Pericardial Fluid Analysis

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.At a Glance
Why Get Tested?
To help diagnose the cause of inflammation of the membrane surrounding the heart (pericardium) and/or fluid accumulation around the heart
When To Get Tested?
When a health care practitioner suspects that you have a condition associated with inflammation of the pericardium and/or fluid accumulation around your heart
Sample Required?
A sample of fluid collected from the pericardial sac using a procedure called a pericardiocentesis
Test Preparation Needed?
None
What is being tested?
The pericardium is a two-layered, sac-like membrane that surrounds the heart. Pericardial membranes produce pericardial fluid, a liquid that sits between the pericardium’s membranes. The fluid acts as a lubricant for the movement of the heart, reducing friction as the heart pumps blood.
A variety of conditions and diseases can cause inflammation of the pericardium (pericarditis) and/or excessive accumulation of pericardial fluid (pericardial effusion). Pericardial fluid analysis is a group of tests that evaluate this liquid to help diagnose the cause of the increased fluid.
The two main reasons for fluid accumulation in the pericardial space are:
- An imbalance between the pressure within blood vessels—which drives fluid out of blood vessels—and the amount of protein in blood—which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. Transudates are most often caused by congestive heart failure or cirrhosis.
- An injury or inflammation of the pericardium, in which case the fluid that accumulates is called an exudate. Conditions such as infections, malignancies (metastatic cancer, lymphoma, mesothelioma), or autoimmune disease may cause the accumulation of exudate.
Determining if the increased fluid is transudate or exudate is important because it helps narrow down the possible causes of pericardial fluid buildup. Health care practitioners and laboratorians use an initial set of tests, including cell count, protein or albumin level, and appearance of the fluid, to distinguish between transudates and exudates. Once the fluid is determined to be one or the other, additional tests may be performed to further pinpoint the disease or condition causing pericarditis and/or pericardial effusion.
Common Questions
Related Content
On This Site
Tests: Pleural Fluid Analysis, Peritoneal Fluid Analysis, Gram Stain, Susceptibility Testing, Total Protein, Albumin, Glucose, AFB Testing, LD
Elsewhere On The Web
National Heart, Lung, and Blood Institute: What is Pericarditis?
American Heart Association: What is Pericarditis?
MedlinePlus Medical Encyclopedia: Pericarditis
View Sources
Sources Used in Current Review
Chen, M. (Updated 2014 May 13). Pericardiocentesis. MedlinePlus Medical Encyclopedia. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003872.htm. Accessed 9/8/2016.
Levy, D. (Updated 2014 November 11). Pericardial fluid gram stain. MedlinePlus Medical Encyclopedia. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003719.htm. Accessed 9/8/2016.
Vyas, J. M (Updated 2014 December 7). Pericardial fluid culture. MedlinePlus Medical Encyclopedia. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003720.htm. Accessed 9/8/2016.
Shlamovitz, G. (2015 April 17). Pericardiocentesis. Medscape Reference. Available online at http://emedicine.medscape.com/article/80602-overview#showall. Accessed 9/8/2016.
Yau, S.W.Y. (2015 October 13). Pericardial fluid analysis. Medscape Reference. Available online at http://emedicine.medscape.com/article/2123066-overview. Accessed 9/8/2016.
Hoit, B. (Revised 2015 October). Acute pericarditis. Merck Manual Professional Version. Available online at http://www.merckmanuals.com. Accessed 9/8/2016.
Strimel, W. (Updated 2016 January 3). Pericardial effusion workup. Medscape Reference. Available online at http://emedicine.medscape.com/article/157325-overview. Accessed 9/8/2016.
Chen, M. (Updated 2016 January 24). Pericarditis. MedlinePlus Medical Encyclopedia. Available online at https://medlineplus.gov/ency/article/000182.htm. Accessed 9/8/2016.
Mayo Clinic Staff (2016 June 17). Pericardial effusion. Mayo Clinic. Available online at http://www.mayoclinic.com/health/pericardial-effusion/DS01124/METHOD=print. Accessed 9/8/2016.
Sources Used in Previous Reviews
Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby’s Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 714-717.
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp 1535-1536.
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Gandelman, G. (2006 November 6, Updated). Pericarditis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000182.htm. Accessed on 6/21/08.
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(© 2008). American Heart Association. Pericardium and Pericarditis [On-line information]. Available online at http://www.americanheart.org/presenter.jhtml?identifier=4683. Accessed on 6/28/08.
Mayo Clinic Staff (2007 May 2). Pericarditis. MayoClinic.com [On-line information]. Available FTP online at http://www.mayoclinic.com/health/pericarditis/DS00505. Accessed on 6/28/08.
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Strimel, W. and Ayub, B. (Updated 2012 May 31). Pericardial Effusion. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/157325-overview. Accessed June 2012.
Shlamovitz, G. (2011 August 4). Pericardiocentesis. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/80602-overview#showall. Accessed June 2012.
Mikati, I. (Updated 2010 June 1). Pericardiocentesis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003872.htm. Accessed June 2012.
Mayo Clinic Staff (2010 December 15). Pericardial effusion. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/health/pericardial-effusion/DS01124/METHOD=print. Accessed June 2012.
Hoit, B. (Modified 2011 June). Pericarditis. Merck Manual for Healthcare Professionals [On-line information]. Available online through http://www.merckmanuals.com. Accessed June 2012.
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Levy, D. (2010 April 27). Pericardial fluid culture. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003720.htm. Accessed June 2012.
Levy, D. (2010 April 27). Pericardial fluid gram stain. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003719.htm. Accessed June 2012.
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