About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Pericardial Effusion: Causes and Risk Factors
Introduction
Pericardial effusion refers to the accumulation of excess fluid in the pericardial sac, which surrounds the heart. This condition can lead to serious complications, including cardiac tamponade, if not diagnosed and managed appropriately. Below, we explore the main causes of pericardial effusion and their implications.
Causes of Pericardial Effusion
Pericardial effusion may arise from various underlying conditions, including:
1. Inflammatory and Infectious Causes
- Viral pericarditis (e.g., Coxsackievirus, influenza, herpes)
- Bacterial infections (e.g., tuberculosis, purulent pericarditis)
- Fungal and parasitic infections (less common but possible)
2. Autoimmune and Inflammatory Diseases
- Rheumatoid arthritis
- Systemic lupus erythematosus (SLE)
- Scleroderma and other connective tissue disorders
3. Malignancy-Related Causes
- Primary or secondary tumors of the pericardium
- Metastatic cancer spreading from the lungs, breast, hematologic malignancies, or melanomas
4. Post-Cardiac Injury and Trauma
- Post-myocardial infarction pericarditis (Dressler’s syndrome or early pericarditis)
- Iatrogenic causes (e.g., post-cardiac surgery, catheterization complications, radiotherapy to the chest)
- Blunt or penetrating chest trauma
5. Metabolic and Systemic Diseases
- Uremic pericarditis (seen in chronic kidney disease or dialysis patients)
- Hypothyroidism (myxedema heart)
- Severe hypoalbuminemia (e.g., due to malnutrition or nephrotic syndrome)
6. Drug-Induced Pericardial Effusion
- Certain chemotherapeutic agents (e.g., doxorubicin, cyclophosphamide)
- Hydralazine, isoniazid, and other medications
Clinical Implications
- Small pericardial effusions may be asymptomatic and incidental findings on echocardiography.
- Large or rapidly accumulating effusions can lead to cardiac tamponade, a life-threatening condition requiring urgent intervention.
Summary
Understanding the various causes of pericardial effusion enables early diagnosis and appropriate management. When evaluating a patient with pericardial effusion, it is crucial to consider infectious, inflammatory, neoplastic, and systemic causes.
Source recommendations
1. American Heart Association Guidelines on Pericardial Diseases
- https://www.ahajournals.org/doi/full/10.1161/circulationaha.105.561514
- https://www.heart.org/en/health-topics/pericarditis/what-is-pericarditis
- https://www.sciencedirect.com/science/article/abs/pii/S1936878X24001608
- https://www.jacc.org/doi/10.1016/j.jacc.2019.11.021
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Pericardial-Diseases-Guidelines-on-the-Diagnosis-and-Management-of
2. European Society of Cardiology Guidelines for the Diagnosis and Management of Pericardial Diseases
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Pericardial-Diseases-Guidelines-on-the-Diagnosis-and-Management-of
- https://academic.oup.com/eurheartj/article/36/42/2921/2293375
- https://pubmed.ncbi.nlm.nih.gov/26320112/
- https://www.escardio.org/Working-groups/Working-Group-on-Myocardial-and-Pericardial-Diseases/Publications/Paper-of-the-Month/2015-esc-guidelines-on-the-diagnosis-and-management-of-pericardial-diseases
- https://pubmed.ncbi.nlm.nih.gov/15120056/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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