Cardiac Path Online

Pathology of Pericardial  Effusion

Dr Sampurna Roy MD




Normal pericardial sac contains 30 to 50 ml clear, straw-yellow serous fluid.

Visit: Pericardial Disease

Pericardial effusion appears due to a variety of conditions, which rarely exceed 500 ml.


- Serous:  

This is the most common form and mostly seen in congestive cardiac failure and hypoproteinemia. 

Serous surfaces are smooth and glistening. 

Fluid accumulates slowly and therefore, is well tolerated  until a large volume, which compromises diastolic filling.

Hence, withdrawal of the effusion is needed for the relief.

- Serosanguinous : 

This is usually due to blunt injury

Example: Cardiopulmonary resuscitation.

It is rarely clinically significant.

- Chylous : 

This is caused by lymphatic obstruction (benign or malignant) and has little clinical significance.

- Hemopericardium : 

This is the accumulation of  blood in the pericardium without an inflammatory component.

It is usually seen in myocardial rupture after transmural myocardial infarct, traumatic perforation, rupture of the intrapericardial aorta or hemorrhage from an abscess or metastasis.

Escaping blood rapidly fills the sac under high pressure, and as little as 200 to 300 ml may cause cardiac tamponade.

Visit: Histopathology reporting of Pericardial Specimen

Further reading:

The syndrome of cardiac tamponade with "small" pericardial effusion

Pericardial effusion in celiac disease.

Primary effusion lymphoma.

Comparison of immunocytochemical sensitivity between formalin-fixed and alcohol-fixed specimens reveals the diagnostic value of alcohol-fixed cytocentrifuged preparations in malignant effusion cytology.

Infantile cardiac haemangioma with large pericardial effusion diagnosed during acute bronchiolitis episode.

Pleural, peritoneal and pericardial effusions - a biochemical approach.

A rare cause of pericardial effusion: giant cell arteritis.

The potential additional diagnostic value of assessing for pericardial effusion on cardiac magnetic resonance imaging in patients with suspected myocarditis.

Pericardial effusions in the cancer population: prognostic factors after pericardial window and the impact of paradoxical hemodynamic instability.

A 63-year-old woman with a pericardial effusion, bilateral pleural effusions, and ascites: is the whole greater than the sum of its parts?

Pericardial and pleural effusions in congestive heart failure-anatomical, pathophysiologic, and clinical considerations.





Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)








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