Overview
Diagnosis
To diagnose pericardial effusion, a healthcare professional reviews your medical history, asks about symptoms, and examines you. Listening to the heart and lungs with a stethoscope helps detect abnormal sounds.
Tests used to confirm pericardial effusion may include:
• Echocardiogram. Sound waves create images of the beating heart, showing heart chambers, valves, and fluid accumulation. This test can determine if the heart is struggling due to cardiac tamponade.
• Electrocardiogram (ECG or EKG). Measures the heart’s electrical activity using sticky sensors on the chest, arms, and legs. Certain patterns may suggest cardiac tamponade.
• Chest X-ray. Displays the size and shape of the heart and condition of the lungs. Large pericardial effusions can make the heart appear enlarged.
• CT and MRI scans. These imaging tests can detect pericardial effusion, often incidentally when performed for other reasons.
Treatment
Treatment for pericardial effusion depends on the fluid amount, underlying cause, and whether cardiac tamponade is present or at risk.
Medicines may be used if there is no immediate threat of cardiac tamponade:
• Aspirin
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
• Colchicine
• Corticosteroids, such as prednisone
Procedures or surgery may be needed if medicines are insufficient, if symptoms are severe, or if cardiac tamponade develops:
• Pericardiocentesis. A needle is guided by echocardiogram into the sac around the heart to drain fluid using a catheter, which may remain for a few days.
• Open-heart surgery. Used for bleeding into the pericardial sac or when drainage is needed to prevent complications. Surgeons may create a pathway to the abdominal cavity to allow fluid to drain.
• Pericardiectomy. Removal of all or part of the sac around the heart may be necessary for recurrent pericardial effusions.
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