At a Glance
Why Get Tested?
To help diagnose the cause of inflammation of the pericardium and/or fluid accumulation around the heart
When to Get Tested?
When a doctor suspects that someone has a condition associated with inflammation of the pericardium and/or fluid accumulation around the heart
A sample of fluid collected from the pericardial sac using a procedure called a pericardiocentesis
Test Preparation Needed?
The Test Sample
What is being tested?
Pericardial fluid is a liquid that acts as a lubricant for the movement of the heart. It is found in small quantities between the two layers of the pericardium. Pericardial fluid is produced by mesothelial cells in the membranes and acts to reduce 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 make a diagnosis as to 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. This type of fluid may be the result of conditions such as infection, malignancies (metastatic cancer, lymphoma, mesothelioma), or autoimmune disease.
Differentiation between the types of fluid is important because it helps diagnose the specific disease or condition. Doctors and laboratorians use an initial set of tests (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.
How is the sample collected for testing?
A sample of fluid is collected from the pericardial sac by a doctor with a syringe and needle using a procedure called a pericardiocentesis.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No special preparation is usually needed.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
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 through http://emedicine.medscape.com. 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 through http://emedicine.medscape.com. 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 through http://www.mayoclinic.com. 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.
(2010 August 1). How Is Pericarditis Diagnosed? National Heart Lung and Blood Institute [On-line information]. Available online at http://www.nhlbi.nih.gov/health/health-topics/topics/peri/diagnosis.html through http://www.nhlbi.nih.gov. Accessed June 2012.
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.
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.
Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition]. Pp 1438-1439.
Forbes, B. et. al. (© 2007). Bailey & Scott's Diagnostic Microbiology, Twelfth Edition: Mosby Elsevier Press, St. Louis, Missouri. Pp 904 – 913.
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.
Berger, J. (2006 March 30, Updated). Pericarditis, Bacterial. eMedicine [On-line information]. Available online at http://www.emedicine.com/ped/TOPIC1765.HTM through http://www.emedicine.com. Accessed on 6/29/08.
Gandelman, G. (2006 November 6, Updated). Pericardiocentesis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003872.htm. Accessed on 6/28/08.
(© 2008). American Heart Association. Pericardium and Pericarditis [On-line information]. Available online at http://www.americanheart.org/presenter.jhtml?identifier=4683 through http://www.americanheart.org. 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 through http://www.mayoclinic.com. Accessed on 6/28/08.
(2008 March). NHLBI. What is Pericarditis? [On-line information]. Available online at http://www.nhlbi.nih.gov/health/dci/Diseases/peri/peri_whatis.html through http://www.nhlbi.nih.gov. Accessed on 6/28/08.