Why does pericardial effusion reduce the pulse pressure difference?

Written by Di Zhi Yong
Cardiology
Updated on September 10, 2024
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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.

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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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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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Should fluid intake be controlled for pericardial effusion?

Whether pericardial effusion requires control of water intake depends on the cause of the pericardial effusion, as there are many reasons for it, such as heart failure, tuberculous pericarditis, tumors, and hypoproteinemia. Pericardial effusion caused by heart failure requires water intake restriction, as excessive drinking can aggravate the symptoms of heart failure. However, for pericardial effusion caused by tuberculosis or tumors, water intake does not significantly affect the pericardial effusion, so there is no need to deliberately control water consumption. Patients with pericardial effusion should quit smoking and avoid alcohol in their daily lives, as smoking and drinking can exacerbate the symptoms of pericardial effusion. Additionally, patients should not overexert themselves.

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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 Xie Zhi Hong
Cardiology
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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.