This may be due to bacterial infection resulting in collection of pus in the pericardium (exudates) or to some non-infective inflammation with collection of serous fluid in the pericardium (transudate), for example in rheumatoid arthritis.

Clinical Features

  • This condition may be asymptomatic if it is due to non infective cause and is a small effusion.
  • Chest pain that is acute or a dull ache depending to the cause of effusion.
  • On examination, the apex beat may be difficult to palpate and the heart sounds may be distant if the amount of fluid in
    the pericardium is large.


  • Full blood count
  • Chest x-ray
  • ECG
  • Echocardiogram
  • If pericardiocentesis is done, send fluid for microscopy, protein estimation, and culture.


  • Pericardiocentesis may be diagnostic as well as therapeutic.
  • Treat according to type of fluid.