Pericardial Effusion: Causes, Symptoms, Treatment and Cost

Pericardial effusion is a condition that happens when an abnormally large amount of fluid gathers in the pericardium, which is the thin sac that surrounds the heart. The presence of this fluid might be caused by a variety of circumstances, including an infection, trauma, or even some types of cancer.

There are three main types of pericardial effusion: transudative, exudative, and haemorrhagic.

• Transudative: Transudative pericardial effusions are caused by an imbalance between pressure and the volume of fluid in the pericardial space. Examples include congestive heart failure or excessive intravenous fluids. These effusions are often made up of transparent fluid that has a relatively low protein concentration.
• Exudative: Exudative effusions occur when there is inflammation or infection in the pericardium due to an underlying medical condition such as cancer or autoimmune disease. These effusions usually have a higher protein content, which can be seen on laboratory testing of the fluid sample taken from the patient.
• Haemorrhagic: Hemorrhagic pericardial effusions are caused by bleeding into the pericardial space due to trauma or rupture of a vessel in this area. These types of effusions usually contain large amounts of red blood cells and will have high levels of iron on laboratory testing with low levels of protein content compared to exudative type effusions.

• Mumps, rubella, and Coxsackievirus are examples of viral infections.
• Tuberculosis and other bacterial illnesses, as well as fungal infections
• Autoimmune diseases, such as lupus and rheumatoid arthritis
• Certain drugs and radiation therapy
• Trauma to the chest or heart surgery
• Congenital heart defects
• Cancer that has spread to the pericardium

• Chest pain, especially when lying down or taking deep breaths
• Shortness of breath
• Coughing
• Palpitations or irregular heartbeat
• Fatigue or general feeling of malaise
• Swelling in the abdomen, neck, and/or face

• Avoid the risk factors associated with Pericardial Effusion, such as certain infections and conditions that affect the heart.
• Maintain a healthy lifestyle by engaging in frequent exercise and eating a food that is both balanced and nutritious.
• Follow your doctor’s instructions for any medications prescribed to treat or prevent Pericardial Effusion.
• Closely monitor your condition, and make sure to attend all of the follow-up appointments that your healthcare practitioner schedules for you.

• Physical exam: Physical exam to assess for pericardial effusion, including palpation of the chest and auscultation for a pericardial friction rubll.
• Chest X-ray: It is used to check for cardiac silhouette enlargement and fluid buildup in the pericardial sac.
• Electrocardiogram (ECG): it is used to check for changes that indicate an effusion is present
• Echo: Echocardiogram (echo) to visualise any fluid accumulation around the heart
• CT and MRI Imaging techniques: Computed tomography (CT) or magnetic resonance imaging (MRI) scan to provide detailed images of the heart and surrounding structures
• Pericardiocentesis: Pericardiocentesis, a procedure where a physician inserts a needle or catheter into the pericardial space to remove excess fluid
• Echocardiography: Echocardiography is often used for diagnosing pericardial effusion because it provides clear images of the heart structures which allow doctors to assess any damage that has been caused by fluid accumulation in the pericardium.

Possible complications of pericardial effusion include

• Heart Failure,
• Arrhythmias,
• Tamponade (fluid accumulation in the sac surrounding the heart),
• Infection, and constriction of the heart.

Following are the herbs which could consume by pericardial patient at home

• Ashwagandha: This herb is believed to have anti-inflammatory and stress-reducing effects, which may be helpful in managing pericardial effusion.
• Shankhapushpi: This herb is thought to have calming and cognitive-enhancing effects, and it may also help to lower blood pressure.
• Brahmi: This herb is believed to have a number of potential health benefits, including reducing anxiety and improving cognitive function.
• Triphala: This Ayurvedic formula is made from a blend of three fruits and is thought to have antioxidant, digestive, and detoxifying effects.

• It is important to eat a well-balanced diet when you have pericardial effusion.
• It is recommended that you consume foods high in fibre, such as unprocessed fruits, vegetables, and grains.
• Fish, poultry, and beans are all good examples of lean protein sources that can aid in the reduction of inflammation.
• In addition, eating foods that are high in omega-3 fatty acids can be helpful for lowering discomfort and swelling in the body.
• Always remember to keep drinking lots of water to keep your body hydrated and to see your primary care physician before making any significant dietary adjustments.

• Foods to avoid include:
• High-sodium foods,
• Processed meats and
• Foods high in saturated fat, such as fried foods and red meats.
• You should also try to cut down on the amount of sugar and processed carbs, such as white bread and pasta, that you consume.
• Additionally, it is important to stay away from alcoholic beverages as they can worsen the symptoms of Pericardial Effusion.

