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What Is Pericardial Effusion?

Symptoms and Causes of Pericardial Effusion

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Updated May 21, 2014

Rheumatoid arthritis and lupus are two examples of arthritic conditions that can have systemic effects (i.e., pertaining to or affecting the whole body rather than localized). Pericardial effusion is one of the possible systemic effects, though it is considered a rare complication of either rheumatoid arthritis or lupus.

Defining and Diagnosing Pericardial Effusion

The sac that surrounds the heart is called the pericardium. If excess fluid collects in the pericardium, the condition is known as pericardial effusion. If the excess fluid accumulates slowly, the pericardium expands and attempts to continue normal function. Symptoms associated with pericardial effusion are generally not evident until a large amount of fluid has accumulated, if it has been accumulating slowly.

If the fluid accumulates quickly in the pericardium, even if it is relatively little fluid, heart function can be affected. If pericardial effusion causes compression around the heart so that the heart cannot beat properly nor pump blood adequately, the condition is known as cardiac tamponade.

Ultrasound of the heart, CAT scans, or MRIs are used to diagnose the condition of pericardial effusion and cardiac tamponade.

Symptoms of Pericardial Effusion

Physical symptoms that point to pericardial effusion include:

  • severe edema (fluid retention)
  • low blood pressure
  • shortness of breath
  • dizziness
  • chest pain
  • cough
  • rapid pulse

Causes of Pericardial Effusion

Other than inflammatory types of arthritis, such as lupus and rheumatoid arthritis, there can be other causes of pericardial effusion including:

  • cancer
  • infection
  • kidney failure
  • heart surgery
  • hemorrhage
  • trauma
  • unknown cause

Treating Pericardial Effusion

There are cases of pericardial effusion in which the amount of fluid remains small and no treatment is required. If the episode of pericardial effusion is due to one of the inflammatory types of arthritis, anti-inflammatory medications (i.e., NSAIDs, corticosteroids) may improve the situation. When the pericardial effusion is more severe, it is usually drained using a needle which is passed through the chest wall and into the space where the fluid is located. In rare instances, surgery is required to drain the fluid.

Sources:

Pericardial Effusion. John L. Zeller, MD, PhD. JAMA. (Vol. 297 No. 16, April 25, 2007) <http://jama.ama-assn.org/cgi/content/full/297/16/1844>.

Pericardial Effusion: What are the symptoms?. Martha Grogan MD. MayoClinic.com. <http://www.mayoclinic.com/health/pericardial-effusion/HQ01198>.

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