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Causes
By Mayo Clinic staffInflammation of the pericardium (pericarditis) is a response to disease, injury or an inflammatory disorder that affects the pericardium. Pericardial effusion is often one component of this inflammatory response.
Pericardial effusion may also occur when the flow of pericardial fluids is blocked or when blood accumulates within the pericardium. It's unclear how some diseases contribute to pericardial effusion, and sometimes the cause can't be determined.
Specific causes of pericardial effusion may include:
- Viral, bacterial, fungal or parasitic infections
- Inflammation of the pericardium due to unknown cause (idiopathic pericarditis)
- Inflammation of the pericardium following heart surgery or a heart attack (Dressler's syndrome)
- Autoimmune disorders, such as rheumatoid arthritis or lupus
- Waste product in the blood due to kidney failure (uremia)
- Underactive thyroid (hypothyroidism)
- HIV/AIDS
- Spread of cancer (metastasis), particularly lung cancer, breast cancer, leukemia, non-Hodgkin's lymphoma or Hodgkin's disease
- Cancer of the pericardium or heart
- Radiation therapy for cancer if the heart is within the field of radiation
- Chemotherapy treatment for cancer, such as doxorubicin (Doxil) and cyclophosphamide (Lyophilized Cytoxan)
- Trauma or puncture wound near the heart
- Certain prescription drugs, including hydralazine, a medication for high blood pressure; isoniazid, a tuberculosis drug; and phenytoin (Dilantin, Phenytek, others), a medication for epileptic seizures
- Little WC, et al. Pericardial disease. Circulation. 2006;113(12):1622-1632.
- Cardiopulmonary syndromes (PDQ®): Malignant pericardial effusion. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/cardiopulmonary/HealthProfessional. Accessed Nov. 1, 2008.
- Martin M, et al. Pericardial disease. In: Libby P, et al., eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/108738632-2/0/1549/0.html. Accessed Oct. 29, 2008.
- Khunnawat C, et al. Cardiovascular manifestations in human immunodeficiency virus-infected patients. American Journal of Cardiology. 2008;102(5):635-642.
- Maisch B, et al. Guidelines on the diagnosis and management of pericardial diseases executive summary: The task force on the diagnosis and management of pericardial diseases of the European Society of Cardiology. European Heart Journal. 2004;25(7):587-610.
- Ristic AD, et al. Management of pericardial effusion: The role of echocardiography in establishing the indications and the selection of the approach for drainage. Herz. 2005;30(2):144-150.
