What Causes Pericardial Effusions?

Mesothelioma tumors growing on the heart lining (pericardium) may cause pericardial effusion.

Other causes of pericardial effusion include:

  • Pleural mesothelioma or other cancers of the chest
  • Inflammation of the heart lining
  • Bacterial, viral, fungal or parasitic infection
  • Certain chemotherapy drugs such as doxorubicin and cyclophosphamide
  • Radiation therapy
  • Underactive thyroid
  • Inflammation
  • Infection
  • Other primary cancers of the chest
Diagram showing pericardial mesothelioma affecting the heart
Pericardial mesothelioma is thought to occur when asbestos lodges itself around the heart.

Pericardial effusion is a common symptom of pericardial mesothelioma. It is a rare cancer that forms in the lining of the heart.

This lining, known as the pericardium, contains two layers. A small amount of fluid exists between these layers. It lubricates the lining and offers protection around the heart.

What Are the Symptoms of Pericardial Effusions?

Not everyone with pericardial effusion will experience symptoms.

Symptoms of pericardial effusion include:

  • Shortness of breath or breathing difficulties
  • Uncomfortable breathing while lying down
  • Chest pain (often on the left side)
  • A sense of fullness or pressure in the chest

Excess fluid can increase pressure on the heart, a condition called cardiac tamponade. This prevents the chambers from filling. Poor circulation and inadequate oxygen supply result.

Treatment for pericardial effusion involves minor or major surgical procedures.

Pericardial Effusion Treatment

Procedures that treat this condition drain the fluid or remove the lining.


pericardiocentesis is a minor surgical procedure. It drains fluid from around the heart.

Process of a Pericardiocentesis

  1. Application of a local anesthetic.
  2. A heart ultrasound guides insertion of a thin needle into the pericardial lining.
  3. A catheter replaces the needle.
  4. The catheter drains the excess fluid, which may take several hours.

There is a chance the fluid could return after a pericardiocentesis. A pericardiectomy to prevent recurrence helps patients with recurring pericardial effusion.


pericardiectomy is a surgery that removes part or all the heart lining. It treats pericardial effusion, inflammation of the pericardium (pericarditis) and pericardial mesothelioma. A pericardial window is another term for the procedure.

There are two types of pericardiectomies:

  • A partial pericardiectomy removes a diseased part of the heart lining.
  • A total pericardiectomy removes all the lining.

The surgery prevents fluid from accumulating again. Recovery in the hospital takes one to two weeks.