Does pericardial effusion hurt?

Written by Di Zhi Yong
Cardiology
Updated on September 11, 2024
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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.

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Written by Di Zhi Yong
Cardiology
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Why does pericardial effusion cause difficulty in breathing?

Pericardial effusion primarily manifests as palpitations, chest tightness, and difficulty breathing. Sometimes, pericardial effusion can exacerbate heart failure. Once heart failure is alleviated, these symptoms can also subside. Currently, it appears that pericardial effusion mainly presents as palpitations, chest tightness, and difficulty breathing, which are related to diet and fatigue, especially after exercise. This increase in myocardial oxygen consumption can lead to heart failure, resulting in difficulty breathing, particularly exertional dyspnea. At this point, it is necessary to provide low-flow oxygen inhalation and improve the patient's cardiopulmonary function, which is also helpful. It is still necessary to actively treat pericardial effusion. The treatment mainly involves diagnostic aspiration of the fluid. If the pericardial effusion is caused by inflammation, it can be treated with antibiotics.

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Written by Di Zhi Yong
Cardiology
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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.

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Written by Li Hai Wen
Cardiology
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Is pericardial effusion prone to recurrence?

Whether pericardial effusion is prone to recurrence depends on the causes of the effusion. There are many causes of pericardial effusion, such as organic heart disease, heart failure, tumors, tuberculosis, and hypoproteinemia, all of which can lead to the development of pericardial effusion. Among these, pericardial effusion caused by tuberculous pericarditis will not recur as long as standardized anti-tuberculosis treatment is administered and the tuberculosis is controlled. However, pericardial effusion caused by heart failure may recur repeatedly because heart failure itself can also recur. Moreover, pericardial effusion caused by tumors, if the tumors cannot be eradicated, often also recurs.

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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 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.