What Is Pericardial Effusion?

Pericardial effusion is when the sac around the heart, called the pericardium, fills with extra fluid. It is normal for a thin layer of fluid to be inside the pericardium. However, too much fluid can put pressure on the heart and impact its function.

In this article, you will learn about the causes, symptoms, diagnosis, treatments, and prognosis for pericardial effusion.

Man clutching his hands to his chest

manusapon kasosod / Getty Images

Pericardial Effusion Symptoms

Most people with pericardial effusion will have no symptoms directly caused by the effusion itself. They may experience symptoms as a result of the underlying cause of the pericardial effusion. Examples of causes for this condition include the following:

  • Cancer
  • Infection or inflammation of the pericardial sac
  • Injury
  • Immune system problems
  • Kidney failure
  • Medication reactions
  • Radiation

In severe cases, pericardial effusion can lead to cardiac tamponade.

Cardiac Tamponade

Cardiac tamponade occurs when the buildup of pericardial fluid is enough to seriously compromise heart function, producing significant cardiovascular symptoms. Cardiac tamponade is a medical emergency.

If an infection causes pericardial effusion, you may experience a fever and chills. Other symptoms may include:

When to Call 911

If you experience pain in your chest, back, neck, or shoulder, call 911 or seek immediate medical attention.

Causes

The leading cause of pericardial effusion is pericarditis, in which the pericardium becomes inflamed. Pericarditis can result from the following:

  • Viral, bacterial, fungal, or parasitic infections
  • Cancer or cancer treatments, such as radiation
  • Autoimmune diseases such as lupus or rheumatoid arthritis

Additional conditions that can cause pericarditis include:

  • HIV infection and AIDS
  • Hypothyroidism
  • Renal disease or kidney failure
  • Tuberculosis

Pericarditis can also happen after a heart attack, heart surgery, or damage to the heart or esophagus. Medications that suppress the immune system can also cause pericarditis.

Males aged 16–65 are at the highest risk for pericarditis, but it can happen to people of all ages.

Diagnosis

Your healthcare provider will use a stethoscope to listen to your heart and diagnose pericardial effusion. The extra fluid in the pericardium causes a scraping sound called a pericardial rub, by which the pericardium and the heart are rubbing against one another.

Other tools to diagnose pericardial effusion include:

You may also need a troponin blood test to check your heart for muscle damage. Troponin is a protein in the heart muscles but not in the blood. If troponin is in your blood, it indicates that your heart muscles have some damage. Higher levels of troponin mean more severe heart damage.

Additional tests that your healthcare provider may order include:

  • Antinuclear antibody (ANA): Blood testing for evidence of autoimmune disease
  • Blood culture: Blood testing for the presence of bacteria
  • C-reactive protein: Blood testing for inflammation markers
  • Rheumatoid factor: Blood testing for a specific protein that indicates certain autoimmune diseases
  • Tuberculin skin test: Skin testing for an immune response to the bacterium that causes tuberculosis

How Do You Treat Pericardial Effusion?

The most important step in treating pericardial effusion is to identify and treat the underlying cause. Depending on the cause, pericardial effusion can go away on its own.

Sometimes, a healthcare provider may use high doses of nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine medication to reduce swelling in the pericardium. However, if an underlying bacterial infection causes the pericardial effusion, the first line of treatment may be antibiotics.

Other treatment options include:

  • Diuretics (water pills) to remove excess fluid
  • Corticosteroids such as prednisone
  • Pericardiocentesis, a procedure that drains fluid using a needle
  • Surgery to cut or remove part of the pericardium

Does Pericardial Effusion Go Away?

Pericardial effusion can be mild to severe, depending on the cause. Outcomes are good if the condition is treated right away. After treatment begins, most people recover in two weeks to three months.

When pericardial effusion is severe or goes untreated, heart tissue may become damaged, causing a condition called restrictive pericarditis, which can cause long-term issues with heart function.

For those treated for acute pericarditis or pericardial effusion, about 30% will develop the condition again.

Summary

Pericardial effusion is when the sac around the heart, called the pericardium, fills with excess fluid. If left untreated, it can impact heart function. There are various possible causes for this condition. Your healthcare provider may use specific techniques, tests, or imaging to make a diagnosis. Depending on the severity of the pericardial effusion, it may go away without treatment, require medication, or in severe cases, surgery. Prognosis for pericardial effusion is good. If treated early, most people will recover within a few weeks.

A Word From Verywell

Finding out that you have a health issue with your heart can be scary. Because pericardial effusion can sometimes happen after an illness, it can be disheartening to manage a new health issue. The main pericardial effusion symptoms include chest, back, neck, or shoulder pain. If you experience this, call 911 immediately. If you experience symptoms like sudden leg swelling, fatigue, or a dry cough that isn’t going away, make an appointment right away to see your healthcare provider.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pérez-Casares A, Cesar S, Brunet-Garcia L, Sanchez-de-Toledo J. Echocardiographic evaluation of pericardial effusion and cardiac tamponadeFrontiers in Pediatrics. 2017;5. doi:10.3389/fped.2017.00079

  2. National Cancer Institute. Pericardial effusion.

  3. Cedars Sinai. Pericardial effusion.

  4. MedlinePlus. Pericarditis.

  5. American Heart Association. What is pericarditis?

  6. University of Washington Department of Medicine. Techniques: heart sounds & murmurs.

  7. MedlinePlus. Troponin test.

  8. Yamani N, Abbasi A, Almas T, Mookadam F, Unzek S. Diagnosis, treatment, and management of pericardial effusion- reviewAnn Med Surg (Lond). 2022;80:104142. Published 2022 Jul 9. doi:10.1016/j.amsu.2022.104142

By Carisa Brewster
Carisa D. Brewster is a freelance journalist with over 20 years of experience writing for newspapers, magazines, and digital publications. She specializes in science and healthcare content.