A thin membrane called pericardium surrounds your heart. The membrane protects your heart against infections and prevents from expanding too much. When there is an abnormal fluid between your heart and pericardium, the condition is termed as pericardial effusion. Your normal pericardial sac consists of nearly 30 to 50 mL of fluid. In pericardial effusion, the volume of abnormal fluid increases up to two liters.
When there is any inflammation, your heart releases excess fluid and accumulates in the pericardial sac. Usually, in normal conditions, the fluid around your heart is continuously produced and drained, keeping the levels of fluid constant. But, in conditions such as heart attack or heart failure, the fluid in the pericardial sac is not drained properly. Your body, however, will continue to produce fluid causing excess fluid around your heart.
In most cases, inflammation leads to pericardial effusion. If the flow of fluid is blocked or when the blood is accumulated in the pericardium, it may result in pericardial effusion. Sometimes, the exact cause is never found. A wide range of conditions may cause pericardial effusion that includes the following:
Sometimes, fluid in the pericardium increases slowly without any signs and symptoms. But, if there is sudden increase in the pericardial fluid, it may cause the following pericardial effusion symptoms:
The risk factors for pericardial effusion include:
If the condition is not treated, it may lead to chronic pericardial effusion, where the condition lasts more than six months.
In severe cases, pericardial effusion may cause cardiac tamponade. The symptoms of cardiac tamponade include blue tinge on the lips and skin, shock, and change in the mental status. This condition is considered as a medical emergency and requires an immediate draining of the fluids.
Your doctor initiates the diagnosis by a complete medical examination. If pericardial is suspected, your doctor might order the following tests.
Sometimes, your pericardial fluid is aspirated to analyze the protein level, cell count and for culture. If your doctor suspects malignant pericardial effusion, then pericardial biopsy might be suggested.
Your doctor would suggest the appropriate pericardial effusion treatment based on severity, underlying cause, and extent of risk for developing cardiac tamponade.
The primary goal of medical management is to treat the underlying cause that results in pericardial effusion. Your doctor might recommend the following medications.
If you have a large amount of fluid in the pericardial sac that might cause cardiac tamponade, then draining the fluid would be the best option. For treating the large pericardial effusions, your doctor might suggest any of the following surgical procedures.