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Pericardial Effusion

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Pericardial effusion is excess fluid in the pericardium, the sac around the heart. Symptoms can mimic those of heart failure, including difficulty catching your breath, chest pain and coughing.

What is Pericardial Effusion?

The pericardium is a two-layered sac surrounding the heart, with a small amount of fluid between the layers. When the pericardium is inflamed, effusion, the escape of fluid, can occur.

The condition also can occur without inflammation. Pericardial effusion can put pressure on the heart, impairing its ability to function properly. Without treatment, it can cause heart failure or death.

Other symptoms include painful breathing, fever, rapid heart rate and fainting. Some people do not have symptoms.

What Causes Pericardial Effusion?

The pericardium can become inflamed due to injury, disease or another disorder. Inflammation can occur after heart surgery or a heart attack, or as a result of a viral, bacterial, fungal or parasitic infection. Other diseases and disorders that can cause pericardial effusion include:

  • Cancer
  • Lupus
  • Rheumatoid arthritis
  • Hypothyroidism
  • Uremia

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Diagnosis of Pericardial Effusion

Tests to diagnose pericardial effusion include:

Echocardiogram (also called echo) – This test uses sound waves to assess the function and structure of the heart muscle and valves.

Chest X-ray – A radiograph or picture of the heart and lungs including blood vessels, ribs and bones of the spine.

Electrocardiogram (EKG/ECG) – A test that records the electrical activity of the heart.

CT scan (computed tomography scan, also called CAT scan) – An imaging procedure that uses X-rays and computer technology to produced cross-sectional, detailed images of the body, including bones, muscles, fat and organs. 

Cardiac MRI (cardiac magnetic resonance imaging or CMR) – A noninvasive, sophisticated imaging procedure that uses large magnets and a computer to produce detailed images of the structure and function of the heart while it is beating.

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Treatment of Pericardial Effusion

Treatment of pericardial effusion depends on the extent of fluid accumulated and how likely it is to impair heart functioning.


Medications to treat pericardial effusion include nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin and corticosteroids.

Surgery and Other Procedures

Procedures to treat pericardial effusion focus on removing excess fluid and preventing it from accumulating in the future.

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Ohio State Medical Center Physicians Who Treat This Condition

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