What Is Water Around the Heart?
According to the Mayo clinic, “Pericardial effusion (per-ih-KAHR-de-uhl e-FYU-zhun) is the accumulation of excess fluid around the heart.” Your heart is surrounded by a sac, called the pericardium, and it has two layers. The space between these two layers contains a small amount of liquid. The inner layer lies against the heart and the outer layer is thick and just a little stretchy. When the amount of fluid exceeds the normal limit, the pericardium expands toward the heart, affecting the heart’s functioning. The pumping chambers of the heart do not fill completely, and may collapse. At this point, blood supply to your body is limited and it will not receive the oxygen it needs. This condition is called tamponade and can be life-threatening if not treated.
Water around the heart refers to an excess of the fluid in the pericardium. You can have pericardial effusion and have no symptoms at all, especially if the water build-up happened slowly over time. This happens more often when the cause is a chronic inflammatory disorder or cancer, as the fluid increases slowly over time. Symptoms include:
- Breathing difficulties
- Chest pain
- Nausea
- Coughing
- Difficulty swallowing
- Dizziness
- Fast heart rate
- Overall weakness or fatigue
Pericardial effusion happens as a result of disease, injury, an inflammatory disorder, or when blood accumulates and blocks the flow of fluids. Causes (from mayoclinic.com) may include:
- Infections
- Inflammation of the pericardium
- Autoimmune disorders, such as rheumatoid arthritis or lupus
- Kidney failure (uremia)
- Underactive thyroid (hypothyroidism)
- HIV/AIDS
- Cancer metastasis, cancer in the heart, and radiation or chemotherapy
- Wounds near the heart
- Certain prescription drugs, including hydralazine, isoniazid,and phenytoin
An excess of water in the pericardium is sometimes discovered accidentally when you have an echocardiogram for some other condition. An electrocardiogram (ECG or EKG) records the electrical activity of your heart. It can also spot the presence of a poorly functioning heart due to tamponade.
A chest X-ray can show the enlarged heart if the amount of extra fluid is significant. You doctor may also order a CT scan (computerized tomography) or an MRI (magnetic resonance imaging). Additional tests may be performed to try and determine the underlying cause of your pericardial effusion.
Treatment
Treatment for pericardial effusion depends on the amount of fluid, the cause, and how close are you to developing tamponade. If there is no threat of tamponade occurring soon, your doctor may prescribe anti-inflammatory medications, such as aspirin, ibuprofen, or NSAIDs (non-steroidal anti-inflammatory drugs).
Invasive procedures to drain the fluid and prevent it from re-occurring may be needed if your condition is serious. These include: pericardiocentesis, where the fluid is drained from your heart with a catheter and intrapericardial sclerosis, where a substance is injected which seals the two layers of the pericardium together. Open heart surgery may be necessary to drain and repair the pericardium and a pericardiectomy may be performed to remove all or part of the pericardium.