Management of Pleural and Pericardial Effusion


Assistant Professor of Radiology, Department of Radiology, Faculty of Medicine, Jundi Shapur University of Medical Sciences, Ahwaz, Iran



Pleural and pericardial effusion occur when excessfluidcollectsinthepleuralandpericardial spaces. Dyspnea and reduced exercise tolerance will be early signs, progressing to severe in severe cases. Pericardiocentesis is the most useful therapeutic procedure for the early management or diagnosis of large, symptomatic pericardial and pleural effusion . The effect of pericardiocentesis is often immediate: the drainage of a few millilitres of the effusion significantly reduces intrapericardial and atrial pressures. Tachycardia and dyspnoea decrease . Prior to intervention, diagnosis of malignant pleural effusion and exclusion of infection should be made. Treatment focuses on palliation and relief of symptoms. Numerous interventions are available, ranging from drainage with thoracentesis or indwelling pleural catheter to more definitive, invasive options such as pleurodesis. There is no clear best approach, and a patient-centered approach should be taken.A Seldinger technique is employed, usually under ultrasound guidance, to insert a drain into the pleural and pericardial spaces. In cases where effusions are recurrent and symptomatic (e.g. malignancy) then pleurodesis and pericardial fenestration can be performed. Major and minor complications are rare include small pneumothorax, vasovagal response with transient hypotension