Pericardial effusion

Pericardial effusion (per-e-KAHR-dee-ul uh-FU-zhun) is the buildup of too much fluid in the sac around the heart. The sac is called the pericardium. It has two layers.

The space between these layers often has a thin layer of fluid. But if the pericardium is diseased or injured, too much fluid can collect in the area. Bleeding also can cause fluid to build up around the heart. Bleeding may occur after a chest injury or be due to cancer.

Pericardial effusion can put pressure on the heart, affecting how the heart works. If the condition is not treated, it may lead to heart failure or death.

You might not notice any symptoms at first. This is especially true if the fluid has increased slowly.

If pericardial effusion symptoms do occur, they might include:

• Shortness of breath or difficulty breathing.
• Discomfort when breathing while lying down.
• Chest pain, usually behind the breastbone or on the left side of the chest.
• Chest pressure or fullness.
• Lightheadedness or feeling faint.
• Swelling in the legs or belly area.

Call 911 or your local emergency number if you have:

• Chest pain that lasts more than a few minutes.
• Breathing that is difficult or painful.
• Unexplained fainting.

There are many different causes of pericardial effusion. Sometimes the cause is not known.

Health conditions that can cause pericardial effusion include:

• Autoimmune conditions, such as rheumatoid arthritis or lupus.
• Cancer of the heart or the sac around the heart.
• Some infections.
• Spread of cancer, called metastasis. This is especially true with lung cancer, breast cancer or Hodgkin lymphoma.
• Swelling of the sac around the heart after a heart attack or a heart surgery or procedure.
• Underactive thyroid, called hypothyroidism.
• Waste products in the blood due to kidney failure. This is called uremia.

Other things that can cause pericardial effusion are:

• Use of some medicines.
• Exposure to toxins.
• Chest injury.

Radiation therapy for cancer if it's near the heart.

A potential complication of pericardial effusion is cardiac tamponade (tam-pon-AYD). In this condition, extra fluid in the sac around the heart puts pressure on the heart. (6) The pressure prevents the heart chambers from filling completely with blood.

Cardiac tamponade is a life-threatening condition. It causes poor blood flow and too little oxygen for the body. Emergency medical treatment is needed.