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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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.

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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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Is pericardial effusion related to diet?

If a patient often experiences pericardial effusion, it is recommended that they visit a hospital for a cardiac echocardiogram, as this pericardial effusion is necessarily connected to the heart. Although it is not greatly related to diet, if the patient enjoys eating salty foods, it can still have a certain impact. It is advised to choose a diet low in salt, fat, and sugar, especially limiting sodium intake, because consuming too much salt can exacerbate fluid and sodium retention, leading to pericardial effusion. Currently, treatment mainly focuses on symptomatic treatment, and early use of medications. Diuretics can be used to help alleviate the patient's current condition.

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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.