pericardial effusion:

  • Infections (viral, bacterial, fungal)

  • Inflammation (pericarditis)

  • Autoimmune diseases (lupus or rheumatoid arthritis)

  • Magliancy (spread of cancer to the heart)

  • Cardiac/chest injury or trauma

  • Heart surgery or heart attack complications

Symptoms:

Symptoms vary on how quickly the fluid builds up and how much is present in the sac. Early stages of pericardial effusion have mild or no symptoms:

  • Shortness of breath

  • Sharp chest pain

  • Lightheadedness or fainting

  • Heart palpitations (irregular heartbeats)

  • Swelling in the legs or abdomen

  • Fatigue or low-grade fever

If the pericardial effusion leads to cardiac tamponade, serious signs will emerge:

  • Rapidly falling blood pressure (shock)

  • High resting heart rate (tachycardia)

  • Jugular venous distension (swollen neck veins)

  • Extreme upper body pain

Treatments:

  • Anti-inflammatory medications (ibuprofen, aspirin): to reduce swelling

  • Pericardiocentesis (fluid drainage): uses needle and catheter to drain the fluid in the pericardium, used when severe symptoms are present

  • Pericardiectomy: removal of part or all of the sac, when fluid buildup is recurring

  • Pericardial window: surgically removing a small piece of the pericardium to drain the fluid into the chest or abdominal cavity

Pericardial effusion is mild in most early stages and can quickly become life-threatening if left untreated. Excess fluid buildup in the pericardium interferes with the heart’s ability to function properly and could lead to the heart stopping. With early diagnosis and proper management, most patients who had pericardial effusion are unlikely to get cardiac tamponade.

Randy Wu
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