What are the Symptoms of Pericardial Effusion

When excess fluid collects in the sac (pericardium) surrounding the heart, doctors refer to this as pericardial effusion. It may be caused by inflammation of the pericardium (pericarditits). Signs and symptoms of pericardial effusion may include:

Fluid retention (edema)
Low blood pressure
Shortness of breath
Dizziness or fainting
Chest pain
Cough
Fast heart rate or heart palpitations

Causes of pericardial effusion include:

Infection
Inflammatory disorders, such as lupus
Cancer that has spread (metastasized) to the pericardium
Kidney failure with excessive blood levels of urea nitrogen
Heart surgery

If the fluid accumulates slowly, the pericardium may initially stretch enough to accommodate it. Signs and symptoms may not occur until a large amount of fluid collects over time. Rapid fluid accumulation — even if the fluid amount is relatively small — can severely impair the function of the heart. Cardiac tamponade occurs when the pericardial effusion compresses the heart and prevents effective pumping of blood to the body. This can be life-threatening.

A doctor may confirm a diagnosis by:

Ultrasound of the heart (echocardiogram)
CT or MRI scan

Treatment depends on the underlying cause and the severity of the heart impairment. Pericardial effusion due to a viral infection usually goes away within a few weeks without treatment. Some pericardial effusions remain small and never need treatment. If the pericardial effusion is due to a condition such as lupus, treatment with anti-inflammatory medications may help. If the effusion is compromising heart function and causing cardiac tamponade, it will need to be drained, most commonly by a needle inserted through the chest wall and into the pericardial space. A drainage tube is often left in place for several days. In some cases, surgical drainage may be required.