Why does pericardial effusion cause difficulty in breathing?

Written by Di Zhi Yong
Cardiology
Updated on September 01, 2024
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Pericardial effusion primarily manifests as palpitations, chest tightness, and difficulty breathing. Sometimes, pericardial effusion can exacerbate heart failure. Once heart failure is alleviated, these symptoms can also subside.

Currently, it appears that pericardial effusion mainly presents as palpitations, chest tightness, and difficulty breathing, which are related to diet and fatigue, especially after exercise. This increase in myocardial oxygen consumption can lead to heart failure, resulting in difficulty breathing, particularly exertional dyspnea. At this point, it is necessary to provide low-flow oxygen inhalation and improve the patient's cardiopulmonary function, which is also helpful.

It is still necessary to actively treat pericardial effusion. The treatment mainly involves diagnostic aspiration of the fluid. If the pericardial effusion is caused by inflammation, it can be treated with antibiotics.

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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 Li Hai Wen
Cardiology
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Does pericardial effusion cause proteinuria?

Pericardial effusion generally does not cause proteinuria. Conditions that cause proteinuria mainly include hypertension and diabetes, which are common causes of proteinuria in the elderly. Additionally, patients with glomerulonephritis may also experience proteinuria, but this is more often seen in younger people. Pericardial effusion primarily affects the heart, leading to reduced cardiac pumping and resulting in ischemia and hypoxia, which can cause symptoms such as dyspnea, fatigue, and limb edema. In cases of significant pericardial effusion, cardiac tamponade may occur, leading to a sharp drop in blood pressure, with the patient experiencing profuse sweating, cold and clammy skin, and confusion, which are signs of hypotensive shock and often require emergency pericardial fluid drainage to alleviate symptoms.

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Written by Chen Tian Hua
Cardiology
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How is pericardial effusion treated?

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.

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Written by Yuan Qing
Pulmonology
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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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Written by Di Zhi Yong
Cardiology
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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.