Pericardial Effusion

What is Pericardial Effusion?

In pericardial effusion, too much of fluid gets accumulated in the sac-like double layered structure that surrounds the heart, called pericardium. Generally, there exists a thin layer of fluid between these two layers. But in case the pericardium gets injured, the pericardium will get an inflammation. This inflammation can make the fluid to be excessive.

Another reason could be post-traumatic bleeding in the heart. If you have pericardial effusion, it will result on building up of excessive pressure on the heart. If you do not get it treated on time, it could eventually lead to cardiac arrest and can be life-threatening.

Symptoms

If the quantity of liquid in your pericardium increases gradually over a period of time, you could experience no symptoms until the volume is quite large. Some symptoms are:

  • Fullness in the chest
  • Orthopnea – Feeling uncomfortable to breathe while lying down
  • Dyspnea – Shortness of breath
  • Chest pain behind the breastbone
  • Chest pain on the left side of the chest

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Causes

There could be various causes for the inflammation of the pericardium:

  • The way your heart responds to an injury or illness
  • Due to trauma in the chest, when blood accumulates within the pericardium
  • After you have a heart surgery or heart attack
  • Due to hypothyroidism, or infections that are viral, bacterial, parasitic or fungal in nature
  • Attributed to Uremia or kidney failure, in which waste is not eliminated from blood
  • A result of chemotherapy if your heart was in the radiation zone
  • Non-Hodgkin’s lymphoma or Hodgkin’s disease
  • Spreading of cancer through other parts like breast, lung or blood
  • Because of Pericardial cancer
  • Because of some drugs you might have been prescribed for other cardiac ailments
  • Idiopathic pericarditis – Undetermined causes

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Risks

You could be in the risky zone of Pericardial effusion if you have had infections like tuberculosis, cancers, hypothyroidism, usage of long term agents like Dopamine and infection disorders like Lupus and rheumatoid arthritis.

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Prevention

You can lower the chances of pericardial effusion by reducing the severity and complications of pericardial effusion, by maintaining a healthy lifestyle and taking proper medication on time.

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How is it diagnosed?

A number of diagnostic tools may be used by your specialist at Medanta to identify the presence of pericardial effusion. These tools are:

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How is it treated?

Generally, all cardiologists recommend on acting at the root cause of pericardial effusion. Therefore, depending on the cause and severity of your situation, treatments at Medanta could include:

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  • Drug therapy

    Medications to reduce inflammation and prevent blood clotting, like aspirin and ibuprofen are administered in this process.

  • Drain therapy

    If the medication therapy is not effective enough, your cardiologist might recommend draining of excessive fluid from the pericardium using a surgical procedure called pericardiocentesis. This procedure refers to usage of a needle fitted with a catheter to drain extra fluid from the layers. The catheter might then be left at the place, to prevent reoccurrence of the disorder. During the surgery, imaging techniques like echocardiography or fluoroscopy are used.

  • Open heart surgery

    This might be suggested if there is blood leakage into pericardium and if it is a complicated scenario. Using an open heart surgery, the surgeon drains the pericardium and repairs the damages caused by it.

  • Balloon pericardiotomy

    Although quite rare, this surgery is carried out to insert a deflated balloon between the two layers of pericardium. It is then inflated, to increase the space between the layers.

  • Pericardiectomy

     If pericardial effusion keeps repeating itself even after draining out the excess fluid, this surgery is used to remove parts or the whole of pericardium.

When do I contact the doctor?

You have to consult your doctor if you have shortness of breath, chest pain for more than a few minutes, unexplained fainting spells or painful breathing.

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