Pericardial Effusion
Pericardial Effusion Overview
Pericardial effusion describes the excessive collection of fluid within the two layers of the pericardium, the thin membrane surrounding the heart. When the fluid volume exceeds normal “full” levels, poor heart function can result because of the pressure. If the build-up is rapid, it can further lead to cardiac tamponade, a potentially life-threatening condition that impairs heart functions and requires emergency medical treatment.
Pericardial effusion is often associated with pericarditis, the inflammation of the pericardium. But pericardial effusion can occur without inflammation, resulting instead from the accumulation of blood after a surgical procedure or injury.
Other possible causes include:
- Viral, bacterial, fungal or parasitic infections
- Autoimmune disorders, such as rheumatoid arthritis or lupus
- HIV/AIDS
- Kidney failure
- Cancer that has spread (metastasized) to the pericardium
- Under-active thyroid (hypothyroidism)
Symptoms
Many patients with pericardial effusion do not feel symptoms in the early stages and may not see any signs of the condition until a considerable amount of fluid has collected within the pericardium. If symptoms do occur, they may result from compression on surrounding organs. These include:
- Chest pressure or pain
- Shortness of breath or painful breathing even with limited activity
- Rapid or irregular heartbeat or pulse
- Dizziness or fainting
- Nausea or abdominal fullness
- Fever
Symptoms showing that pericardial effusion may be developing into cardiac tamponade—a severe compression of the heart that requires immediate medical attention—include:
- Blue tinge to the lips and skin
- Rapid and faint pulse, and rapid breathing at rest
- Shock
- Change in mental status
Pericardial Effusion Prevention
Most initial cases of pericardial effusion cannot be prevented. But you can take steps to reduce pericardial effusion from becoming more severe or developing into cardiac tamponade.
Reduce Your Risk of Pericardial Effusion Disease
You can lower your chances of more severe forms of pericardial effusion by getting prompt treatment, adhering to the plan you and your Wellstar physician devise and continuing medical care.
Tests and Screenings
In diagnosing for pericardial effusion, your Wellstar physician will take a careful medical history and perform a physical examination. With a stethoscope, your physician can listen for a high-pitched, scratchy sound in your heart called a friction rub. If there is a large amount of fluid, your heartbeat may be muffled or sound distant.
Based on the exam, your physician might order some of these tests:
- Chest X-ray to reveal fluid accumulation around the heart.
- Electrocardiogram (ECG) to record the electrical activity of your heart and to reveal if there are rhythm issues or if there had been a heart attack..
- Echocardiogram, an ultrasound test, designed to outline the structural features of the myocardium and surrounding structures..
- Cardiac stress tests, which measure your heart’s performance during exertion..
- Cardiac computerized tomography (CT) scan or magnetic resonance imaging (MRI), which can provide a three-dimensional image of your heart.
- Blood tests to check your kidney and thyroid functions or for diseases that could affect the performance of your heart and to ensure that you are not having a heart attack.
Pericardial Effusion Diagnosis
If screening tests are abnormal your Wellstar physician will perform further evaluations regarding pericardial effusion.
Pericardial Effusion Treatment
Treatment of pericardial effusion depends on the cause as well as the severity of the condition and whether the excess fluid may be rich in protein (exudate) or water (transudate). If there is no immediate threat of cardiac tamponade, a prescription of medication may be sufficient to treat the condition.
Medication
Your Wellstar physician may prescribe medication to reduce the inflammation of the pericardium that is contributing to this condition. Some of these medications include aspirin, non-steroidal anti-inflammatory drug (NSAID), colchicines or corticosteroids.
Medical Procedures and Surgery
In some cases, your Wellstar physician may recommend more invasive treatments, particularly in instances of cardiac tamponade. Such procedures include:
- Pericardiocentesis, in which your Wellstar cardiologist uses a sterile needle or small tube (catheter) to remove and drain the excess fluid from the pericardial cavity.
- Pericardiectomy, a surgical procedure to remove those portions of the pericardium that has become rigid and is compromising the performance of your heart.
- Open heart surgery, particularly if there is bleeding into the pericardium usually as a result of a previous heart surgery or complicating factor.
- Intrapericardial sclerosis, a procedure in which a solution is injected into the space between the layers of the pericardium that seals the layers together. This procedure is most often used if cancer caused the pericardial effusion or if the condition is recurring.
Ongoing Care for Pericardial Effusion
Wellstar’s world-class, community-based physicians utilize state-of-the-art medical centers and hospitals with the latest technologies and medical resources.
Other clinicians are dedicated to:
- Helping you create and maintain healthy lifestyles
- Offering advice to prevent illness and injuries
- Providing early and appropriate care of acute illness to prevent its progression
Heart Care at Wellstar
Wellstar provides top-flight Cardiac Care throughout its physicians’ offices, urgent care centers and emergency rooms. Emergency departments at Wellstar Cobb, Wellstar Douglas, and Wellstar Kennestone hospitals provide comprehensive cardiac services. Wellstar Cobb and Wellstar Kennestone hospital’s cardiac diagnostic and treatment services provide the next level of defense against heart disease. The technologically advanced Cardiac Center at WellStar Kennestone Hospital and partnership with Emory Healthcare for adult open-heart surgery raises the bar on world-class cardiac care. Wellstar’s Cardiac Rehabilitation Services’ medically supervised programs focus on helping heart disease patients maintain a healthier heart through education and support groups.
Ongoing Care at Home
Proper care and treatment of pericardial effusion can often improve symptoms and help you live longer. You and your Wellstar physician can work together to make your life more comfortable, so pay close attention to your body and your post-treatment regiment and keep your doctor updated.
As part of your post-treatment care and in addition to maintaining a healthy diet and exercise, you should:
- Seek prompt medical attention when symptoms increase in severity.
- Keep track of all medications you take. Keep track of your weight and blood pressure.
- Write down your questions, and never be afraid to ask your Wellstar physicians for clarification regarding your condition or your treatment.