Pericardial Effusion Causes and Treatment

Pericardial Effusions in People with Cancer

diagram of pericardial sac
What is a pericardial effusion, and why are they important for people with cancer?. A.D.A.M. Medical Encyclopedia

Definition: Pericardial Effusion

A pericardial effusion is the buildup of fluid within the pericardium, the layer of tissues that lines the heart. A pericardial effusion may develop slowly (chronic pericardial effusion) and cause few symptoms. If it develops rapidly (acute pericardial effusion), it causes life-threatening symptoms and is a medical emergency (cardiac tamponade).

Pericardial effusion may occur for many reasons (some of these are listed below) but are far too common in people with lung cancer.

Symptoms of Pericardial Effusions

Symptoms may include shortness of breath, especially when lying down, lightheadedness, chest pain and a rapid heart rate (among others).


There are many causes of pericardial effusions. Some of these causes include:

  • Infections
  • Autoimmune conditions - such as with rheumatoid arthritis
  • Cancers - both those that spread to the pericardium from other regions of the body and those that begin in the pericardium
  • Kidney failure
  • Inflammation (including pericarditis)
  • Chest surgery
  • Heart attacks
  • Medications

Some of the medications that may cause pericardial effusions include:

  • The chemotherapy medications Adriamycin (doxorubicin) and Cytoxan (cyclophosphamide)
  • The tuberculosis drug Isoniazid
  • The seizure medication Dilantin (phenytoin)
  • The medication Rogaine (minoxidil) used for male pattern baldness and high blood pressure

Pericardial Effusions with Cancer

Pericardial effusions may occur with lung cancer, but also with cancers such as breast cancer and lymphomas.

Treatment of Pericardial Effusions Associated with Lung Cancer

Treatment can vary depending upon how extensive the cancer is. In some cases, chemotherapy and radiation therapy have reduced a pericardial effusion so that surgery can later be successful. Most of the time, however, a pericardial effusion is associated with other areas of cancer spread - metastatic cancer, and treatment is palliative - done for comfort reasons but not with an attempt to cure cancer.

Examples: Jack was told that his small cell lung cancer had spread to the area between his lungs (the mediastinum) and had caused a pericardial effusion. With lung cancer, a pericardial effusion can develop if a tumor presses on the heart and causes inflammation, or if tumor cells spread to the pericardium (malignant or cancerous pericardial effusion).


Hoit, B. Diagnosis and Treatment of Pericardial Effusion. UpToDate. Updated 11/25/15.

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