Pericardial Effusion: Overview of Aetiology, Pathophysiology, Diagnosis, and Management

TL;DR

This paper reviews the causes, mechanisms, diagnosis, and treatment of pericardial effusion, a condition involving fluid buildup around the heart.

Contribution

The paper provides a comprehensive overview of pericardial effusion, focusing on clinical management and diagnostic approaches.

Findings

Pericardial effusion can be asymptomatic or life-threatening, depending on the rate of fluid accumulation.

Echocardiography is the primary diagnostic tool for identifying pericardial effusion.

Treatment options vary based on the underlying cause and severity of symptoms.

Abstract

The pericardium is a membrane that envelopes the heart and the proximal great vessels. In normal physiological conditions, there is approximately 10-50 ml of pericardial fluid. However, accumulation of pericardial fluid can occur due to inflammation or infection of the pericardium and adjacent structures. This may be an asymptomatic and incidental finding following imaging for another disease process, or the patient may present in shock due to cardiac tamponade. It is important to note that it is the rate of accumulation, not absolute size, that primarily determines symptoms. Whilst the clinical suspicion may be raised by the history, examination, electrocardiogram, or chest X-ray, the echocardiogram is the mainstay of diagnosis. Options for treatment will depend on the cause and haemodynamic consequences. This article will consider the aetiology, pathophysiology, investigations and management of pericardial effusions.

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