When should the pericardial effusion drainage tube be removed?

Written by Di Zhi Yong
Cardiology
Updated on September 05, 2024
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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 Di Zhi Yong
Cardiology
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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.

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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 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.

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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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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.