Patient education: Pericardial effusion (The Basics)

What is pericardial effusion? — This is a collection of fluid around the heart. It affects the sac that surrounds the heart, called the "pericardium" (figure 1).

The pericardium has 2 layers. Normally, there is a small amount of fluid between the layers. This protects the heart and keeps it from rubbing against nearby organs. With a pericardial effusion, too much fluid collects. This can lead to symptoms. In severe cases, it can put pressure on the heart and prevent it from pumping blood normally. This is called "cardiac tamponade." It is life-threatening if not treated right away.

Pericardial effusion can happen after an infection, illness, or injury. Sometimes, the cause is not known.

What are the symptoms of pericardial effusion? — If the extra fluid is putting pressure on the heart, it can cause symptoms. These might include:

●Chest pain or fullness

●Trouble breathing

●Feeling very tired

●Dizziness or fainting

Depending on what caused the fluid collection, you might have other symptoms, too. For example, if you have an infection, you might have a fever.

Some people do not have any symptoms. They learn that they have a pericardial effusion after getting tests for another reason.

Will I need tests? — Your doctor will ask about your symptoms and do 1 or more of these tests:

●Echocardiogram – This uses sound waves to create an image of your heart as it beats (figure 2).

●Electrocardiogram ("ECG") – This measures the electrical activity in your heart.

●Chest X-ray – This creates pictures of your heart and the area around it.

●Blood tests – These can help your doctor figure out what caused the pericardial effusion.

●Pericardiocentesis – A doctor takes a sample of fluid from around your heart. They do this using a needle that goes through the skin on your chest. Then, they do lab tests on the fluid.

How is pericardial effusion treated? — If the pericardial effusion is putting pressure on your heart, your doctor will remove the fluid. This can usually be done with a needle or plastic tube. Sometimes, it is done with surgery.

Other treatment depends on your situation:

●If your pericardial effusion is not severe, your doctor will monitor you. This means getting regular exams and echocardiograms to see if the fluid collection goes away.

●If your doctor knows what caused the pericardial effusion, they can sometimes treat that problem. For example, many people also have something called "pericarditis." This is irritation of the tissue around the heart. It can be treated with medicines.

●If you are at risk for getting pericardial effusion again, your doctor will talk to you about your options. They might need to drain the fluid more than once. In some cases, they can do surgery to cut away a piece of the pericardium.

More on this topic

Patient education: Pericarditis in adults (The Basics)
Patient education: Pericarditis in children (The Basics)
Patient education: Pleuritic chest pain (The Basics)
Patient education: What can go wrong after a heart attack? (The Basics)

Patient education: Pericarditis (Beyond the Basics)