Pericardial effusion is a buildup of fluid between the pericardium, which is the membrane that lines the heart. This fluid buildup can cause excess pressure on the heart. As a result, heart function becomes disrupted.
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| Pericardial Effusion, Causes, Diagnosis, Treatment, Prevention, Complications |
The pericardium consists of two thin layers that cover the heart. Between these two layers is a small fluid-filled space that lubricates the heart so that it can beat or pump blood easily.
Pericardial effusion occurs when the fluid between the pericardial spaces exceeds normal levels. If normally there is only 2-3 tablespoons of fluid, in pericardial effusion, the amount of fluid can be as much as 100 milliliters to more than 2 liters.
Causes of Pericardial Effusion
The causes of pericardial effusion are varied, including:
- Inflammation of the pericardium (pericarditis), either due to disease or injury
- Pericardial cancer, heart cancer, or cancer that has spread from the lungs, lymphatic system, skin, breast, or blood
- Medical procedures, such as radiotherapy, chemotherapy, and heart surgery
- Infection from bacteria, viruses, fungi, or parasites
- Autoimmune diseases, such as rheumatoid arthritis and lupus
- Consumption of certain drugs, such as high blood pressure drugs, tuberculosis drugs, and anti-seizure drugs
- Hypothyroidism
- Kidney failure
- Heart attack
Although there are many conditions that can cause pericardial effusion, there are also many cases of pericardial effusion with no known cause. This condition is called an idiopathic pericardial effusion.
Symptoms of Pericardial Effusion
Pericardial effusion can occur without causing symptoms, especially if the fluid buildup occurs slowly or not too much. When there is a lot of fluid that has accumulated in the pericardium, the lungs, stomach, and nerves in the diaphragm will be compressed. This can generally cause symptoms in the form of:
- Chest feels tight or sore
- Stomach feels full
- Shortness of breath or shortness of breath which may get worse when lying down
- Nauseous
- Difficult to swallow
In pericardial effusion caused by inflammation, for example due to a side effect of chest radiotherapy or a viral infection, there is a characteristic symptom of chest pain that gets worse when taking a deep breath and improves when the body leans forward.
Other symptoms that can also appear are:
- Fever
- Fatigue
- Muscle ache
- Vomit
- Diarrhea (in viral infections)
When to see a doctor
Check with your doctor if you experience the above symptoms, especially if you feel chest pain that lasts more than 5 minutes, difficulty or pain when breathing, and fainting for no reason.
Immediately go to the hospital emergency room to get medical help if complaints arise in the form of:
- Short breath
- Heart beat
- Blue lips and skin
- Decreased consciousness (weakness, drowsiness, or confusion)
- Faint
- Shock (cold, clammy, pale skin)
Pericardial effusion diagnosis
The doctor will ask about the patient's symptoms, followed by a physical examination, by listening to the sound of the patient's heartbeat using a stethoscope. If the patient is suspected of having pericardial effusion, the doctor will carry out the following investigations to confirm the diagnosis:
- Electrocardiogram (EKG)
- Echocardiography
- Chest X-ray photo
- Scanning with a CT scan or MRI
Pericardiocentesis or examination of pericardial fluid samples may also be performed to find out in more detail the cause of the pericardial effusion.
Treatment of Pericardial Effusion
Treatment of pericardial effusion depends on the cause, how much fluid is in the pericardium, and how much the patient is at risk of developing a severe pericardial effusion. Methods that doctors can use to treat pericardial effusion include:
Give medicines
The doctor will prescribe drugs to reduce inflammation in the pericardium, if the patient is not at risk of developing a severe pericardial effusion. Prescription drugs can be:
- Aspirin
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
- Corticosteroids, such as prednisone
- Colchicine
Perform medical procedures
Doctors will perform medical procedures if medications are ineffective and if a patient has or is at risk of developing cardiac tamponade. Some of these procedures are:
- Echocardiography-assisted pericardiocentesis, to remove fluid that has accumulated in the pericardium
- Open-heart surgery, to remove blood or fluid from the pericardium, repair damage to the pericardium, and sometimes install a tube from the pericardial cavity to the abdominal cavity so that fluid can flow into the abdominal cavity so that it is then absorbed by the body
- Percutaneous balloon pericardiotomy, to widen the space between the layers of the pericardium using a balloon and a catheter
- Pericardiectomy, to remove part or all of the pericardium, for patients who have experienced multiple pericardial effusions even though they have been treated with other methods
Pericardial effusion complications
Pericardial effusion that takes place quickly and the amount of fluid that is large can interfere with the function of the heart in pumping blood. This condition is called cardiac tamponade and can cause organ failure, shock, and even death.
Prevention of pericardial effusion
In most cases, pericardial effusion cannot be prevented. However, you can reduce your risk of developing diseases that can cause pericardial effusion, such as infection, kidney failure, and heart attack, by doing the following:
- Living a healthy lifestyle, such as consuming a balanced nutritious diet, maintaining an ideal body weight, and exercising regularly
- Take the drug according to the rules of use, and if necessary, consult with your doctor first
- Conduct regular health checks to the doctor
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