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They found that the fluid is made up of a high concentration of lactate dehydrogenase (LDH), protein and lymphocytes. In a healthy adult there is up to 50 ml of clear, straw-coloured fluid. [3] However, there is little data on the normal composition of pericardial fluid to serve as a reference. [4] [5]
A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane. The two layers of the serous membrane enclose the pericardial cavity (the potential space) between them. [1]
Pericardial drainage. There are several therapeutic mechanisms that can be used to drain purulent fluid from the pericardial sac. These include pericardiocentesis, and possible subxiphoid pericardiotomy, pericardiectomy, and video-assisted thoracic surgery in complicated cases. [3] [8] [10]
[4] [5] Diagnosis is based on the presence of chest pain, a pericardial rub, specific electrocardiogram (ECG) changes, and fluid around the heart. [6] A heart attack may produce similar symptoms to pericarditis. [1] Treatment in most cases is with NSAIDs and possibly the anti-inflammatory medication colchicine. [6]
Pericardiocentesis can relieve the symptoms of pericarditis. [3] [4] There may be a normal amount of pericardial fluid, but inflammation still causes compression of the heart. Removal of some of this fluid reduces pressure on the heart. [citation needed]
Pericardiocentesis is a procedure whereby the fluid in a pericardial effusion is removed through a needle. It is performed under the following conditions: [15] presence of moderate or severe cardiac tamponade; diagnostic purpose for suspected purulent, tuberculosis, or neoplastic pericarditis; persistent symptomatic pericardial effusion
If fluid increases slowly the pericardial sac can expand to contain more than 2 liters; however, if the increase is rapid, as little as 200 mL can result in tamponade. [2] Tamponade is a medical emergency. [5] When it results in symptoms, drainage is necessary. [8]
On auscultation, pericardial friction rub can be heard. Cardiac tamponade: Cardiac tamponade occurs due to fluid accumulation in the pericardial space and typically presents with chest pain often accompanied by symptoms like dyspnea, hypotension, and pulsus paradoxus. Clinical signs include Beck's triad—hypotension, jugular venous distension ...