Pericardial Effusion with Tamponade

Pericardial effusion is an accumulation of extra fluid in the pericardial space. This is the space between the heart and the sac that surrounds it. This space normally contains a small amount of fluid which serves as lubrication for the heart inside the sac. If it becomes a large amount, it causes problems for the working of the heart. This is known as tamponade. It can be caused by numerous problems that may come on suddenly or over a long period of time. It causes more severe problems if it comes on suddenly. Usually the cause is either damage to the sac or from an injury.

CAUSES

A higher incidence of pericardial effusion is associated with certain diseases. Some common causes of pericardial effusion are:

  • Aids.

  • Cancer.

  • Infection.

  • Injury.

SYMPTOMS

Very small effusions may cause no problems. Even a small effusion if it comes on rapidly can be deadly. Some common symptoms are:

  • Chest pain, pressure, discomfort.

  • Light-headed feeling.

  • Fainting.

  • Cough.

  • Shortness of breath.

  • Feeling of palpitations.

  • Hiccoughs.

  • Anxiety.

  • Confusion.

DIAGNOSIS

  • Your caregiver may do a number of blood tests and imaging tests (like X-rays) to help determine the cause.

  • Although several imaging modalities are available, ECHO has become the diagnostic method of choice. This is due to its portability and availability. CT and MRI are also used, and may be more accurate.

  • Pericardioscopy, where available, uses a little telescope-like instrument to look inside the pericardial sac.

  • This may be helpful in cases of unexplained pericardial effusions. It allows your caregiver to look at the pericardium and do pericardial biopsies if something abnormal is found.

  • Sometimes fluid may be removed to help with diagnosing the cause of the accumulation. This is called a pericardiocentesis.

TREATMENT

Treatment is directed at removal of the extra pericardial fluid and treating the cause. Small amounts of effusion that are not causing problems can simply be watched. If the fluid is accumulating rapidly (a tamponade), this represents a severe threat to life and emergency removal of fluid must be done. In an emergency situation, there may not be time to discuss this procedure with family or other loved ones.