Fluid Around the Heart

Our heart is surrounded by a double-layered thin membrane called the pericardium. Under normal circumstances, a few milliliters of fluid can be found between the pericardium and the heart muscles. Pericardial effusion occurs when there is an abnormal accumulation of fluid around the heart. In rare instances, even blood is found in the excess fluid.

Fluid Around the Heart: Causes
Excess buildup of fluid around the human heart is not age and/or gender specific. There are many health conditions that can lead to fluid around the heart, and lungs for that matter. This condition may occur when the flow of pericardial fluid gets blocked, or blood accumulates within the pericardium. Cancer of the thyroid, kidney, cervix, stomach, larynx, esophagus, pancreas, leukemia, etc. and/or cancer that has spread to the pericardium, can cause excess fluid build up. Cancerous cells on the pericardium cause a reactive fluid buildup. Infections such as viral, bacterial, fungal, parasitic or even tuberculosis may also be a cause of fluid around the heart. Pericardial effusion causes also include congestive heart failure, or kidney diseases. There may also be fluid around the heart after surgery. Cancer treatment like radiation and chemotherapy also speed the fluid build up. Autoimmune disorders such as rheumatoid arthritis or lupus are also seen as a cause. Any type of injury or trauma to the heart, as well as certain medications cause pericardial effusion. Patients suffering from breast cancer and lung cancer also complain of excess fluid around the heart.

Fluid Around the Heart: Symptoms
Shortness of breath or difficulty in breathing while performing daily activities and/or lying down is the first symptom of pericardial effusion. Sharp chest pain along with a feeling of tightness, and a spell of chronic dry cough could also happen. Fainting, dizziness or nausea, and difficulty in swallowing are all exhibited as symptoms of fluid around the heart. Patients also often complain of a low grade fever, accompanied by pain, that radiates between the chest, neck, shoulder, back or abdomen. In severe conditions, skin and lips may develop a bluish color tinge. If left untreated, this condition may also lead to cardiogenic shock.

Fluid Around the Heart: Treatment
Unchecked and untreated fluid around the heart can lead to a complicated condition called 'tamponade'. Due to the pressure created by pericardial effusion, the heart chambers that pump blood fail to perform, and one or more chambers may partially collapse, resulting in poor blood circulation and an inadequate supply of oxygen to the body. Hence, it is advisable to seek early medical intervention and treatment. Multiple tests are recommended to determine the course of treatment. They include chest x-ray, Computed tomography (CT) scan, echocardiogram, etc. Treatment depends upon the amount of fluid build up and the underlying cause for it.

If there is no immediate threat of the condition to deteriorate, then medications to treat inflammation of the pericardium may include nonsteroidal anti-inflammatory drugs (NSAIDs), like indomethacin or ibuprofen, steroids; steroid hormones, diuretics and other heart failure medications, and /or infection fighting antibiotics.

If one is at risk of developing tamponade, then surgery for draining the pericardium may become an unavoidable option. Various types of surgical treatments include:

• Ultrasound-guided pericardiocentesis: Commonly performed, this is a safe and effective medical procedure used to remove or drain excess fluid from the pericardium.
• Video-assisted thoracoscopic surgery (VATS): This procedure is performed under general anesthesia, where visual evaluation of the pericardium can be conducted. This procedure drains and prevents re-accumulation of excess fluid.
• Intrapericardial sclerosis: In this procedure, a solution is injected into the space between the layers of the pericardium for sealing them together. This procedure is usually used for pericardial effusion caused by cancer.
• Pericardiectomy: This procedure involves surgical removal of full or partial pericardium. However, this surgery is only performed in very complicated cases of fluid buildup.

These were some of the causes, symptoms and treatment options for fluid around the heart. The right course of treatment, along with adequate prevention, as advised by a medical practitioner, will help one lead a life of good health and minimal health related complications.