Treatment

Treatment for pericardial effusion will depend on the amount of fluid, the underlying cause, and whether you have or are likely to develop cardiac tamponade. Treating the cause of pericardial effusion often corrects the problem.

Medications that reduce inflammation

If you don't have tamponade or there's no immediate threat of tamponade, your doctor might prescribe an anti-inflammatory drug to reduce inflammation of the pericardium:

• Aspirin
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as indomethacin (Indocin) or ibuprofen (Advil, Motrin IB, others)
• Colchicine (Colcrys)
• Corticosteroid, such as prednisone

Medical procedures and surgery

If anti-inflammatory treatments don't correct the problem or you have or are likely to have tamponade, your cardiologist may recommend one of the following procedures to drain fluids or prevent fluids from accumulating again.

• Drain the fluid. Your doctor can enter the pericardial space with a needle and then use a small tube (catheter) to drain fluid — a procedure called pericardiocentesis. The doctor uses echocardiography or a type of X-ray imaging called fluoroscopy to guide the catheter to the right position. In most cases, the catheter will be left in place to drain the area for a few days to help prevent the fluid from building up again.
• Open-heart surgery. If there's bleeding into the pericardium, especially due to recent heart surgery or other complications, open-heart surgery may be done to drain the pericardium and repair damage. Occasionally, a surgeon may also create a "passage" that allows fluid to drain as necessary into the abdominal cavity, where it can be absorbed.
• Open the layers. Balloon pericardiotomy is a rarely performed procedure in which a deflated balloon is inserted between the layers of the pericardium and inflated to stretch them.
• Remove the pericardium. The surgical removal of all or part of the pericardium (pericardiectomy) is usually reserved for people who have recurring pericardial effusions despite catheter drainage.