Pericardial Effusion:  Indications for Surgery: Pericardial effusion may be the result of peiicarditis due to infection, autoimmune disease or neoplasm. Non-inflammatoly diseases like renal failure, hypo thyroidism, amyloidosis and congestive heart failure can cause effusion. It can also be due to post cardiotomy syndrome. They may present with cardiac tamponade. It depends on the amount of fluid collected and also how rapidly the accumulation occurs. Pericardial effusion can occasionally be localised and then produce regional tamponade. Slow collection of fluid may not produce acute tamponade but present a picture of chronic effusive constrictive pericardial disease.

The diagnosis is confirmed by chest X-ray, ECG echocardiogram and finally by pericardiocentesis. Acute cardiac tamponade is an indication for emergency pericardiocentesis. In patients with renal failure, uraenmic peiicarditis with effusion is a known complications. If they are on haemodialysis, the effusion may become haemorrhagic. It could be managed with increasing frequency of dialysis and adopting regional heparinisation during haemodialysis.