Pericardial effusion

Pericardial effusion
A 2D echo transthoracic echocardiogram of pericardial effusion. The "swinging" heart.
SpecialtyCardiac surgery

A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane. The two layers of the serous membrane enclose the pericardial cavity (the potential space) between them.[1] This pericardial space contains a small amount of pericardial fluid, normally 15-50 mL in volume.[2] The pericardium, specifically the pericardial fluid provides lubrication, maintains the anatomic position of the heart in the chest (levocardia), and also serves as a barrier to protect the heart from infection and inflammation in adjacent tissues and organs.[3][4]

By definition, a pericardial effusion occurs when the volume of fluid in the cavity exceeds the normal limit.[5] If large enough, it can compress the heart, causing cardiac tamponade and obstructive shock.[6] Some of the presenting symptoms are shortness of breath, chest pressure/pain, and malaise. Important etiologies of pericardial effusions are inflammatory and infectious (pericarditis), neoplastic, traumatic, and metabolic causes. Echocardiogram, CT and MRI are the most common methods of diagnosis, although chest X-ray and EKG are also often performed. Pericardiocentesis may be diagnostic as well as therapeutic (form of treatment).

  1. ^ Phelan, D.; Collier, P.; Grimm, R. A. (July 2015). "Pericardial Disease". www.clevelandclinicmeded.com. Retrieved 2009-08-20.
  2. ^ Cite error: The named reference :0 was invoked but never defined (see the help page).
  3. ^ Vogiatzidis, Konstantinos; Zarogiannis, Sotirios G.; Aidonidis, Isaac; Solenov, Evgeniy I.; Molyvdas, Paschalis-Adam; Gourgoulianis, Konstantinos I.; Hatzoglou, Chrissi (18 March 2015). "Physiology of pericardial fluid production and drainage". Frontiers in Physiology. 6: 62. doi:10.3389/fphys.2015.00062. ISSN 1664-042X. PMC 4364155. PMID 25852564.
  4. ^ Vakamudi, Sneha; Ho, Natalie; Cremer, Paul C. (2017-01-01). "Pericardial Effusions: Causes, Diagnosis, and Management". Progress in Cardiovascular Diseases. A New Renaissance in Pericardial Diseases. 59 (4): 380–388. doi:10.1016/j.pcad.2016.12.009. ISSN 0033-0620. PMID 28062268. Retrieved 2020-11-12.
  5. ^ McIntyre, William F.; Jassal, Davinder S.; Morris, Andrew L. (2015-06-01). "Pericardial Effusions: Do They All Require Pericardiocentesis?". Canadian Journal of Cardiology. 31 (6): 812–815. doi:10.1016/j.cjca.2015.01.006. ISSN 0828-282X. PMID 26022991.
  6. ^ Stashko, Eric; Meer, Jehangir M. (2021). Cardiac Tamponade. Treasure Island (FL): StatPearls Publishing. PMID 28613742. Retrieved 2021-11-13.