Common Causes of Pericardial Effusion

Transudative Pericardial Effusion

Transudative effusion typically results from systemic conditions that affect fluid balance in the body. Common causes include congestive heart failure, liver cirrhosis, kidney failure, and hypoalbuminemia. These conditions lead to increased pressure in the blood vessels or reduced levels of albumin, a protein that helps maintain fluid within the bloodstream, causing fluid to leak into the pericardial space.

Exudative Pericardial Effusion

Exudative effusion is often linked to inflammation or infection of the pericardium. Infectious causes include bacterial, viral, fungal, and tuberculosis-related infections. Viruses such as coxsackievirus, echovirus, and adenovirus are among the most common culprits.

Malignancy and Autoimmune Conditions

Another significant cause of exudative pericardial effusion is malignancy. Cancers such as lung cancer, breast cancer, and lymphomas can metastasize to the pericardium, leading to fluid buildup. Additionally, autoimmune and inflammatory diseases like rheumatoid arthritis and systemic lupus erythematosus (SLE) can cause pericarditis and subsequent effusion.

Post-Myocardial Infarction and Trauma

In some cases, pericardial effusion may develop following an acute myocardial infarction, particularly during the early healing phase. This is often due to localized inflammation around the heart. More seriously, a cardiac rupture after a heart attack can result in hemopericardium — a buildup of blood within the pericardial sac — which can be life-threatening.

Identifying the root cause of pericardial effusion is crucial for effective treatment. Symptoms, clinical history, imaging studies, and fluid analysis all play a role in determining whether the effusion is due to a benign, infectious, or malignant process. Early diagnosis and targeted therapy can significantly improve patient outcomes.