Q: I am a 27 years old male suffering from repeated pericardial effusions for the last one year and have undergone pericardial tapping procedures twice. The doctors told me that it is due to mediastinal tuberculosis (TB) and I am on TB medicines for the last seven months. Is mediastinal tuberculosis curable? Which gland secretes this pericardial fluid?

A:Pericardial cavity is the potential space, which exists between the parietal and the visceral layer of the pericardium (a layer of tissue which surrounds the heart). Abnormal accumulation of fluid within this space is called pericardial effusion. This may occur due to a variety of reasons- both infectious as well as non-infectious. In the Indian context, tuberculosis is an important infective cause of pleural effusion. The management of this condition consists of management of the primary cause which causes the effusion (in this case tuberculosis), and removal of the pericardial fluid if necessary- (this process is called pericardial tapping) for alleviating the symptoms and improving cardiovascular function. The primary cause of tuberculosis pericardial effusion can be effectively treated by taking anti-tuberculous medications properly. The pericardial fluid can also be cultured for tuberculosis and other bacteria, besides doing routine cytological and biochemical analysis.