Pericardial effusion

Pericardial effusion

• 1.
  Pericardial Effusion • Thereis a sac around the heart that is called pericardial membrane • Pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity Because of the limited amount of space in the pericardial cavity fluid accumulation leads to an increased intrapericardial pressure which can negatively affect heart function
• 3.
  How much pericardialfluid is normal? • Pericardial Effusion and Cardiac Tamponade. The pericardial sac normally contains up to 50 mL of fluid; it can hold 80 to 200 mL of fluid acutely, and even up to 2 L if the fluid accumulates slowly. Type of pericardial effusion 1) transudative 2) exudative 3) hemorrhagic 4) malignant (due to fluid accumulation caused by metastasis)
• 4.
   The twomain reasons for fluid accumulation in the pericardial space are i. An imbalance between the pressure within blood vessels—which drives fluid out of blood vessels—and the amount of protein in blood—which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate ii. An injury or inflammation of the pericardium, in which case the fluid that accumulates is called an exudate. Conditions such as infections .
• 5.
  • If thefluid is milky, consider the involvement of the lymphatic system (ie, chylopericardium). If the fluid is cloudy and turbulent, it is suggestive of signs of increased capillary leakage and leukocytosis and is concerning for infectious effusion
• 6.
  causes In most cases,inflammation of the sac, a condition called pericarditis, leads to the effusion 1) Severe kidney failure, also called uremia 2) Autoimmune disease (lupus, rheumatoid arthritis, and others) 3) Bacterial infections, including tuberculosis 4) Cancer 5) Injury to the sac or heart from a medical procedure 6) Heart attack
• 7.
  Signs and symptoms the main symptom is chest pain. It may get worse when you breathe 1) Fever 2) Fatigue 3) Muscle aches 4) Shortness of breath 5) Nausea, vomiting, and diarrhea (if you have a virus) 6) Chest pain 7) pressure are common symptoms cardiac tamponade
• 8.
  How is thesample collected for testing? • A healthcare practitioner uses a syringe and needle to collect a fluid sample from the pericardial sac in a procedure called pericardiocentesis.
• 10.
  Transportation of pericardialfluid • Initially fluid is collected into a plain sterile container for microbiology and chemical pathology. • A large volume should be submitted if tuberculosis infection is suspected as much fluid as possible should submitted for cytology add heparin(at final conc.of 5u/ml of fluid)or sodium citrate as an anticoagulant.
• 11.
  • A biopsymay be collected at the time of aspiration and unfixed fluid sent for cell surface marker if lymphoma is suspected. • Refrigerate if more than 24 hour delay for laboratory. • Clinical information is necessary.
• 12.
  • Inflammatory conditions(including possible bacterial viral and fungal infection) and suspected primary or secondary neoplasm