Pericardial effusion

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Written by Xie Zhi Hong
Cardiology
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Causes of recurrent pericardial effusion

Pericardial effusion is generally seen in inflammatory responses, such as nonspecific bacterial infections, as well as tuberculosis, chlamydia, mycoplasma, rheumatic heart disease, and it can also be caused by heart failure, uremia leading to pericardial effusion. Some are caused by tumors. In general, common nonspecific infections and tuberculosis can be quickly controlled with treatment, but in cases of tumors or due to various reasons such as hypoalbuminemia, heart failure, if the cause cannot be eliminated, pericardial effusion can frequently reoccur. Therefore, individuals with recurring pericardial effusion should go to the hospital for an examination to clarify the cause and rule out malignant tumors or other reasons, and receive timely treatment.

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Written by Li Hai Wen
Cardiology
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Is pericardial effusion related to pneumonia?

Pericardial effusion is generally not closely related to pneumonia. The common causes of pericardial effusion mainly include tuberculous pericarditis, as well as factors such as tumors, heart failure, and hypoproteinemia. The onset of pulmonary inflammation primarily affects the lungs, with symptoms often manifesting as cough and yellowish sputum. Some patients may also experience pleural effusion. Pulmonary CT scans typically show inflammatory exudative changes. If the pericardial effusion is minor, it is usually not a significant issue, but proper medical examination is necessary to rule out causes like tuberculosis or tumors that could lead to pericardial effusion.

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Written by Di Zhi Yong
Cardiology
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What position should be taken for pericardial effusion?

If the patient is diagnosed with pericardial effusion, it is generally recommended that the patient remain in a semi-recumbent position, or with legs dangling, to reduce cardiac load and improve symptoms. This is because the main complication of pericardial effusion is the occurrence of myocardial ischemia, or myocardial necrosis. Additionally, the primary treatment for pericardial effusion is still based on pericardiocentesis to improve cardiac function. During this period, it is also essential to actively monitor changes in the patient's blood pressure. If the patient's blood pressure is too high, antihypertensive medications should be used. Generally, a semi-recumbent position is still recommended for patients with pericardial effusion.

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Written by Li Hai Wen
Cardiology
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Can pericardial effusion cause chest pain?

Pericardial effusion can cause chest pain because patients with pericardial effusion have limited cardiac diastolic expansion, resulting in a restricted blood volume during the cardiac diastolic phase. This ultimately causes reduced cardiac pumping, leading to symptoms of ischemia and hypoxia, such as chest tightness or chest pain. Furthermore, as the amount of pericardial effusion decreases, for example from moderate or large volumes to a small amount, chest pain symptoms can also occur. This is because when the volume of pericardial effusion significantly reduces, there can often be friction between the visceral and parietal layers of the pericardium, thereby triggering chest pain. This condition is often accompanied by a pericardial friction rub, which can be felt by touching the precordial area.

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Written by Cai Li E
Cardiology
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Why does pericardial effusion cause abnormal pulses?

Pulsus paradoxus refers to a condition where the pulse weakens significantly or disappears during inhalation, caused by a decrease in the left ventricular stroke volume. Normally, the strength of the pulse is not affected by the respiratory cycle. However, when cardiac tamponade, significant pericardial effusion, or constrictive pericarditis occurs, inhalation can restrict the relaxation of the right heart, leading to a reduced volume of blood returning to the heart and affecting the right heart’s output. Consequently, the amount of blood the right ventricle pumps into the pulmonary circulation is reduced. Furthermore, the pulmonary circulation is affected by the negative thoracic pressure during inhalation, causing pulmonary vessels to dilate and reducing the volume of blood returning from the pulmonary veins to the left atrium. Therefore, the output of the left heart also decreases. These factors lead to a weakened pulse during inhalation, which can sometimes be imperceptible, also known as pulsus paradoxus. This condition can be identified by a significant drop in systolic pressure by more than 10mmHg during inhalation compared to exhalation.

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Written by Di Zhi Yong
Cardiology
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Is it serious if the fluid drained from pericardial effusion is red?

If the fluid drawn from pericardial effusion is red, it indicates that there is definitely bloody fluid seeping out. This situation is very serious, and it is recommended that hospitalization be chosen for treatment, as this can alleviate symptoms and improve the patient's cardiac function. If these symptoms persist, they may sometimes worsen, leading to heart failure. The patient may experience palpitations, chest tightness, difficulty breathing, and swelling in the lower limbs. Because pericardial effusion directly affects the function of the heart, treatment may involve the use of cardiotonic and diuretic medications. Mainly, medications that invigorate muscle strength are used to improve the myocardial oxygen consumption of the patient, thereby achieving the goal of alleviating clinical symptoms.

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Written by Di Zhi Yong
Cardiology
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What position should be adopted for difficulty in breathing due to pericardial effusion?

If a patient frequently experiences difficulty in breathing, it is recommended to immediately adopt a sitting position, as this can reduce the load on the heart, thereby alleviating expansion. Currently, for the purpose of treating breathing difficulties, conditions like pericardial effusion are very serious, and puncture aspiration for examination can be chosen as a treatment. For heart failure caused by pericardial effusion, sometimes it is necessary to use some cardiotonic diuretics, thus improving the patient's breathing difficulties. Currently, symptomatic treatment is primarily adopted in therapy, mainly adopting a semi-recumbent position or dangling both legs, which can reduce the heart's afterload, thereby easing the patient's condition.

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Written by Di Zhi Yong
Cardiology
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Can pericardial effusion cause shortness of breath?

If the patient has pericardial effusion, this situation is very serious, as pericardial effusion can lead to symptoms such as palpitations, chest tightness, and difficulty breathing. If the pericardial effusion is excessive, it can also cause heart failure in the patient. Sometimes, further pericardiocentesis may be needed to examine the fluid. In cases of pericardial effusion, it is important to assess the patient's condition, as mild pericardial effusion can cause shortness of breath. During treatment, the primary approach is usually to use anti-inflammatory medications or drugs that improve heart function. This can help alleviate symptoms. At the same time, it is important to monitor changes in the patient’s blood pressure and heart rate.

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Written by Di Zhi Yong
Cardiology
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Can a large amount of pericardial effusion be cured?

If a patient presents with a large amount of pericardial effusion, surgical treatment is primarily chosen, yet the specific approach should be decided based on the patient's current condition. If the patient's symptoms of heart failure are severe, it is first necessary to actively correct the heart failure before addressing the large pericardial effusion, since a significant pericardial effusion can lead to cardiac tamponade, a very dangerous condition that requires immediate pericardiocentesis to alleviate the heart failure. Currently, symptomatic treatment is the main approach. For severe cases of extensive pericardial effusion, it is best for the patient to be hospitalized to alleviate their condition.

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Written by Di Zhi Yong
Cardiology
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Can pericardial effusion cause chest pain?

Pericardial effusion is a type of cardiovascular disease, and if it is severe, it can cause chest pain. This is primarily due to changes in heart function, with patients mainly experiencing symptoms such as palpitations, chest tightness, and difficulty breathing. If chest pain occurs, it indicates that the symptoms are very severe, and it is recommended to seek active treatment at a hospital, using medications to control heart failure or performing fluid extraction for examination. For the treatment of pericardial effusion, percutaneous fluid drainage can be chosen, which can also alleviate the patient’s condition. Generally, chest pain could also be caused by pericardial effusion. During this period, it's important to monitor changes in the patient's blood pressure, heart rate, and pulse. If blood pressure is too high or heart rate is too fast, it needs to be addressed.