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| {{Infobox_Disease |
| | __NOTOC__ |
| Name = {{PAGENAME}} |
| | {{Pericardial effusion}} |
| Image = CT pericardial effusion.jpg |
| | {{CMG}}; '''Associate Editor-In-Chief:''' {{AIA}}, {{CZ}}, [[Varun Kumar]], M.B.B.S |
| Caption = A Pericaridal Effusion as seen on a [[CT Scan]] |
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| DiseasesDB = 2128 |
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| ICD10 = {{ICD10|I|30||i|30}}, {{ICD10|I|31|3|i|30}} |
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| ICD9 = {{ICD9|420}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = med |
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| eMedicineTopic = 1786 |
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| MeshID = D010490 |
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| }} | |
| {{SI}} | |
| {{WikiDoc Cardiology Network Infobox}} | |
| {{CMG}}
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| '''Associate Editor-In-Chief:''' {{CZ}} | | '''For patient information, click [[Pericardial effusion (patient information)|here]]. |
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| {{Editor Join}}
| | '''To go back to the main page on Pericarditis, click [[Pericarditis|here]].''' |
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| '''For a more extensive discussion, see the chapter entitled [[diseases of the pericardium]]''' | |
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| '''Pericardial effusion''' ("fluid around the heart") is an abnormal accumulation of fluid in the [[pericardial cavity]]. Because of the limited amount of space in the pericardial cavity, fluid accumulation will lead to an increased intrapericardial pressure and this can negatively affect [[heart]] function. When there is a pericardial effusion with enough pressure to adversely affect heart function, this is called [[cardiac tamponade]]. Pericardial effusion usually results from a disturbed equilibrium between the production and re-absorption of [[pericardial fluid]], or from a structural abnormality that allows fluid to enter the pericardial cavity.
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| Normal levels of pericardial fluid are from 15 to 50 mL.
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| ==Types==
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| It may be ''transudative'' ([[congestive heart failure]], [[myxoedema]], [[nephrotic syndrome]]), ''exudative'' ([[tuberculosis]], spread from [[empyema]]) or ''haemorrhagic'' (trauma, rupture of aneuryms, malignant effusion).
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| ==Etiology==
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| * Infectious
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| **Viral
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| **Pyogenic
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| **[[Tuberculosis | Tuberculous]]
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| **Fungal
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| **Other infections (syphilitic, protozoal, parasitic)
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| **[[Pericarditis]]
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| *Noninfectious
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| **Idiopathic
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| **Uremia: [[Kidney failure]] with excessive blood levels of urea nitrogen
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| **Heart surgery<ref>[http://www.mayoclinic.com/health/pericardial-effusion/HQ01198 Pericardial effusion:What are the symptoms?], Dr. Martha Grogan M.D.</ref>
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| **Neoplasia that has spread to the pericardium
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| **Acute myocardial infarction: Post [[myocardial infarction]] pericarditis ([[Dressler's syndrome]])
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| **Postirradiation
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| **[[Aortic dissection]] (with leakage into pericardial sac)
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| **Trauma
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| **[[Sarcoidosis]]
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| **[[Pericarditis]]
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| *Hypersensitivity or autoimmunity related
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| **Rheumatic fever
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| **Collagen vascular disease
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| **Drug-induced
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| **Inflammatory disorders, such as [[lupus]]
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| **[[Pericarditis]]
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| ==Symptoms==
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| [[Chest pain]], pressure symptoms. A small effusion may have no symptoms.
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| Pericardial effusion is also present after a specific type of heart defect repair. An [[Atrial Septal Defect]] Secundum, or [[ASD]], when repaired will most likely produce a pericardial effusion due to one of the methods of repair. One repair method of an [[ASD]] is to take a piece of the peridcardial tissue and use it as a patch for the hole in the atrial cavity.
