Is pericardial effusion prone to recurrence?

Written by Li Hai Wen
Cardiology
Updated on January 13, 2025
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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 Li Hai Wen
Cardiology
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Does pericardial effusion require diuresis?

Whether pericardial effusion requires diuretic treatment depends on the cause of the pericardial effusion. If the pericardial effusion is caused by heart failure, the patient often experiences symptoms of heart failure such as difficulty breathing, fatigue, and swelling of the limbs. In this case, diuretic treatment is necessary. Appropriate diuretic treatment can effectively improve the symptoms of heart failure, reduce the degree of pericardial effusion, and may even avoid the need for pericardial puncture. If the pericardial effusion is caused by tuberculosis, diuretic treatment often cannot effectively reduce the pericardial effusion. If the amount of pericardial fluid is large, puncture and fluid extraction are often needed to improve symptoms, while actively treating the tuberculosis causing the condition.

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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.

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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.

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Written by Di Zhi Yong
Cardiology
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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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Written by Di Zhi Yong
Cardiology
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Why does pericardial effusion reduce the pulse pressure difference?

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.