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 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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Written by Xie Zhi Hong
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The causes of recurrent pericardial effusion

Pericardial effusion can be caused by many factors, such as acute pericarditis or chronic tuberculous pericarditis. Other causes include hypothyroidism, tumors, heart failure, and severe hypoproteinemia due to liver dysfunction, all of which can lead to pericardial effusion. Common pericardial effusion infections, hypothyroidism, or heart failure might improve after treatment. However, if the cause of certain intractable diseases cannot be removed, pericardial effusion may recur. For example, pericardial effusion caused by malignant tumors and hypoproteinemia is common in patients with cirrhosis, severe liver failure, or nephrotic syndrome. Such individuals often experience recurring pericardial effusions. Another example is patients with heart failure, who, in the terminal stages of heart disease, also frequently experience recurrences of pericardial effusion. Therefore, managing recurrent pericardial effusions in patients, particularly when not due to infectious factors, can be quite challenging.

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Written by Di Zhi Yong
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Can pericardial effusion cause shortness of breath?

If the patient has pericardial effusion, this situation is very serious, as pericardial effusion can lead to symptoms such as palpitations, chest tightness, and difficulty breathing. If the pericardial effusion is excessive, it can also cause heart failure in the patient. Sometimes, further pericardiocentesis may be needed to examine the fluid. In cases of pericardial effusion, it is important to assess the patient's condition, as mild pericardial effusion can cause shortness of breath. During treatment, the primary approach is usually to use anti-inflammatory medications or drugs that improve heart function. This can help alleviate symptoms. At the same time, it is important to monitor changes in the patient’s blood pressure and heart rate.

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Can you exercise with pericardial effusion?

If the patient has pericardial effusion, it is acceptable to encourage them to participate in outdoor activities, but they should exercise moderately and not too vigorously, especially avoiding strenuous physical workouts. Also, aerobic exercises should be moderate, and they should not spend too long on outdoor activities. Decisions should be made based on the individual's condition. If the condition of heart failure is severe, it is advisable for the patient to rest primarily. Particularly in terms of diet, the intake of sodium should be restricted. Sometimes, excessive intake of sodium can exacerbate symptoms like palpitations, chest tightness, and breathing difficulties. These are serious symptoms that require active management and treatment.

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Is pericardial effusion related to diet?

If a patient often experiences pericardial effusion, it is recommended that they visit a hospital for a cardiac echocardiogram, as this pericardial effusion is necessarily connected to the heart. Although it is not greatly related to diet, if the patient enjoys eating salty foods, it can still have a certain impact. It is advised to choose a diet low in salt, fat, and sugar, especially limiting sodium intake, because consuming too much salt can exacerbate fluid and sodium retention, leading to pericardial effusion. Currently, treatment mainly focuses on symptomatic treatment, and early use of medications. Diuretics can be used to help alleviate the patient's current condition.