Can pericardial effusion cause chest pain?

Written by Di Zhi Yong
Cardiology
Updated on September 24, 2024
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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.

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Written by Di Zhi Yong
Cardiology
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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.

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Written by Li Hai Wen
Cardiology
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Can pericardial effusion be drained?

In cases of moderate or large pericardial effusion, fluid can be drained, such as when the thickness of the pericardial effusion exceeds two centimeters. Draining the fluid can relieve the symptoms caused by the pericardial effusion, improve cardiac blood supply, and also allow for the collection of samples for routine and biochemical analysis of the effusion, as well as pathological examination. By analyzing the drained fluid, it is possible to determine the nature of the effusion, such as whether it is an exudate or a transudate. This can then further help in determining the cause of the effusion, where exudates are often caused by factors such as tuberculosis and cancer, while transudates are often due to heart failure or hypoproteinemia and other factors.

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Written by Di Zhi Yong
Cardiology
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Can pericardial effusion be aspirated?

Pericardial effusion can be treated with percutaneous fluid drainage, particularly in cases where there is a significant amount of fluid. However, for minor effusions, it is advisable that patients temporarily observe their condition and focus on symptomatic treatment. These small amounts of pericardial effusion can be absorbed naturally, and this typically pertains to milder cases. It is also recommended that patients regularly visit the hospital for echocardiography to monitor their condition. If the pericardial effusion does not fully resolve, fluid drainage may sometimes be necessary to alleviate the patient's current condition, as this fluid generally represents an inflammatory exudative change.

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Written by Yuan Qing
Pulmonology
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Can tuberculous pleurisy cause pericardial effusion?

Tuberculous pleurisy can also cause pericardial effusion. Firstly, tuberculous pleurisy is actually caused by the tubercle bacillus, a type of immune response in the human body that manifests as inflammation in the serous cavity. The serous cavities include various types such as the pleura surrounding the lungs, the pericardium around the heart, and the peritoneum in the abdomen. Therefore, tuberculous inflammation can occur in multiple serous cavities, including the pleura, pericardium, and abdominal cavity. Of course, when diagnosing, one cannot solely rely on the presence of effusion in multiple serous cavities to diagnose tuberculous pleurisy. Instead, it is essential to aspirate the pleural fluid and test certain markers in it, such as adenosine deaminase and lactate dehydrogenase. Most importantly, the presence of acid-fast bacilli in the fluid should be checked. If detected, it can generally be diagnosed as tuberculous.

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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.