Pericardial Effusion

Treating Cardiovascular Diseases in Wisconsin and Northern Illinois

A pericardial effusion is the accumulation of extra fluid around the heart. The fluid can develop between the lining of the heart (pericardium) and the heart itself, causing a variety of pericardial effusion symptoms.

Pericardial effusion can be related to inflammation of the heart from disease or injury. Fluid can also occur without inflammation, and may be associated with blood accumulation after heart surgery. 

When pericardial fluid becomes too much for the heart to handle, it decreases heart function. If left untreated, it can lead to heart failure or death.

Pericardial Effusion Symptoms

Symptoms of pericardial effusion vary depending on the amount of fluid present. In some cases, symptoms may not become evident until a fairly large amount of fluid has accumulated.

There are many signs and symptoms of pericardial effusion, including:

  • A cough
  • A feeling of anxiety
  • Chest pain that usually feels worse when you inhale or lie down
  • Dizziness or fainting
  • Low grade fever
  • Nausea or abdominal fullness
  • Painful breathing
  • Rapid heart beat
  • Shortness of breath (dypsnea)
  • Shortness of breath when lying flat (orthopnea)

In some cases, the fluid can lead to a more serious condition and cause changes in mental status, shock or blue-tinged skin or lips (cyanosis).

Risks and Causes of Pericardial Effusion

There are many conditions that can cause pericardial effusion, and it is not always clear how they contribute to the fluid accumulation. Specific causes include:

  • Autoimmune disorders, such as rheumatoid arthritis or lupus
  • Cancer of the pericardium
  • Chemotherapy drugs
  • HIV/AIDS
  • Hypothyroidism (underactive thyroid)
  • Inflammation of the pericardium following heart surgery
  • Kidney failure
  • Metastatic cancer (cancer that originated in one part of the body and spread), especially lung cancer, breast cancer or leukemia
  • Radiation therapy for cancer (when the heart is within the radiation field)
  • Trauma or injury near the heart
  • Viral, bacterial or fungal infections

In some cases, the paricardium becomes inflammed for no known reason. This is known as idiopathic pericarditis.

Diagnosing Pericardial Effusion

Your doctor will diagnose pericardial effusion based on your medical history, a physical exam that includes listening to your heart with a stethoscope and results from various tests, such as:

  • Chest X-ray 
  • Computed tomography (CT scan) of the chest 
  • Echocardiography, which is an ultrasound of the heart
  • Electrocardiogram (EKG)

Treating Pericardial Effusion

Depending on the underlying cause of your pericardial effusion, your doctor may prescribe any of the following medications:

  • Antibiotics to help treat infections that cause pericardial effusion
  • Chemotherapy or radiation to help treat cancer of the pericardium
  • Diuretics to help treat heart failure that causes pericardial effusion
  • Nonsteroidal anti-inflammatory drugs (Advil, Motrin or high-dose aspirin) or Colchicine to help treat inflammation of the pericardium         

When medications are not effective, a cardiologist or surgeon may perform any of the following procedures to drain fluid from around the heart:

  • Ultrasound guided pericardiocentesis, which uses a catheter (a thin tube) guided by ultrasound to aspirate (remove) the excess fluid
  • Video assisted thoracotomy, which involves a small incision to access the pericardium, drain the fluid and prevent it from re-accumulating
  • Pericardial window, a surgical procedure that involves a small incision to open the pericardium and drain the fluid

A Leader in Diagnosing and Treating Pericardial Effusion

Aurora Health Care is a leader in heart care. We offer the latest imaging technology available to accurately diagnose pericardial effusion. We also have many cardiologists and surgeons who can provide effective treatment options.

Aurora doctors are conveniently located throughout eastern Wisconsin and northeastern Illinois. Find a doctor or heart specialist near you. To get a second opinion or if you need assistance finding a provider, please call 888-649-6892.