Key takeaways
Pericardial effusion is fluid buildup between the layers of the pericardium, the sac surrounding your heart. It can result from conditions such as pericarditis (inflammation), infections, heart failure, cancer, injury, or kidney failure.
Symptoms may include chest pain, shortness of breath, a feeling of fullness in your chest, and discomfort when lying down. However, some people don’t experience noticeable symptoms.
Treatment depends on the cause and severity and may involve antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), or draining the fluid through a catheter or open-heart surgery.
The pericardium surrounds and protects the heart. When it becomes injured or infected, fluid can build up between its layers. Pericardial effusion, as the condition is called, strains the heart’s ability to pump blood.
This condition can have serious complications. If it’s not treated, it can also be life threatening. Here, we’ll cover the causes, symptoms, and treatments for fluid buildup around your heart.
The causes of fluid around your heart can vary widely.
Pericarditis
This condition refers to inflammation of the pericardium — the thin sac that surrounds your heart. Inflammation related to a
is a common cause.
The
points out that men between the ages of 16 and 65 years old are the most likely to experience pericarditis.
There are several different types of pericarditis, including idiopathic, viral, and bacterial.
Idiopathic pericarditis
Idiopathic pericarditis refers to pericarditis with no cause that doctors can determine.
Viral pericarditis
Viral pericarditis can be a complication of a viral infection in your body. Upper respiratory infections are most likely to cause this issue, but gastrointestinal viruses and
may also cause viral pericarditis.
Bacterial pericarditis
Staphylococcus, streptococcus, and other kinds of bacteria can enter the fluid that surrounds the pericardium and cause
.
Congestive heart failure
More than
Americans live with
. This condition occurs when your heart isn’t pumping blood efficiently. It can lead to fluid around your heart and other complications, though the effusion is less likely to cause problems itself.
Injury or trauma
An injury or trauma can puncture the pericardium or injure your heart itself, causing fluid to build up around your heart.
Cancer or cancer treatment
In some cases, the chemotherapy drugs doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan) can cause a pericardial effusion. This complication is
.
Heart attack
A
can cause the pericardium to become inflamed. This is called Dressler’s syndrome.
This inflammation can cause fluid around your heart. However, it’s much
now in the era of revascularization procedures.
Kidney failure
Kidney failure with
can cause a
of metabolites in the blood that results in inflammation. For some people, this results in pericardial effusion.
Fluid around your heart is called pericardial effusion. Fluid around your lungs is called a
.
There are some conditions that can lead to fluid around both your heart and your lungs. These include:
congestive heart failure
severe lung infection (
)
organ failure
trauma or injury
You may have fluid around your heart and not have any signs or symptoms. If you notice symptoms, they may
:
sharp chest pain that is worse with breathing
a feeling of “fullness” in your chest
chest pain when lying down
shortness of breath (
)
difficulty breathing
If a doctor suspects that you have fluid around your heart, you’ll be tested before you receive a diagnosis. Tests you might need to diagnose this condition include:
chest X-ray
lab tests to look for inflammation
If your doctor diagnoses fluid around your heart, they may need to remove some of the fluid to test it for infection or cancer.
Treating fluid around the heart will depend on the underlying cause, as well as your age and general health.
Treatment for pericarditis
anti-inflammatory medication, such as NSAIDs and colchicine. Sometimes, aspirin is given in place of NSAIDs. In some cases, doctors may prescribe anti-interleukin-1 anti-inflammatory agents (rilonacept, anakinra) or steroids.
For bacterial pericarditis, doctors will treat the underlying cause with antibiotics. Your healthcare professional will also likely recommend exercise restriction for at least one month and until the effusion is better.
If fluid around your heart continues to build up, the pericardium can put so much pressure on your heart that it becomes dangerous. In these cases, your doctor may recommend draining the fluid through a
inserted into your chest or
to repair your pericardium and your heart.
Can fluid around the heart go away on its own?
Depending on the cause, a small pericardial effusion may go away on its own. However, symptomatic pericardial effusions require treatment.
Healthcare professionals will monitor your heart to watch for progression. If the fluid volume increases, you’ll likely require treatment.
When fluid builds up around the heart quickly or when an effusion is large, it can cause a serious condition called tamponade.
In tamponade, the heart can’t fill with blood properly. This is a life threatening medical emergency that requires immediate treatment.
If you have symptoms of pericardial effusion, seek medical attention to evaluate for pericarditis and tamponade.
Fluid around the heart has many causes. Some of these causes carry higher health risks than others. Once your doctor has determined that you have this condition, they will help you decide on treatment.
In some cases, fluid can cause a life threatening condition that impairs heart function. Draining the fluid with a catheter or surgery may be necessary. Your best chance at successfully treating this condition is getting an early diagnosis. Speak to a doctor if you’re concerned that you may have fluid around your heart.