What should I do if pericardial effusion prevents me from lying down?

Written by Di Zhi Yong

Cardiology

Updated on September 14, 2024

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If pericardial effusion occurs and the patient cannot lie flat, it indicates that this heart failure has not been timely corrected. The patient should immediately go to the hospital to use medications, especially cardiovascular and diuretic drugs, to improve cardiac function and alleviate the current condition of the patient.

Generally, it is still recommended that patients primarily adopt a semi-recumbent position to reduce the load on the heart muscle, thereby improving symptoms. If the patient cannot lie flat, do not force it; a semi-recumbent position will suffice as it makes no significant difference.

With aggressive internal medicine treatment, pericardial effusion can be alleviated, and the patient's symptoms will improve. However, during this period, it is still necessary to monitor changes in the patient's heart rate, blood pressure, and pulse, and to address any issues promptly.

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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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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 Di Zhi Yong

Cardiology

45sec

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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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Written by Li Hai Wen

Cardiology

47sec

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Can pericardial effusion be drained?

In cases of moderate or large pericardial effusion, fluid can be drained, such as when the thickness of the pericardial effusion exceeds two centimeters. Draining the fluid can relieve the symptoms caused by the pericardial effusion, improve cardiac blood supply, and also allow for the collection of samples for routine and biochemical analysis of the effusion, as well as pathological examination. By analyzing the drained fluid, it is possible to determine the nature of the effusion, such as whether it is an exudate or a transudate. This can then further help in determining the cause of the effusion, where exudates are often caused by factors such as tuberculosis and cancer, while transudates are often due to heart failure or hypoproteinemia and other factors.

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Cardiology

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When should the pericardial effusion drainage tube be removed?

If the patient has pericardial effusion and there is no apparent leakage from the drainage tube, and no fluid drainage, it is possible to consider removing the tube after two days. In cases like this, active drainage is sometimes still necessary because pericardial effusion is a type of exudate, which can be inflammatory. Draining can help relieve the cardiac workload. If the drainage tube is clear and there is no fluid leakage, removing the tube after about two days can be considered. However, there is a situation where the tube must not be removed. If there is fluid leaking from the pericardial effusion, or if the symptoms of pericardial effusion are still severe, and there is some fluid remaining in the pericardial cavity, the tube should not be removed.