Pericardial effusion

An abnormal accumulation of serous, hemorrhagic, or exudative fluid within the pericardial space surrounding the heart, which may impair cardiac filling and hemodynamics when large in volume or rapidly developing.

Causes

• Infectious causes

  • Viral infections: HIV, coxsackievirus

  • Tuberculosis

  • Fungal infections

  • Parasitic infections

  • Bacterial infections causing purulent pericarditis

• Autoimmune and connective tissue causes

  • Systemic lupus erythematosus (SLE)

  • Rheumatoid arthritis

  • Autoimmune pericardial inflammation

• Malignant causes

  • Lung cancer

  • Breast cancer

  • Hematologic malignancies (lymphoma, leukemia)

  • Metastatic cancer involving the pericardium

• Cardiovascular causes

  • Heart failure

  • Post-myocardial infarction inflammatory syndrome (Dressler syndrome)

• Renal and metabolic causes

  • Kidney failure (uremic pericarditis)

  • Hypothyroidism (myxedema-related pericardial fluid accumulation)

• Traumatic and iatrogenic causes

  • Blunt or penetrating cardiac trauma

  • Cardiac surgery

  • Catheter-based cardiac procedures

  • Pacemaker or device-related injury

• Other causes

  • Radiation-induced pericardial disease

  • Post-surgical inflammatory changes