Pericardial effusion

Posted by admin on August 29th, 2008 at 11:33pm

Pericardial effusion is defined as an abnormal collection of fluid in the pericardial cavity i.e. around the heart. As there is not that much amount of space in the pericardial cavity, the fluid accumulation leads to an increase in intra-pericardial pressure and this affects the cardiac function.

Whenever there is an accumulation of the pericardial fluid which is having enough pressure affecting cardiac function, then this is called as cardiac tamponade. Usually pericardial effusion is caused due to disturbance in the equilibrium between the production and re-absorption of fluid present in pericardium, or due to presence of any structural abnormality allowing the fluid to enter into the pericardial cavity. The pericardial fluid levels normally from fifteen to fifty milliliters.

It may be of transudative type such as congestive cardiac failure, myxedema, and nephrotic syndrome, or of exudative type such as tuberculosis, spreading from empyema or of hemorrhagic type like trauma, or rupture of aneuryms, and malignant effusion.

Causes of pericardial effusion

The causes of the pericardial effusion are pericarditis, or other infections, may be viral infection where the virus named coxsackie is causative, many times pericardial effusion is followed after the inflammatory disorders like lupus and post-myocardial infarction pericarditis which is commonly known as Dressler’s syndrome. Cancer may be also one factor which has spread to the pericardium. Other causes are cardiac surgery, Trichinosis and renal failure with hematuria.

Symptoms of pericardial effusion

A small type of pericardial may not have any symptoms rather than the chest pain and other pressure symptoms. Many times pericardial effusion is also seen after the repair of specific type of cardiac defect like an atrial septal defect secundum, or ASD.  When these are repaired then there is more chance of development of a pericardial effusion, this happens due to one of the procedure of repairing. One type of repairing procedure is of ASD in which a piece of the peridcardial tissue is taken and is used for attaching as a patch for the hole in the atrial cavity.

The radiographic sign of pericardial effusion is called as water-bottle heart, in this sign, there is enlargement of the cardio pericardial silhouette and it assumes like the shape of a flask or of water bottle. So it is called as water-bottle heart. It is also seen associated along with Ewart’s sign.

Treatment of pericardial effusion

Treatment of pericardial effusion depends on its underlying cause and how severely the heart is impaired. Usually pericardial effusion caused due to a viral infection reveals within a few weeks that too without any treatment. And many of the pericardial effusions remains small and they never need treatment. But if the cause of pericardial effusion is a condition such as lupus then treatment is needed here containing anti-inflammatory drugs.

If the effusion is disturbing the function of the heart and is causing the cardiac tamponade then it needs the draining of fluid by inserting the needle through the chest wall into the pericardial space. Sometimes a drainage tube is left there itself for several days. Surgical drainage may be often required by pericardiocentesis, in this procedure, a needle or a catheter is used to drain excess fluid.

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