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| | ==[[Pericardial effusion overview|Overview]]== |
| | ==[[Pericardial effusion types|Classification]]== |
| | ==[[Pericardial effusion pathophysiology|Pathophysiology]]== |
| | ==[[Pericardial effusion causes|Causes]]== |
| | ==[[Pericardial effusion differential diagnosis|Differential Diagnosis]]== |
| | ==[[Pericardial effusion epidemiology and demographics|Epidemiology and Demographics]]== |
| | ==[[Pericardial effusion natural history|Natural History, Complications and Prognosis]]== |
| ==Diagnosis== | | ==Diagnosis== |
| | [[Pericardial effusion history and symptoms|History and Symptoms]] | [[Pericardial effusion physical examination|Physical Examination]] | [[Pericarditis laboratory studies|Laboratory Findings]] | [[Pericardial effusion electrocardiogram|Electrocardiogram]] | [[Pericardial effusion chest x ray|Chest X-Ray]] | [[Pericardial effusion CT|CT]] | [[Pericardial effusion MRI|MRI]] | [[Pericardial effusion echocardiography|Echocardiography]] | [[Pericardial effusion cardiac catheterization|Cardiac Catheterization]] |
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| ===EKG=== | | ==[[Pericardial effusion treatment overview|Treatment]]== |
| | | [[Pericardiocentesis]] | [[Pericardial window|Pericardial Window]] |
| <gallery>
| | [[Category:Up-To-Date]] |
| Image:Alternans.jpg|Pericardial Effusion
| | [[Category:Up-To-Date cardiology]] |
| </gallery>
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| ===Chest X-Ray===
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| Labeled radiologic images shown below are courtesy of Radswiki
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Pericard-effusion-01.jpg|Pericardial effusion Day of the admission
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| Image:Pericard-effusion-02.jpg|Pericardial effusion. The second day of treatment.
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Pericardial effusion_3.jpg|Pericardial effusion
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| Image:Pericardial effusion_4.jpg|Pericardial effusion
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| </gallery>
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| </div>
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| ===CT=== | | ==Related Chapters== |
| *CT attenuation measurements also enable the initial characterization of pericardial fluid.
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| *A fluid collection with attenuation close to that of water is likely to be a simple effusion.
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| *Attenuation greater than that of water suggests malignancy, hemopericardium, purulent exudate, or effusion associated with hypothyroidism.
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| *Pericardial effusions with low attenuation also have been reported in cases of chylopericardium.
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| Image shown below is courtesy of Radswiki and copylefted.
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Pericard-effusion-03.jpg|Pericardial effusion. Same patient's image. Second day of the admission.
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| </gallery>
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| </div>
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| ===MRI===
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| *The appearance of pericardial fluid is different on SE and GRE cine MR images.
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| *Nonhemorrhagic fluid has low signal intensity on T1-weighted SE images and high intensity on GRE cine images. Conversely, hemorrhagic effusion is characterized by high signal intensity on T1-weighted SE images and low intensity on GRE cine images.
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| *When an effusion is secondary to malignancy, an irregularly thickened pericardium or pericardial nodularity may be depicted on MR images.
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| ===Cardiac Catheterization===
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| Flouroscopic images show pericardial effusion:
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| <googlevideo>-7129815717409714366&hl=en</googlevideo>
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| <googlevideo>7051277599064845698&hl=en</googlevideo>
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| <googlevideo>1013614061451207857&hl=en</googlevideo>
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| <googlevideo>3444457597731375301&hl=en</googlevideo>
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| == Differential Diagnosis ==
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| === Serus ===
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| *Acute Pancratitis
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| *Chemotheraputics
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| *Chronic disease
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| *[[Cirrhosis]]
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| *[[Congestive Heart Failure]]
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| *[[Dressler's Syndrome]]
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| *[[Hypoalbuminemia]]
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| *[[Hypothyroidism]]
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| *Infection
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| *Irradiation
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| *Malnutrition
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| *[[Nephrotic Syndrome]]
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| === Blood ===
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| *[[STEMI|Acute Myocardial Infarction]]
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| *Anticoagulants
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| *Aortic rupture
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| *Cardiac Catheter
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| *Chemotherapeutics
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| *Coagulotherapy
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| *Heart Surgery
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| *Neoplasm
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| *Perforation
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| *Trauma
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| *Uremia
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| === Lymph or chylus ===
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| *Benign obstruction of thoracic duct
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| *Idiopathic
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| *Neoplasm
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| === Metastatic tumor ===
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| *[[Breast cancer]]
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| *[[Leukemia]]
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| *[[Lung cancer]]
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| *[[Lymphoma]]
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| *[[Pericarditis]] | | *[[Pericarditis]] |
| | | *[[Constrictive pericarditis]] |
| === Miscellaneous ===
| | *[[Cardiac tamponade]] |
| *[[Cardiomyopathy]] | |
| *[[Systemic Lupus Erythematosus]] | |
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| ==Treatment==
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| 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 by [[pericardiocentesis]], in which a needle, and sometimes a [[catheter]] are used to drain excess fluid.
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| ==References==
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| <references />
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| <br> | | <br> |
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| [[es:Efusión pericárdica]] | | [[es:Efusión pericárdica]] |
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| {{Circulatory system pathology}}
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| {{Electrocardiography}}
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| {{SIB}}
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| [[Category:Diseases involving the fasciae]] | | [[Category:Diseases involving the fasciae]] |
| [[Category:Cardiology]] | | [[Category:Cardiology]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
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| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |