Pericardial Effusion

Overview

Pericardial effusion occurs when fluid accumulates in the space surrounding the heart, known as the pericardium. This condition can arise from various causes, including infections, physical trauma, or other health issues. A rapid or excessive fluid buildup can squeeze the heart, potentially leading to a critical health crisis.

If the fluid gathers gradually, the pericardium has the ability to expand, accommodating the additional fluid. However, a swift accumulation does not allow the pericardium to adjust, resulting in increased pressure on the heart. This pressure restricts the expansion of the heart’s chambers, limiting their capacity to fill with blood. Consequently, the heart’s blood output decreases, which can reduce blood flow to the body’s organs.

Without proper treatment, this condition might progress to heart failure or become fatal in severe cases.

Symptoms

Pericardial effusion might not always manifest noticeable symptoms, especially if the accumulation of fluid is gradual.

However, when symptoms of pericardial effusion do present, they can include:

• Dizziness or a faint feeling
• Discomfort while breathing in a lying down position
• Difficulty breathing or shortness of breath (known as dyspnea)
• A sensation of fullness in the chest
• Swelling in the legs or abdomen
• Pain in the chest, often located behind the breastbone or on the left side

Immediately call your local emergency services if you experience persistent chest pain lasting more than a few minutes, if breathing becomes difficult or painful, or if you faint without any clear reason.

If you notice shortness of breath, it’s important to schedule a visit with your healthcare provider.

Causes

Pericardial effusion is a condition characterized by the accumulation of fluid around the heart. The causes vary significantly between developed and developing countries. In developed nations, the exact cause often remains unidentified, while in developing regions, tuberculosis is frequently identified as the primary cause. This condition is commonly associated with, or a result of, pericarditis—a condition involving inflammation of the pericardium.

Various factors can lead to the development of pericardial effusion, such as:

• Infections: Viral, bacterial (including tuberculosis and HIV), fungal, and parasitic infections can lead to pericardial effusion. It’s important to note that pericardial effusion itself is not contagious.
• Cancer: The presence of tumors in the heart or the spread of tumors from other parts of the body can adversely affect the pericardium.
• Immune system conditions or inflammatory disorders: Conditions such as lupus, rheumatoid arthritis, and Sjögren’s syndrome can cause pericardial effusion.
• Hormonal disorders or problems: An underactive thyroid gland (hypothyroidism), which results in insufficient thyroid hormone production, is an example.
• Trauma: Chest injuries from blunt impacts (e.g., car accidents) or penetrative trauma (e.g., stabbings or gunshot wounds) can result in pericardial effusion.
• Heart or circulatory problems: Conditions including heart attacks, heart valve diseases, and aortic dissection (a separation or tear in the inner layer of the aorta) can lead to pericardial effusion.
• Medical causes: The condition can arise following heart surgery, radiation therapy for cancer, or as a side effect of certain medications.
• Other causes: Heart failure, chronic kidney disease, kidney failure, and liver cirrhosis can also result in pericardial effusion.