ICU Chest Films > Fluid in the Chest > Pericardial Effusions

Pericardial Effusions

Generally, the pericardium is not visible on an AP view of the chest. Pericardial effusions are accumulations of fluid between the visceral (epicardium) and parietal pericardium. Several factors may lead to pericardial effusions including blockage of the lymphatic or venous systems by tumors, changes in osmostic or oncotic pressures due to metabolic diseases, or increased permeability of the pericardium due to inflammation. Blood in the pericardium (hemopericardium) may be an important clue to post operative bleeding. Effusions which do not raise the intrapericardial pressure more than 3 or 4 mmHg will not cause symptoms. The best evidence to determine if a pericardial effusion will become hemodynamically significant is to monitor how quickly it is accumulating.