How is pericardial effusion treated?

Written by Chen Tian Hua
Cardiology
Updated on April 12, 2025
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The treatment of pericardial effusion mainly includes the following measures:

First, treatment should be based on the different causes of pericardial effusion. For example, pericardial effusion caused by infection should be treated with anti-infection measures, and pericardial effusion caused by heart failure should be treated with anti-heart failure measures;

Second, for a large amount of pericardial effusion or pericardial effusion causing cardiac tamponade, active pericardiocentesis and drainage should be provided to relieve the pressure on the heart caused by the pericardial effusion;

Third, when severe pericardial effusion causes hypotension or even shock, volume expansion and pressor agents should also be administered;

Fourth, for some patients with pericardial effusion, if the absorption of the effusion is not effective after general treatment, corticosteroids may be appropriately administered.

Other Voices

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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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Can a large amount of pericardial effusion be cured?

If a patient presents with a large amount of pericardial effusion, surgical treatment is primarily chosen, yet the specific approach should be decided based on the patient's current condition. If the patient's symptoms of heart failure are severe, it is first necessary to actively correct the heart failure before addressing the large pericardial effusion, since a significant pericardial effusion can lead to cardiac tamponade, a very dangerous condition that requires immediate pericardiocentesis to alleviate the heart failure. Currently, symptomatic treatment is the main approach. For severe cases of extensive pericardial effusion, it is best for the patient to be hospitalized to alleviate their condition.

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Written by Yuan Qing
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Can tuberculous pleurisy cause pericardial effusion?

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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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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Can pericardial effusion cause chest pain?

Pericardial effusion is a type of cardiovascular disease, and if it is severe, it can cause chest pain. This is primarily due to changes in heart function, with patients mainly experiencing symptoms such as palpitations, chest tightness, and difficulty breathing. If chest pain occurs, it indicates that the symptoms are very severe, and it is recommended to seek active treatment at a hospital, using medications to control heart failure or performing fluid extraction for examination. For the treatment of pericardial effusion, percutaneous fluid drainage can be chosen, which can also alleviate the patient’s condition. Generally, chest pain could also be caused by pericardial effusion. During this period, it's important to monitor changes in the patient's blood pressure, heart rate, and pulse. If blood pressure is too high or heart rate is too fast, it needs to be addressed.