In this article, you will learn about the causes, symptoms, diagnosis, treatments, and prognosis for pericardial effusion.
Pericardial Effusion Symptoms
Most people with pericardial effusion will have no symptoms directly caused by the effusion itself. They may experience symptoms as a result of the underlying cause of the pericardial effusion. Examples of causes for this condition include the following:
CancerInfection or inflammation of the pericardial sacInjuryImmune system problemsKidney failureMedication reactionsRadiation
In severe cases, pericardial effusion can lead to cardiac tamponade.
If an infection causes pericardial effusion, you may experience a fever and chills. Other symptoms may include:
Anxiety Fatigue Leg or foot swelling Dry cough Difficulty breathing while lying down
Causes
The leading cause of pericardial effusion is pericarditis, in which the pericardium becomes inflamed. Pericarditis can result from the following:
Viral, bacterial, fungal, or parasitic infections Cancer or cancer treatments, such as radiation Autoimmune diseases such as lupus or rheumatoid arthritis
Additional conditions that can cause pericarditis include:
HIV infection and AIDS Hypothyroidism Renal disease or kidney failure Tuberculosis
Pericarditis can also happen after a heart attack, heart surgery, or damage to the heart or esophagus. Medications that suppress the immune system can also cause pericarditis.
Males aged 16–65 are at the highest risk for pericarditis, but it can happen to people of all ages.
Diagnosis
Your healthcare provider will use a stethoscope to listen to your heart and diagnose pericardial effusion. The extra fluid in the pericardium causes a scraping sound called a pericardial rub, by which the pericardium and the heart are rubbing against one another.
Other tools to diagnose pericardial effusion include:
Heart magnetic resonance imaging (MRI) or computed tomography (CT) scan: Imaging techniques to help your provider visualize your heart Echocardiogram: An ultrasound of your heart Electrocardiogram: A test that evaluates your heart’s electrical system Chest X-ray or MRI: Imaging techniques to help your provider visualize your chest
You may also need a troponin blood test to check your heart for muscle damage. Troponin is a protein in the heart muscles but not in the blood. If troponin is in your blood, it indicates that your heart muscles have some damage. Higher levels of troponin mean more severe heart damage.
Additional tests that your healthcare provider may order include:
Antinuclear antibody (ANA): Blood testing for evidence of autoimmune disease Blood culture: Blood testing for the presence of bacteria C-reactive protein: Blood testing for inflammation markers Rheumatoid factor: Blood testing for a specific protein that indicates certain autoimmune diseases Tuberculin skin test: Skin testing for an immune response to the bacterium that causes tuberculosis
How Do You Treat Pericardial Effusion?
The most important step in treating pericardial effusion is to identify and treat the underlying cause. Depending on the cause, pericardial effusion can go away on its own.
Sometimes, a healthcare provider may use high doses of nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine medication to reduce swelling in the pericardium. However, if an underlying bacterial infection causes the pericardial effusion, the first line of treatment may be antibiotics.
Other treatment options include:
Diuretics (water pills) to remove excess fluid Corticosteroids such as prednisone Pericardiocentesis, a procedure that drains fluid using a needle Surgery to cut or remove part of the pericardium
Does Pericardial Effusion Go Away?
Pericardial effusion can be mild to severe, depending on the cause. Outcomes are good if the condition is treated right away. After treatment begins, most people recover in two weeks to three months.
When pericardial effusion is severe or goes untreated, heart tissue may become damaged, causing a condition called restrictive pericarditis, which can cause long-term issues with heart function.
For those treated for acute pericarditis or pericardial effusion, about 30% will develop the condition again.
Summary
Pericardial effusion is when the sac around the heart, called the pericardium, fills with excess fluid. If left untreated, it can impact heart function. There are various possible causes for this condition. Your healthcare provider may use specific techniques, tests, or imaging to make a diagnosis. Depending on the severity of the pericardial effusion, it may go away without treatment, require medication, or in severe cases, surgery. Prognosis for pericardial effusion is good. If treated early, most people will recover within a few weeks.
A Word From Verywell
Finding out that you have a health issue with your heart can be scary. Because pericardial effusion can sometimes happen after an illness, it can be disheartening to manage a new health issue. The main pericardial effusion symptoms include chest, back, neck, or shoulder pain. If you experience this, call 911 immediately. If you experience symptoms like sudden leg swelling, fatigue, or a dry cough that isn’t going away, make an appointment right away to see your healthcare provider.
