A pericardial effusion is an accumulation of extra fluid within the pericardium, the protective sac that surrounds your heart. Pericardial effusion can occur due to inflammation of the heart from disease or injury, or it can be related to blood accumulation after heart surgery. 

Specific causes of pericardial effusion include:

  • Autoimmune disorders, such as rheumatoid arthritis or lupus
  • Hypothyroidism (underactive thyroid)
  • 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)
  • Viral, bacterial or fungal infections
In some cases, the pericardium becomes inflamed for no known reason. This is known as idiopathic pericarditis.

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. That’s why it’s important to contact your doctor if you have symptoms.


Symptoms of a pericardial effusion can include:

  • Dizziness or fainting
  • Nausea or abdominal fullness
  • Painful breathing
  • Rapid heart beat
  • Shortness of breath (dypsnea)
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).


To diagnose pericardial effusion, your doctor will ask about your medical history and any symptoms you have. He or she will also perform a physical exam that includes listening to your heart with a stethoscope. Your doctor may also order diagnostic test such as: 

Services & Treatment 

Depending on the underlying cause of your pericardial effusion, your doctor may prescribe medication, such as antibiotics, diuretics or nonsteroidal anti-inflammatory drugs (e.g., Advil, Motrin, and ibuprofen)

If medications are not effective, a cardiologist or surgeon may drain fluid from around the heart using:

  • Ultrasound-guided pericardiocentesis – a thin tube (catheter) is guided by ultrasound to remove excess fluid
  • Video-assisted thoracotomy – a small incision is made to access the pericardium, drain the fluid and prevent it from re-accumulating
  • Pericardial window – a small incision is made to to open the pericardium and drain the fluid
Your doctor will discuss which treatment options are right for you.

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