Pericardial effusion

Pericardial effusion is a collection of fluid around the heart in excess of the usual 15 to 50mls of pericardial fluid. 

It is often associated with pericarditis – 60% of cases of pericarditis are accompanied by a pericardial effusion. 

Causes include: 

• Malignancy (especially lung, breast, leukaemia, lymphoma) 
• Idiopathic 
• Trauma 
• Uraemia
• Radiation
• Postoperative 
• Infection 
• Connective tissue disease 
• Hypothyroidism

Management 

• Depends on aetiology 
• Pericardiocentesis only if: 
• Tamponade
• Suspicion of purulent pericarditis 
• Chronic large effusion

Complication: Cardiac tamponade

References:

Ball, J. and Morrison, W. Cardiac tamponade. Postgrad Med J. 1997; 73(857):141-145. European Society of Cardiology. Guidelines on the Diagnosis and Mnaagement of Pericardial Diseases. Available at http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/pericardial-diseases.aspx 

Soler-Soler, J. Sagrista-Sauleda, J. and Permanyer-Miralda, G. Managaement of pericardial effusion. Heart. 2001; 86(2): 235-240.