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 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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Does pericardial effusion increase or decrease pulse pressure?

In general, if a patient develops pericardial effusion, the pulse pressure difference typically decreases, especially the gap between diastolic and systolic pressures. This is because pericardial effusion can weaken the contractility of the heart chambers, leading to either decreased diastolic pressure or increased systolic pressure, thus reducing the pulse pressure difference. If pericardial effusion is timely addressed and corrected, this condition can improve. Currently, it is recommended that patients actively monitor changes in blood pressure. If there is a history of hypertension, it is necessary to actively use antihypertensive medications to treat and control this condition.

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Written by Li Hai Wen
Cardiology
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Is pericardial effusion hereditary?

Pericardial effusion is not hereditary. Pericardial effusion is not a genetic disease, and the causes of pericardial effusion are often acquired factors. For example, tuberculosis infection can cause tuberculous pericarditis, leading to pericardial effusion. Symptoms often include unexplained low-grade fever, cough, and night sweats, with a PPD test often showing a rigid change. Pericardial effusion caused by heart failure often presents with repeated exertional dyspnea, accompanied by limb edema. Cardiac ultrasound often reveals changes in the heart structure, such as cardiac enlargement and reduced cardiac pumping function. Additionally, hypoalbuminemia and tumors can also cause pericardial effusion, but these factors are not related to genetics.

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Written by Di Zhi Yong
Cardiology
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What will happen if there is too much pericardial effusion?

If a patient has an excessive amount of pericardial effusion, symptoms such as palpitations, chest tightness, and difficulty breathing can occur. Currently, the treatment primarily focuses on symptomatic relief. If there is excessive pericardial effusion, symptoms such as chest tightness, palpitations, and difficulty breathing may occur. I personally suggest going to the hospital for a cardiac echocardiogram to further confirm the diagnosis and determine the treatment plan. For simple pericardial effusion, if the amount is relatively small, it can be temporarily observed without treatment. However, for cases with excessive pericardial effusion, it is necessary to perform a pericardiocentesis to remove the fluid and improve cardiac function. During this period, it is still necessary to actively monitor the patient's blood pressure, heart rate, and pulse changes, and address any rapid heart rate.

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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.