The heart is enveloped by tissue called the pericardium, which has two layers. On occasion and due to a variety of possible conditions, these layers may become overfilled with pericardial fluid, creating a situation where extra pressure exists on the heart. This is called a pericardial effusion and it poses potentially great risk to heart function since growing pressure may inhibit the heart’s ability to beat properly. Given this risk, pericardial effusion must always be taken seriously, and people may need a variety of treatments to address the problem.
There are many potential causes of pericardial effusion. It can happen as a result of heart surgery, due to taking certain medications, or if people have inflammatory conditions like lupus or rheumatoid arthritis. Traumatic injury, infection, certain forms of cancer or cancer treatment, or low levels of thyroid hormone might result in it. Sometimes doctors are unable to determine cause of this condition and deem it “idiopathic.”
These risk factors for pericardial effusion suggest people should be alert to its potential symptoms, which may be numerous. They can include low fever, some difficulty breathing or shortness of breath, and pain in the chest where the heart is located. People might also experience cough, dizziness, tiredness, and quicker heart beat. It should be noted that the main symptoms of pericardial effusion in children, especially those recovering from heart surgery, could be cranky behavior and a slight fever.
When all or a few of these symptoms are observed, seeing a doctor is important to get diagnosis. Doctors may test for this condition in several ways. They could take an x-ray, order an echocardiogram or sonogram of the heart, and recommend other scans. Listening to the heart may provide clues too, since the sound can indicate the pericardium’s layers are creating pressure. Once diagnosis is made, determination of treatment is the next step.
Different treatment options exist and doctors decide which ones are most appropriate for patients based on level of fluid build-up and other factors. Occasionally people are not treated but are watched for several weeks, or they may alternately take medications like salicylates or non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and swelling. In this latter treatment, follow-up is still required to make certain pericardial effusion is recessing.
More aggressive treatment could be needed if impairment to heart function is likely or imminent. One way to address the issue is to perform pericardiocentesis, where a needle is inserted into the two layers and heart fluid is collected to relieve the pressure. An open-heart surgery may accomplish the same thing, but may be too risky for some patients. A drain can be placed in the pericardium, though, and this may help remove fluid from the heart via a chest tube; this may be an option for some people, but they’ll need to remain hospitalized during this treatment.
The risk of not treating or ignoring pericardial effusion is a condition called cardiac tamponade. This is potential collapse of a heart chamber, or more than one, which means blood may not adequately circulate in the body. This risk should be taken seriously, and people need to seek treatment if they think they might have pericardial effusion. On the other hand, it should be noted that many people developing this condition respond extremely well to treatment, will not have life-threatening risks, and will fully recover.
