Pericardial Effusion

Pericardial effusion, sometimes called fluid around the heart, causes an accumulation of fluid between the heart and the pericardium, the heart’s lining.

When the volume of fluid in the pericardium gets too high, pericardial effusion puts pressure on the heart, reducing the heart’s function.

Pericardial Effusion Causes

Inflammation of the pericardium, called pericarditis, is one cause. It can also happen when the flow of pericardial fluids is blocked or when blood accumulates in the pericardium after an injury or surgery.

Other possible causes of pericardial effusion include:

  • Sarcoidosis, inflammation of the body’s organs
  • Trauma
  • Uremia
  • Whipple disease, a condition where nutrients are not absorbed properly

Pericardial Effusion Symptoms

Symptoms of pericardial effusion include:

  • Anxiety
  • Chest pain, pressure, or discomfort relieved by sitting up or leaning forward, and worsened by lying flat
  • Confusion
  • Cough or shortness of breath
  • Fainting
  • Light-headedness
  • Palpitations

Diagnosis of Pericardial Effusion

Your UT Southwestern Medical Center doctor will use a number of different tests to diagnose the problem and determine your treatment options.

Diagnostic tests may include:

Chest X-ray
An imaging study to detect a “water bottle” appearance of the heart
Imaging of the chest to see fluid around the heart
A noninvasive test that sends sounds waves from the chest to the heart to create a moving picture of the heart; in pericardial effusion, an echo-free space between layers of the pericardium
A test of the heart’s electrical system that shows low voltage signal throughout
A test using a needle to draw some fluid that is checked for infections, tumor cells, etc.
Physical Exam
An exam can detect hypotension, muffled heart sounds, elevated jugular vein pulse; pericardial friction rub heard with stethoscope; pulsus paradoxus, a decrease in systolic blood pressure greater than 10mmHg with inhalation; widened pulse pressure

Treatment Options for Pericardial Effusion

Treatment depends on how much fluid has accumulated and the cause of the disorder. Common options include:

Aspirin, nonsteroidal anti-inflammatory drugs, steroids, or antibiotics, depending on the cause
Subxiphoid pericardial window with pericardiostomy
A minimally invasive procedure that allows fluid to drain
Video-assisted thoracic surgery
A minimally invasive technique used to see a wider area of the pericardium and the pleural region

Request an Appointment

To schedule an appointment with a pericardial effusion expert at UT Southwestern's facilities in Dallas or for more information about our services, request an appointment or call 214-645-8300.