Pericardial effusion is a condition involving fluid accumulation around the heart. If this occurs rapidly, the excess fluid can place severe pressure on the heart, leading to potentially fatal outcomes. What causes pericardial effusion, and how is it managed? Discover the full explanation below.

What is Pericardial Effusion?

The pericardium is a protective membrane surrounding the heart, consisting of two layers: the inner serous layer and the outer fibrous layer.

Under normal conditions, about 15-50 ml of fluid fills the space between these layers, serving as a lubricant during heartbeats. When inflammation occurs, however, it can lead to abnormal fluid buildup, creating intense pressure on the heart.

In cases of slow fluid accumulation, the heart muscle may stretch to accommodate the fluid. However, if the buildup is sudden or severe, it may compress the heart and create a medical emergency.

Causes of Pericardial Effusion

Pericardial effusion often arises from other health issues. Some possible causes include:

• Infection: Viral, fungal, or parasitic infections can lead to fluid accumulation. Conditions such as tuberculosis (TB), HIV, and other infections can trigger this response.
• Cancer or tumors: Tumors in or near the heart, or those that spread from elsewhere, may damage the pericardium, leading to fluid buildup.
• Autoimmune or inflammatory disorders: Conditions like lupus, rheumatoid arthritis, or Sjögren’s syndrome can cause inflammation in the pericardium.
• Hormonal imbalances: Issues like hypothyroidism may contribute to fluid accumulation.
• Trauma: Chest injuries, including blunt force trauma or stab wounds, can result in pericardial effusion.
• Heart or circulatory disorders: Heart attacks, heart valve disease, or aortic dissection (tearing of the aorta) can all lead to pericardial effusion.
• Medical procedure effects: Following heart surgery, cancer radiation therapy, or as a side effect of certain drugs, pericardial effusion may develop.

Symptoms of Pericardial Effusion

Mild pericardial effusion often produces no noticeable symptoms. Symptoms typically become evident in severe cases, especially those that progress quickly, involve large fluid volumes, or cause cardiac tamponade—a life-threatening condition in which excess fluid or blood accumulates between the heart muscle and the pericardium.

The primary symptoms of pericardial effusion and cardiac tamponade include:

• Shortness of breath
• Chest pain or pressure
• Rapid or irregular heartbeat
• Dizziness or lightheadedness
• Fainting
• Fatigue
• Anxiety or confusion
• Cyanosis (bluish tint of lips, fingernails, or skin due to oxygen deprivation)

When the effusion becomes large, it can also compress nearby tissues or nerves, resulting in additional symptoms like:

• Difficulty swallowing
• Persistent hiccups
• Coughing or hoarseness

Treatment for Pericardial Effusion

Treatment approaches for pericardial effusion depend on the amount of fluid present, the underlying cause, the risk of cardiac tamponade, and medications being used.

If cardiac tamponade is absent, a doctor may prescribe anti-inflammatory and pain-relieving medications such as aspirin, NSAIDs like ibuprofen or corticosteroids, while surgery or other procedures can also be recommended.

In cases where fluid persists or tamponade risk exists, other interventions might be recommended:

• Pericardiocentesis, the fluid is removed using a needle and catheter
• Open heart surgery
• Pericardial removal, If drainage alone does not resolve the issue and pericardial effusion keeps occuring

Pericardial effusion can escalate into a severe condition, carrying the risk of complications and death. If you experience heart-related symptoms, it’s essential to consult a physician or consider using the Ai Care app's consultation feature, available on the App Store and Play Store.

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