Fluid around the heart in pets - Pericardial effusion and surgery

Fluid around the heart, also known as pericardial fluid or pericardial effusion, is a condition in which fluid accumulates in the sac (pericardium) surrounding the heart. This can impair the heart's pumping function and cause life-threatening situations such as cardiac tamponade. It occurs more often in dogs than in cats.

In this article we discuss the causes, symptoms, diagnosis, and treatment - including surgical procedures - for fluid around the heart.

What Is pericardial fluid?

The pericardium is a sturdy membrane that envelops the heart. When fluid accumulates within this membrane, it is called pericardial fluid or pericardial effusion. This fluid can consist of blood, inflammatory fluid, or lymph. In large amounts, it puts pressure on the heart, preventing it from filling properly - a life-threatening condition.

Causes of pericardial fluid

• Tumors in or around the heart (for example, hemangiosarcoma in dogs)
• Inflammation or infection of the pericardium
• Heart failure or serious systemic illness
• Trauma with bleeding into the pericardium
• Rupture of an atrium
• Idiopathic (no clear cause, more common in dogs)

Symptoms of pericardial fluid

• Lethargy and reduced stamina
• Rapid or labored breathing
• Fainting or collapse
• Enlarged abdomen due to fluid buildup
• Pale mucous membranes and weak pulse

Diagnosis of pericardial fluid

The diagnosis is made using:

• Physical examination: muffled heart sounds and signs of shock
• Echocardiography: the gold standard for visualizing fluid around the heart
• X-rays: often show an enlarged, globe-shaped cardiac silhouette
• ECG: can show heart rhythm disturbances and electrical alternans (varying QRS height)
• Pericardiocentesis: removing fluid from the pericardium with a needle for diagnosis and temporary relief

Treatment of pericardial fluid

Treatment depends on the cause and severity:

• Pericardiocentesis: puncturing and draining the fluid with a needle is a life-saving emergency measure
• Treatment of the underlying cause, for example chemotherapy for certain types of tumors

Surgery for pericardial fluid

When the fluid keeps recurring or is caused by a tumor, surgery may be necessary:

• Pericardectomy: (partial) removal of the pericardial sac, often via a thoracoscopic (minimally invasive) or open approach
• Tumor resection: removal of the tumor causing the fluid, if possible

Surgical procedures are mainly performed at specialized centers and can significantly improve quality of life.

Prognosis

The prognosis for pericardial fluid depends on the underlying cause. Idiopathic cases often respond well to pericardectomy. When tumors are the cause, the prognosis is generally less favorable. Early diagnosis and prompt treatment are crucial to prevent life-threatening complications.

Want to know more?

Read more about cardiology and surgery at Nesto. Our specialized veterinarians have extensive experience treating pericardial fluid in dogs and cats.

Frequently asked questions (FAQ)

What is pericardial fluid?

An accumulation of fluid in the pericardial sac, which puts pressure on the heart and impairs its pumping function.

Is pericardial fluid more common in dogs or cats?

It occurs more often in dogs; cats are affected less frequently.

How is pericardial fluid diagnosed?

Through echocardiography, X-rays, and sometimes pericardiocentesis.

Can pericardial fluid be treated?

Yes, through drainage (pericardiocentesis), medication, or surgery, depending on the cause.

What is the prognosis for pericardial fluid?

That depends on the cause: idiopathic cases have a good prognosis, while cases caused by tumors are often less favorable.