Pericardial effusion history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Pericardial effusion is a relatively common finding and sometimes the clinical picture of the patient leads directly to the cause for pericardial effusion.

History and Symptoms

• Mild pericardial effusion is a relatively a common finding, especially in elderly women and they are usually asymptomatic.

• When inflammation of the sac causes a pericardial effusion, the main symptom is chest pain.
  • It may get worse when you breathe deeply and better when you lean forward.

Common symptoms may include:

• Fever
• Fatigue
• Muscle aches
• Shortness of breath
• Nausea, vomiting, and diarrhea (if you have a virus)

Large, serious pericardial effusions, or smaller ones that develop quickly, may cause other symptoms that include:

• Shortness of breath
• Palpitations (sensation that the heart is pounding or beating fast)
• Light-headedness or passing out
• Cool, clammy skin

A pericardial effusion with these symptoms is a medical emergency and may be life-threatening.

• Chest pain, pressure symptoms occurs in patients with pericarditis. Other patients, without previous known diseases, seek medical attention because of dyspnea or nonspecific chest discomfort and the thoracic X-ray shows the presence of an enlarged cardiac silhouette with clear lungs.

• 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.

• Clinical manifestations of pericardial effusion depend on the rate of accumulation of fluid in the pericardial cavity. Rapid accumulation may cause elevated intrapericardial pressures with as little as 80 mL of fluid, while gradual accumulation of fluid can grow to 2 liters without symptoms.

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