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Pericardial effusion
The causes of recurrent pericardial effusion
Pericardial effusion can be caused by many factors, such as acute pericarditis or chronic tuberculous pericarditis. Other causes include hypothyroidism, tumors, heart failure, and severe hypoproteinemia due to liver dysfunction, all of which can lead to pericardial effusion. Common pericardial effusion infections, hypothyroidism, or heart failure might improve after treatment. However, if the cause of certain intractable diseases cannot be removed, pericardial effusion may recur. For example, pericardial effusion caused by malignant tumors and hypoproteinemia is common in patients with cirrhosis, severe liver failure, or nephrotic syndrome. Such individuals often experience recurring pericardial effusions. Another example is patients with heart failure, who, in the terminal stages of heart disease, also frequently experience recurrences of pericardial effusion. Therefore, managing recurrent pericardial effusions in patients, particularly when not due to infectious factors, can be quite challenging.
What is the cause of pericardial effusion with persistent high fever?
If the patient presents with pericardial effusion and experiences elevated body temperature, it may indicate the presence of an infection, suggesting that the symptoms are worsening. Currently, the treatment for pericardial effusion primarily involves puncture, fluid extraction, and laboratory analysis. If the pericardial effusion is severe or abundant, fever may occur. Since fever is an indicator of inflammation, it is necessary to use antibiotics for active treatment in order to control this condition. If the body temperature continues to rise, sometimes it is also necessary to use antipyretic drugs to alleviate the symptoms. Persistent high fever indicates that the condition has become very serious, signaling that the infection indices are extremely severe.
Can pericardial effusion cause facial swelling?
If a patient has a history of pericardial effusion, this condition may present with eyelid edema. Because cardiac tamponade can cause the patient to experience sodium and water retention, this retention can manifest as eyelid edema, as well as edema in both lower limbs. In cases where the volume of pericardial effusion is substantial, surgical treatment, such as aspiration for fluid extraction, may sometimes be necessary. For minor and smaller volumes of pericardial effusion, the effusion can be absorbed on its own, with symptomatic treatment being the main approach. Eyelid edema can occur with pericardial effusion, and active treatment should be pursued. Using medications to improve symptoms can provide relief.
What should I do if pericardial effusion prevents me from lying down?
If pericardial effusion occurs and the patient cannot lie flat, it indicates that this heart failure has not been timely corrected. The patient should immediately go to the hospital to use medications, especially cardiovascular and diuretic drugs, to improve cardiac function and alleviate the current condition of the patient. Generally, it is still recommended that patients primarily adopt a semi-recumbent position to reduce the load on the heart muscle, thereby improving symptoms. If the patient cannot lie flat, do not force it; a semi-recumbent position will suffice as it makes no significant difference. With aggressive internal medicine treatment, pericardial effusion can be alleviated, and the patient's symptoms will improve. However, during this period, it is still necessary to monitor changes in the patient's heart rate, blood pressure, and pulse, and to address any issues promptly.
Does pericardial effusion hurt?
If a patient has pericardial effusion, they may experience pain in the precordial area, as well as symptoms of chest tightness, breathing difficulties, and palpitations. A small amount of pericardial effusion can be completely absorbed on its own; however, a large amount of pericardial effusion can sometimes lead to breathing difficulties. For treatment, a pericardiocentesis can be performed to examine the fluid, as this condition is very dangerous. In cases of pericardial effusion, I personally suggest undergoing a cardiac echocardiogram or a chest CT scan for a more definitive diagnosis. During this period, it is still important to actively monitor the patient's blood pressure, heart rate, and pulse changes. If there is a very high heart rate or other complications, active treatment should be pursued.
Is pericardial effusion related to diet?
If a patient often experiences pericardial effusion, it is recommended that they visit a hospital for a cardiac echocardiogram, as this pericardial effusion is necessarily connected to the heart. Although it is not greatly related to diet, if the patient enjoys eating salty foods, it can still have a certain impact. It is advised to choose a diet low in salt, fat, and sugar, especially limiting sodium intake, because consuming too much salt can exacerbate fluid and sodium retention, leading to pericardial effusion. Currently, treatment mainly focuses on symptomatic treatment, and early use of medications. Diuretics can be used to help alleviate the patient's current condition.
Why does pericardial effusion reduce the pulse pressure difference?
Pericardial effusion can result in reduced pulse pressure differences between systolic and diastolic pressures. This occurs because pericardial effusion can compromise the heart's pumping function, leading to decreased myocardial contractility, which in turn may lead to excessive vascular pressure and a decrease in pulse pressure. This is a pathological change caused by pericardial effusion. Currently, in treatment, medication can be chosen to improve patient's cardiac function and thereby increase cardiac output. It is also important to actively treat the pericardial effusion, which may involve pericardiocentesis to drain the fluid and check pressures, as this can also alleviate reduced pulse pressure issues.
Can pericardial effusion cause fever?
Pericardial effusion can sometimes cause fever. If the patient has a fever, it may indicate a poor prognosis and suggest the presence of an infection. In such cases, antibiotics should be used for treatment, along with measures to reduce the fever. If the effusion is caused by other diseases, it is still necessary to actively treat the underlying condition. Currently, for pericardial effusion, if the volume of the effusion is small, it can be absorbed by the body itself. However, if there is a large amount of effusion, the patient might experience symptoms like chest tightness, palpitations, and difficulty breathing. In such cases, it may be necessary to perform a puncture for fluid drainage and examination. If fever occurs during this period, indicating an infection, anti-inflammatory medications should be used for treatment. If necessary, corticosteroid medications might also be needed.
Can you exercise with pericardial effusion?
If the patient has pericardial effusion, it is acceptable to encourage them to participate in outdoor activities, but they should exercise moderately and not too vigorously, especially avoiding strenuous physical workouts. Also, aerobic exercises should be moderate, and they should not spend too long on outdoor activities. Decisions should be made based on the individual's condition. If the condition of heart failure is severe, it is advisable for the patient to rest primarily. Particularly in terms of diet, the intake of sodium should be restricted. Sometimes, excessive intake of sodium can exacerbate symptoms like palpitations, chest tightness, and breathing difficulties. These are serious symptoms that require active management and treatment.
When should the pericardial effusion drainage tube be removed?
If the patient has pericardial effusion and there is no apparent leakage from the drainage tube, and no fluid drainage, it is possible to consider removing the tube after two days. In cases like this, active drainage is sometimes still necessary because pericardial effusion is a type of exudate, which can be inflammatory. Draining can help relieve the cardiac workload. If the drainage tube is clear and there is no fluid leakage, removing the tube after about two days can be considered. However, there is a situation where the tube must not be removed. If there is fluid leaking from the pericardial effusion, or if the symptoms of pericardial effusion are still severe, and there is some fluid remaining in the pericardial cavity, the tube should not be removed.