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Pericardial effusion is the buildup of extra fluid in the space around the heart. If too much fluid builds up, it can put pressure on the heart. This can prevent it from pumping normally.
A fibrous sac called the pericardium surrounds the heart. This sac consists of two thin layers. Normally, there is a small amount of fluid between them. The fluid reduces friction between the two layers as they rub against each other. In some cases, extra fluid can build up between these two layers leading to a pericardial effusion.
A little fluid won’t cause much of a problem. But, if too much fluid builds up it can make it difficult for the heart to expand normally. This condition is called cardiac tamponade. It usually requires emergency treatment. Because of the extra pressure, less blood can enter the heart from the body. All of this can reduce the amount of oxygenated blood going out to the body. But not all pericardial effusions cause cardiac tamponade.
In some cases, pericardial effusion develops quickly. This is known as acute pericardial effusion. Other times, the fluid builds up slowly. This is known as subacute pericardial effusion. Chronic pericardial effusion is when cardiac effusion happens more than once over time.
A number of conditions can cause excess fluid and inflammation in the pericardial sac, such as:
Sometimes the cause of fluid buildup is unknown.
You may not have any symptoms. This is more often the case with a mild problem. You might be more likely to have symptoms from whatever is causing the pericardial effusion. For example, you might have fever if you have an infection of the pericardial sac.
When effusion is more severe, you may have symptoms such as:
If the effusion is very severe, it can also lead to very low blood pressure. This can cause symptoms of shock which include:
Shock is a medical emergency.
The symptoms of pericardial effusion can be like other health problems. Make sure to see your healthcare provider for a diagnosis.
The process starts with a medical history and a physical exam. Your healthcare provider will ask about your symptoms and past medical conditions. For symptoms of shock, it is important to find the cause quickly.
Tests may also be done, such as:
Doctors must try to diagnose the cause of the pericardial effusion with tests such as:
Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is, and what caused it. Chronic and acute pericardial effusions may need different treatment.
If a pericardial effusion is not severe, treatment may include:
A severe pericardial effusion may need to be drained. The fluid is drained with a procedure called pericardiocentesis. This procedure uses a needle and a thin, flexible tube (catheter) to drain the fluid.
In some cases, the pericardial sac may be drained during surgery. The surgeon may remove a piece of the pericardium. This is done to help diagnose the cause of the effusion. It can also prevent the fluid from building up again. Your doctor might be more likely to do this if you have had chronic pericardial effusion.
Symptoms often improve greatly after the excess fluid is drained. The outcome may depend on the cause and severity of the condition, the speed of treatment, and your overall health.
Many times, there are no complications of pericardial effusion. The most serious possible complication is cardiac tamponade. If untreated, it can lead to shock. This can cause serious complications. For example, reduced blood flow to the kidneys during shock can cause the kidneys to fail. Untreated, shock can lead multiple organs to fail, causing death.
You can reduce your risk of some of the medical problems that can lead to pericardial effusion. For example, take care of your heart by:
Many cases of pericardial effusion are not preventable.
If you have any symptoms of pericardial effusion, call your doctor right away. Call 911 if you have trouble breathing, chest pain, or symptoms of shock.
Tips to help you get the most from a visit to your healthcare provider:
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