An accumulation of water in the pericardium – also called pericardial effusion – refers to the presence of fluid between the two connective tissue membranes surrounding the heart (pericardial cavity). This accumulation of water can occur both acutely and chronically. In a healthy person, there is about 20ml of fluid in the pericardium, which is quite normal and supports the heart in its pumping motion within the pericardium.
The danger posed by water in the pericardium depends greatly on the cause and the amount of effusion. The range of risks associated with water in the pericardium extends from asymptomatic without treatment to life-threatening emergency situations. In many cases, especially when the effusion is caused by pathogens, only a small amount of water accumulates in the pericardium, which only slightly exceeds the normal fluid level of about 20ml.
Most of the time, the water collects at the tip of the heart along the force of gravity and does not affect the heart in its function. The development of the amount of water must be constantly monitored in order to be able to assess its progress. In these cases, however, drug therapy is sufficient and naturopathic approaches can also be considered.
The water itself does not need to be treated, only the underlying disease. With larger amounts of water in the pericardium there is a higher acute risk, which is why puncture and relief of the pericardium is often necessary. Bacterial infections, for example, constantly produce new fluids.
As long as the infection and thus the underlying disease is not cured, the amount of water in the pericardium will increase. With higher quantities, the pericardium will fill up more and more and put pressure on the heart. Since the heart muscle is constantly tensing and relaxing as it beats, its function will be restricted if external pressure is exerted on the heart, as is the case with larger amounts of water in the pericardium.
The external pressure prevents the heart from fully relaxing and absorbing blood volume, resulting in heart failure. As a result, the body is no longer supplied with sufficient blood. This condition is also known as “pericardial tamponade” in acute emergency situations.
As a result of the restricted cardiac capacity, heart palpitations, shortness of breath, dizziness and sweating occur. In the worst case, cardiovascular arrest occurs. In these cases, the patient must be transferred to the intensive care unit and, if necessary, the pericardium must be punctured to drain the fluid. As long as the underlying disease is acute and has not been corrected, a drainage can be placed in the pericardium for a few days to allow newly formed fluid to drain off.
