Pericardial Effusion

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What are the complications of this condition?

A pericardial effusion can lead to cardiac tamponade. Between the inner wall of the pericardium and your heart is a thin layer of fluid. This cushions and protects your heart from outside forces (much like bubble wrap around a fragile item inside a shipping box).

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Usually, your pericardium has just enough fluid to cushion your heart, but not so much fluid that it keeps your heart from expanding and filling up with blood. Cardiac tamponade happens when your heart has no room to expand and fill with blood. Without quick treatment, it can make your heart stop, which is eventually fatal within minutes to hours.

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Cardiac tamponade is a complication of pericardial effusion, but not the only one.

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As your heart pumps less and less blood, it speeds up to try to make up for its limited pumping ability. Over time, your heart can’t keep up, and you can go into cardiogenic shock. Without treatment, cardiogenic shock is fatal.

What are the symptoms?

You may not have any pericardial effusion symptoms with a mild case. Symptoms are more likely when an effusion happens quickly, involves a large amount of fluid or causes cardiac tamponade. The main symptoms of pericardial effusions and cardiac tamponade include:

Shortness of breath (dyspnea).
Chest pressure or pain.
Fast heartbeat or heart palpitations.
Lightheadedness or dizziness.
Fainting (syncope).
Fatigue.
Anxiety, confusion or other behavior changes (because of low blood flow to your brain).
Cyanosis (a blue or gray tinge to your lips or under your fingernails that happens when you have low blood oxygen levels).

If a pericardial effusion is large enough, it can press on surrounding tissues or nerves. That can cause symptoms like:

Trouble swallowing (dysphagia).
Hiccups.
Coughing or hoarseness.

What causes pericardial effusion?

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In developed countries, an unknown reason is the most common cause of a pericardial effusion. Tuberculosis is the most common cause in developing countries.

Pericardial effusion has many different causes. It often happens along with (or because of) inflammation of the pericardium (pericarditis).

Possible causes of pericardial effusion include:

Infections. Pericardial effusion often happens because of viral or bacterial infections, including human immunodeficiency virus (HIV) and tuberculosis. It can also happen because of fungal infections or parasites. Pericardial effusion itself isn’t contagious.
Cancer. Tumors in your heart or that spread from elsewhere in your body can damage your pericardium.
Immune system conditions or inflammatory disorders. These include lupus, rheumatoid arthritis or Sjögren’s syndrome.
Hormonal disorders or problems. An example of this is hypothyroidism (where your thyroid gland isn’t producing enough thyroid hormone).
Trauma. Injuries to your chest, including blunt impacts (like car crashes) and punctures from knives or bullets, can cause pericardial effusion.
Heart or circulatory problems. These include heart attacks, heart valve disease or aortic dissection (where layers on the inside of your aorta separate or tear).
Medical causes. Pericardial effusion can happen after heart surgery, radiation therapy for cancer or as a side effect of some medications.
Other. Pericardial effusion can also happen with heart failure, chronic kidney disease, kidney failure or liver cirrhosis.