The heart is normally contained within a sac (pericardium) that has some fluid. Infection, inflammation or cancer, can occasionally lead to significantly more fluid accumulating the sac and this is called a pericardial effusion.
When a pericardial effusion occurs slowly, the sac of the heart can expand and it causes little to no symptoms. However, when this occurs more rapidly the sac (which is relatively rigid) cannot expand fast enough to accommodate the increased fluid accumulation and this results in pressure compressing the heart. When compressed the heart cannot pump blood effectively and this leads to shortness of breath, low blood pressure and ultimately heart failure.
Urgent and emergency treatment can be undertaken by inserting a needle into the sac of the heart to relieve the pressure from the build up of fluid, but it can recur.
A pericardial window is the creation of an opening (approximately 2-3 cm wide) to prevent the fluid from building up in the sac of the heart by allowing the fluid to drain into the chest cavity. In most cases, the bigger surface area of the chest cavity can re-absorb the fluid.
Conventionally, this operation was performed through a sternotomy (by sawing through the breast bone). However with advances in keyhole surgery, it can be done through a single 2-3cm incision, often as a day case operation for suitable patients (you are able to leave hospital on the same day of surgery).
Do feel free to contact me if you would like to know more about this procedure or to discuss you suitability for a day case operation.