Can tuberculous pleurisy cause pericardial effusion?

Written by Yuan Qing
Pulmonology
Updated on January 21, 2025
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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 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 Di Zhi Yong
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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.

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What position should be taken for pericardial effusion?

If the patient is diagnosed with pericardial effusion, it is generally recommended that the patient remain in a semi-recumbent position, or with legs dangling, to reduce cardiac load and improve symptoms. This is because the main complication of pericardial effusion is the occurrence of myocardial ischemia, or myocardial necrosis. Additionally, the primary treatment for pericardial effusion is still based on pericardiocentesis to improve cardiac function. During this period, it is also essential to actively monitor changes in the patient's blood pressure. If the patient's blood pressure is too high, antihypertensive medications should be used. Generally, a semi-recumbent position is still recommended for patients with pericardial effusion.

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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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Will pericardial effusion cause an increase in troponin levels?

In general, if a patient is diagnosed with pericardial effusion, troponin levels might also increase under stress conditions. This is because troponin is primarily used as a marker to assess myocardial infarction. An increase in troponin levels suggests the possibility of a myocardial infarction. However, under stress conditions, especially with pericardial effusion, troponin levels can rise. During this period, it is also advisable to perform an electrocardiogram or a cardiac echocardiography on the patient for a more definitive diagnosis. A mere increase in troponin levels does not conclusively indicate a problem; it is necessary to consider the patient’s current symptoms and results from other diagnostic tests.