Pericardial Effusion

The pericardium is one of the most important parts of the human anatomy that is mostly associated with the working of the heart. It is a tough structure or let's say, a sac that is filled with fluid (pericardial fluid). It is located at a point where it has to surround or wrap around the heart. So essentially, the heart stays inside the sac, and when it beats, it actually slides within it with the help of the fluid. Although there are many functions of this sac, some of the most important ones may include keeping the heart contained in the chest cavity, and keeping the organ from overextending, which may occur due to increase in the blood volume. Now there are certain diseases or disorders which causes an excess accumulation of the pericardial fluid around the heart, and this is what is known as pericardial effusion. More often than not, this condition results from the inflammation of the pericardium. However, there are also cases, wherein, it is not associated any kind of inflammation whatsoever.

An Overview of Pericardial Effusion

What Causes the Condition?

→ There are two main causes behind the development of pericardial effusion. The first cause is the inflammation of the pericardium, which is known as 'pericarditis'. Conditions which are highly suspected to trigger such an inflammation may include:

• Viral infections such as common cold, viral meningitis, cytomegalovirus, glandular fever, cold sores or genital herpes, influenza, hepatitis C, and HIV/AIDS.
• Bacterial infections such as pneumonia or bronchitis
• Rheumatoid arthritis, lupus and other autoimmune disorders
• Kidney failure
• Hypothyroidism
• Damage to the heart caused by a heart attack
• Chest trauma
• Cancer treatment such as radiotherapy
• Metastasized cancer (lung cancer, leukemia, breast cancer, etc.)
• Use of certain prescription drugs

But as cited above, inflammation isn't always responsible. In some patients, blood may start getting accumulated in the sac, or there might occur a blockage which may keep the pericardial fluid from flowing normally. So even these factors may contribute to pericardial effusion. In addition, there are also cases, wherein, the condition remains idiopathic; meaning, its cause cannot be determined.

How is the condition detected?

→ Being aware of the classic symptoms exhibited by the condition helps in initiating early diagnosis, hasty treatment thus, short recovery time. Some of the common symptoms that may indicate the onset of pericardial effusion include:

• A shooting sharp pain that can be felt behind the breastbone, usually on the left side of the chest.
• The pain does not remain localized, and radiates up to the left shoulder and neck.
• Actions such as coughing, laughing, sneezing, or even lying down and eating may aggravate the pain. But sitting up tends to somehow lessen the same.
• The person may have difficulty in breathing while lying down, and even during inhaling.
• Symptoms that may accompany include dizzy spells, a mild fever, abnormally fast heart rate, and being anxious for no good reason
• Swelling of the legs or abdomen, nausea and dry cough

What complications may occur if the condition goes untreated?

→ The excess fluid around the heart that gets accumulated starts pressing against the organ. And without any treatment, this very pressure can extent to such a degree that it may keep the chambers of the heart from filling completely with air. It may also cause one or more chambers to shut down partially. This deterioration in the heart's function is known as tamponade. And the immediate consequence of this malfunction is a poor blood circulation in the body, thus creating a dearth in the supply of oxygen. So, as obvious it is, it might cause a life-threatening situation for the affected person.

What is done for the treatment?

→ The nature of the treatment depends on:

• The causal factors of the pericardial effusion
• The degree of accumulation of the fluid
• Whether the condition is threatening to disrupt the heart's function or not

So weighing all such factors, the doctors proceed to choose for the best treatment available for the patient. Medications that are generally administered in the treatment may include Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), aspirin or colchicine to reduce inflammation that has caused the condition. However, these medications are only used if the person is not under the threat of a decreased heart function caused by the excess fluid. And if in cases, the above medicines comes of no help, or if the condition has caused or is likely to cause tamponade, then surgical procedures may be the options which doctors may go for.

It is important to know that, ignoring the symptoms of pericardial effusion or delaying its treatment, only increases the chances of heart failure. And in extreme cases, when the heart ceases to function completely, then it may even result in death. So recognizing the symptoms, and treating the condition when it is still at its weakest, helps in correcting the problem with ease.