Pericardial effusion

[DickP]

i was diagnosed with pericardial effusion on 8-19-2004. my cardiologist has me on diuretics, a low sodium diet and gave me a week's worth of medrol. the followup is serial echocardiogram. my most recent echo shows that the effusion is still present a month later. my question is are there any other treatments and if i have to have pericardiocentesis, what length of recovery time is associated with it? also, is there anything i can do to help my situation? in conclusion, any other information you could provide would be appreciated, thank you, DickP[/b]

[Dr. Yasser Mokhtar]

Dear Dick,

What did your cardiologist think the effusion was due to? How big was the effusion on the echo? What investigations, if any, were done to search for the cause of the effusion? What initiated the work-up that lead to the diagnosis of the effusion?

Pericardiocentesis is a considered a minor procedure, you can be out of the hospital the same day or the next day at the most if every thing goes well.

The main serious complication of pericardial effusion is cardiac tamponade which is related to the rate of accumulation of the fluid rather that its amount. In cardiac tamponade, the heart is squeezed by the fluid and it can not function as a pump anymore. It can avoided and/or treated by a procedure called pericardial window where the pericardium (the sac surrounding the heart and that contains the fluid that can compress the heart is opened and connected to either the sac surrounding the lung or to the abdominal cavity.

The cause behind the effusion should be found if not already found.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

[DickP]

Thank you so much for your reply and i am sorry it took me so long in getting back to you. Finally last week my cardiologist performed the pericardiocentesis and drew off 900 cc of fluid. I stayed in the hospital overnight and an echocardiogram the next day confirmed that no more liquid had built up overnight. :D I am hoping at my next appointment that he will have sent the fluid for testing so we can find out what caused the effusion. My only question now is how likely is it that this might happen again? I am still currently taking DiovanHCT 160 mg twice a day, lopressor 50mg.once a day and lasix 80 mg. once a day. Thank you for your help.

[Dr. Yasser Mokhtar]

Dear Dick,

The probability that this might happen again depends on its cause. Sending the fluid to be tested is a routine procedure. The results should not take that long.

i think that your doctor will do a follow up echocardiography in a period of time to make sure that there is no recurrence. On recurrence, i think that a pericaridial biopsy could be done.

If this happens once more, treatment then will be in the form of a procedure called a pericardial window where a connection between the pericardium and the sac surrounding the lung called pleura or somtimes with the abdominal cavity is created so that the fluid collects in the bigger sac whether around the lung or in the abdomen and does not compress the heart as previously discussed.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.