The therapy for pericardial effusion is determined by the underlying cause of the ailment as well as its degree of severity. Treatment may include medications, draining the fluid from the pericardial sac, or surgery to repair any underlying conditions.

• Medications: Depending on what is causing the pericardial effusion, medications may be prescribed to treat it. These can include antibiotics, anti-inflammatory drugs or diuretics (water pills).
• Draining the fluid: If the pericardial sac has a substantial quantity of fluid, it can be emptied via a technique known as pericardiocentesis. A needle will be inserted through your chest wall and into your heart during this therapy. Fluid will then be evacuated from your heart. This can provide relief from symptoms such as chest pain and difficulty breathing.
• Lifestyle changes: it may include reducing sodium intake and avoiding strenuous physical activity. Medications such as diuretics, anti-inflammatory drugs, and immunosuppressants may also be prescribed to reduce the size of the effusion.
• Pericardiocentesis: Pericardiocentesis is a treatment in which a needle is inserted into the pericardial sac to remove excess fluid. The procedure is usually done under general anaesthesia, and it can be used to diagnose the cause of the effusion as well as to relieve pressure on the heart.
• Surgical drainage: Surgical drainage of the pericardial sac involves making an incision into the chest wall in order to access the fluid and drain it. This procedure is typically done when there is a large amount of fluid, or if other treatments haven’t been successful in relieving pressure on the heart. In some cases, a permanent patch may be placed over the opening in order to prevent fluid from accumulating again.

If you are suffering any of the symptoms listed above, you should see a doctor who specialises in cardiology as soon as possible.

Some common medications which can use to treat pericardial effusion includes:

• Diuretics: They help the body get rid of excess fluid.
• ACE inhibitors: These help to lower blood pressure and reduce the workload on the heart.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs reduce inflammation and pain.
• Antibiotics: Antibiotics can treat infection if effusion is caused by an infection.
• Immunosuppressant medications: They may reduce inflammation if effusion is caused by an autoimmune disorder.
• Chemotherapy or radiation therapy: Chemotherapy may be used if effusion is caused by cancer.

Recovery from pericardial effusion typically takes several weeks to months, depending on the underlying cause and the severity of the effusion.

The treatment for this condition may entail either addressing any underlying reasons or emptying excess fluid from the pericardium. It may be necessary to take medicine in order to treat an infection or decrease inflammation in certain circumstances. With proper treatment and care, most individuals make a full recovery from pericardial effusion.

The underlying cause of pericardial effusion as well as the treatment modality will determine how successful the patient's therapy will be. In some cases, the effusion may be resolved permanently if treated with medication or through a procedure, such as pericardiocentesis. In other cases, the effusion may recur or become chronic and require ongoing management.

Post treatment for pericardial effusion typically includes observation, drainage of the effusion if necessary, medical therapy and rarely, surgical intervention.

• Observation: Patients with a small amount of fluid or asymptomatic patients should be monitored with regular imaging and/or cardiac markers.
• Drainage: If the fluid is symptomatic or causing hemodynamic compromise, drainage can be done using a percutaneous approach or surgically.
• Medical therapy: Anti-inflammatory drugs such as non-steroidal anti-inflammatories (NSAIDs) may be used to reduce inflammation in the pericardium which can help reduce the size of the effusion.
• Surgery: If medical management fails or is not possible, surgical intervention may be necessary to remove part of the pericardium and drain any remaining fluid from around it (pericardiectomy).

In India, the cost of treating pericardial effusion might vary based on the severity of the condition as well as the treatment that is chosen. Generally, the cost of diagnosis and initial treatment may range from Rs. 5,000 to Rs. 15,000, while more complex treatments may cost up to Rs. 50,000 or more. The exact cost depends on the clinic or hospital where it is being done as well as other factors like tests required for diagnosis or any medications used for treatment.

The most common side effects of treatment for pericardial effusion include chest pain, fever, and shortness of breath. Nausea, vomiting, dizziness, stomach discomfort, heart palpitations, and allergic responses are all possible adverse effects.

If you are suffering from any complications relating to pericardial effusion then you should consult a doctor nearby as they can cause complications like heart failure, arrhythmias, tamponade (fluid accumulation in the sac surrounding the heart), infection, and constriction of the heart, etc. Depending on the severity of the problem, therapy might last anywhere from two to three months to one or two years.