DEAR DR. GOTT:
My 63-year-old male friend has pericardial effusion.
He had increasing shortness of breath and general weakness for about two weeks before having a procedure to remove the fluid. During it a liter of blood fluid was extracted but the biopsy was negative. He has never had any other heart problems but is being treated for emphysema.
He will have follow-up echocardiograms because the fluid is apparently reappearing. The cardiologist does not know the source of the problem and indicated some sort of surgery may be necessary. Can you offer any ideas?
DEAR READER:
The heart is enclosed in a two-layered sac-like structure called the pericardium. Pericardial effusion occurs when extra fluid gathers in between the two layers. Typically there is a small amount of fluid but damage, injury, inflammation and more can cause the amount of fluid to increase. As the fluid increases, it restricts the heart’s ability to pump efficiently.
Symptoms of pericardial effusion include shortness of breath, cough, fainting, dizziness, painful breathing, chest pain, rapid heart rate, low-grade fever, sense of weakness and more. In some cases symptoms may not be noticeable or present at all. This is especially true in individuals in whom the fluid has gradually increased due to certain disorders.
There are several causes including infection, cancer, autoimmune disorders, hypothyroidism, radiation, HIV, chemotherapy, trauma, some prescription medications, kidney failure and more. In some cases, the cause cannot be identified.
Treatment varies from person to person depending on the amount of fluid, the cause, and whether or not it is or could cause decreased heart function. Common treatments include anti-inflammatory medications and various procedures. These can include needle aspiration to remove the fluid, open heart surgery (primarily for bleeding into the space), sealing the two layers together, and removal of all or part of the pericardium.
If your friend is displaying symptoms and has recurrent effusion, he needs to follow his cardiologist’s advice. Severe or repeated episodes can cause heart weakening, heart failure and death if not properly treated.
To give you related information, I am sending you copies of my Health Reports “Coronary Artery Disease” and “An Informed Approach to Surgery”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092.
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