From the Guidelines
Pericardial effusion symptoms include chest pain, shortness of breath, rapid breathing, rapid heart rate, and a feeling of fullness in the chest, which can worsen when lying down and improve when sitting up or leaning forward, as stated in the guidelines by the European Society of Cardiology 1.
Symptoms of Pericardial Effusion
The symptoms of pericardial effusion can vary depending on the size of the effusion and the rate at which it accumulates. Some common symptoms include:
- Chest pain that worsens when lying down and improves when sitting up or leaning forward
- Shortness of breath
- Rapid breathing
- Rapid heart rate
- A feeling of fullness in the chest
- Fatigue
- Weakness
- Cough
- Hiccups
- Low-grade fever
- Swelling in the abdomen or legs In severe cases, cardiac tamponade can develop, causing dizziness, fainting, decreased blood pressure, and shock, as noted in the guidelines for the diagnosis and management of pericardial diseases 2.
Severity of Symptoms
The severity of symptoms typically correlates with how quickly the fluid accumulates and how much pressure it exerts on the heart. Patients experiencing these symptoms, particularly chest pain and shortness of breath, should seek immediate medical attention as pericardial effusion can become life-threatening if it progresses to cardiac tamponade. The European Society of Cardiology guidelines emphasize the importance of targeting therapy at the underlying cause of the pericardial effusion, and considering drainage of the effusion when it becomes symptomatic without evidence of inflammation or when empiric anti-inflammatory drugs are not successful 1.
From the Research
Symptoms of Pericardial Effusion
The symptoms of pericardial effusion can vary depending on the size and severity of the effusion, as well as the underlying cause. Some common symptoms include:
- Chest pain, which can be pleuritic-type and radiate to the left shoulder 3
- Shortness of breath or dyspnea 4
- Fatigue
- Palpitations
- Fever
- Pericardial friction rub, which is a scratching sound heard with a stethoscope 4, 3
Diagnostic Criteria
The diagnosis of pericardial effusion is typically made using a combination of clinical findings, laboratory tests, and imaging studies, such as echocardiography. The diagnostic criteria may include:
- The presence of a pericardial effusion on echocardiography 5, 6, 4
- Elevated inflammatory markers, such as C-reactive protein 5, 6
- Clinical signs of tamponade, such as hypotension, jugular venous distension, and pulsus paradoxus 4
- The presence of underlying conditions, such as cancer, connective tissue disease, or renal failure 6, 4
Treatment Options
The treatment of pericardial effusion depends on the underlying cause and the severity of the effusion. Some treatment options may include:
- Conservative management, which may be appropriate for asymptomatic patients with small effusions 5
- Anti-inflammatory medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) 7
- Pericardiocentesis, which is a procedure to drain the pericardial fluid 6, 4
- Pericardiectomy, which is a surgical procedure to remove part or all of the pericardium 4