Pericardial effusion causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]; Cafer Zorkun, M.D., Ph.D. [3]; Varun Kumar, M.B.B.S., Abdelrahman Ibrahim Abushouk, MD[4]


Pericardial effusion can be classified into serous, bloody and chylous effusions based on the composition of the effusion fluid. Infections and inflammation usually cause serous effusion while bloody effusions are as a result of trauma to the heart. Though iatrogenic causes and infections are the common etiologies, pericardial disease may also be a feature of other disorders such as inflammatory bowel disease. Aortic dissection or free wall rupture should also be considered in patients with unstable hemodynamics and pericardial tamponade.


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Acute myocardial infarction, aortic dissection, aortic rupture, bacterial pericarditis, benign obstruction of thoracic duct, Cantu syndrome, capillary leak syndrome, cardiomyopathy, congestive heart failure, constrictive pericarditis, dilated cardiomyopathy, dissecting aortic aneurysm, Dressler's syndrome, hypersensitivity pericarditis with eosinophilia, hypertrichotic osteochondrodysplasia, Kawasaki disease, myocardial rupture, heart surgery, fungal pericarditis, pyogenic pericarditis, rheumatic pericarditis, tuberculous pericarditis, uremic pericarditis, ventricular aneurysm, viral pericarditis
Chemical / poisoning Asbestosis, silicosis
Dermatologic Behcet syndrome[1], Cantu syndrome, hypertrichotic osteochondrodysplasia
Drug Side Effect Anticoagulants, bleomycin,Bosutinib, certolizumab pegol, chemotherapy, cyclophosphamide, cytarabine, dantrolene, daunorubicin, doxorubicin, hydralazine, isoniazid, minoxidil, Oprelvekin, penicillin, phenylbutazone, phenytoin, procainamide, Sargramostim, sirolimus
Ear Nose Throat Temporal arteritis[2]
Endocrine Addisonian crisis, hypothyroidism, myxedema
Environmental No underlying causes
Gastroenterologic Acute pancreatitis, cirrhosis, inflammatory bowel disease, Whipple's
Genetic Cantu syndrome, congenital disorders of glycosylation, Gaucher disease, hypertrichotic osteochondrodysplasia, Jacobs arthropathy-camptodactyly syndrome, Mulibrey nanism syndrome, recurrent hereditary polyserositis
Hematologic Coagulopathy, leukemia, lymphoma
Iatrogenic Cardiac catheterization, cardiopulmonary resuscitation, cathether ablation for arrhythmias, coronary artery bypass grafting, dialysis, heart surgery, percutaneous coronary intervention, postpericardiotomy syndrome, radiation, TAVI, thoracic surgery, valvuloplasty
Infectious Disease Actinomycosis, adenovirus, alveolar hydatid disease, amebiasis, aspergillus, blastomycosis, borrelia, brucellosis, candida, coccidiomycosis, coxsackie B Virus, cytomegalovirus, Ebstein-Barr virus, echinococcus, echovirus, entamoeba histolytica, escherichia coli, francisella, fungal pericarditis, haemophilus influenza, hepatitis B, histoplasmosis, influenza, klebsiella, legionella, Lyme disease, meningococci, mumps, mycobacterium tuberculosis, mycoplasma pnuemonia, neisseria, nocardia, pneumococci, pneumonia, proteus, pseudomonas, pyogenic pericarditis, rheumatic fever, rickettsia, salmonella, scrub typhus, staphylococcus, streptococci, syphilis, toxoplasmosis, tuberculous pericarditis, tularemia, varicella, viral pericarditis
Musculoskeletal / Ortho Cantu syndrome, hypertrichotic osteochondrodysplasia
Neurologic No underlying causes
Nutritional / Metabolic Malnutrition, congenital disorders of glycosylation
Obstetric/Gynecologic Ovarian hyperstimulation syndrome
Oncologic Breast cancer, carcinoid, fibroma, Kaposi's sarcoma, leukemia, lung cancer, lymphoma, melanoma, mesothelioma, neoplasia that has spread to the pericardium, ovarian cancer, sarcoma, Sipple syndrome
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Bronchogenic cyst, lung cancer, pneumonia, sarcoidosis
Renal / Electrolyte Nephrotic syndrome, renal failure, uremic pericarditis
Rheum / Immune / Allergy Acute rheumatic fever, amyloidosis, ankylosing spondylitis, Behcet syndrome, collagen vascular disease, Dressler's syndrome, inflammatory bowel disease, Kawasaki disease, mixed connective tissue disease, polyarteritis nodosa, polymyositis, Reiter's syndrome, rheumatic pericarditis, rheumatoid arthritis, sarcoidosis, scleroderma, Still's disease, systemic lupus erythematosus, systemic sclerosis, temporal arteritis, Wegener's
Sexual Neisseria gonorrhoeae[3], treponema pallidum
Trauma Blunt or penetrating chest trauma, esophageal rupture, esophogeal perforation, gastric perforation, pancreatic-pericardial fistula
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Hypoalbuminemia, idiopathic, radiation

Causes in Alphabetical Order


  1. Scarlett JA, Kistner ML, Yang LC (1979). "Behçet's syndrome. Report of a case associated with pericardial effusion and cryoglobulinemia treated with indomethacin". Am J Med. 66 (1): 146–8. PMID 420242.
  2. Garewal HS, Uhlmann RF, Bennett RM (1981). "Pericardial effusion in association with giant cell arteritis". West J Med. 134 (1): 71–2. PMC 1272467. PMID 7210667.
  3. Wilson J, Zaman AG, Simmons AV (1990). "Gonococcal arthritis complicated by acute pericarditis and pericardial effusion". Br Heart J. 63 (2): 134–5. PMC 1024342. PMID 2317408.

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