Pericardial Mesothelioma

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Pericardial mesothelioma is one form of asbestos-related cancer. This type of mesothelioma affects the pericardium, which is the lining around the heart muscle. It is one of the least common forms of mesothelioma, which in itself is a rare disease. Pericardial tumors are typically diffuse, meaning they are not localized and tend to cover most of the heart.

Pericardial mesothelioma makes up about half of all pericardial tumors. Research states that this form of cancer accounts for approximately 1% to 6% of all mesotheliomas. This form of cancer is so seldom seen that fewer than 150 cases have been described in medical literature, and just 200 cases have been reported worldwide.

Causes of Pericardial Mesothelioma

As with other forms of mesothelioma, the cause of pericardial mesothelioma is exposure to asbestos dust and fibers. The amount and duration of asbestos exposure affect an individual’s potential risk for developing some form of mesothelioma.

When asbestos fibers are inhaled, they can stick to mucus that lines air passages in the nose and throat and can penetrate into the pleural lining of the lungs and chest wall. Over time, these fibers may break down and enter the bloodstream, eventually reaching the heart, where they lodge into its membranous lining. The lymphatic system can also play a part in spreading dangerous asbestos fibers to other parts of the body.

Asbestos fibers in the pericardium and serous membranes can cause irritation and changes in the cells that result in malignant pericardial mesothelioma, a condition in which fluid builds up in the sac around the heart.

However, researchers still do not fully understand how asbestos exposure causes pericardial mesothelioma.

Symptoms of Pericardial Mesothelioma

Being exposed to asbestos does not result in mesothelioma right away. The symptoms can take 20 to 50 years to manifest and may not even occur until the later stages of the disease. That’s why it’s important to understand the symptoms, so that diagnosis can be made as early as possible.

Many of the pericardial mesothelioma symptoms are the same as for pleural mesothelioma, and they include the following:

  • Shortness of breath
  • Chest pain
  • Chronic cough
  • Fatigue after only light exertion
  • Heart palpitations
  • Irregular heartbeat (arrhythmia)
  • Murmurs
  • Fever or night sweats
  • Difficulty breathing, even when at rest (dyspnea)
  • Orthopnea (difficulty breathing when lying down)

These symptoms are a result of the fluid that is built up around the heart; they are caused by the tumor and are not direct symptoms of the mesothelioma itself. The symptoms that are specific to pericardial mesothelioma are low blood pressure, fainting, fluid retention in the legs, and heart palpitations.

Diagnosing the Disease

Anyone who experiences the symptoms described here should see a doctor immediately. The first part of treatment for pericardial mesothelioma is getting a fast and accurate diagnosis.

Getting an accurate diagnosis begins with a medical history, which includes questions about possible exposure to asbestos. The next logical step is to conduct imaging tests, beginning with an X-ray, to obtain an understanding of the heart’s health. After the X-ray, a CT scan and MRI will likely be conducted. A biopsy of the affected tissue is often used to confirm or rule out the presence of mesothelioma in the lining of the heart. Typically, a diagnosis of pericardial mesothelioma can be made in only about 10% to 20% of cases before the death of the patient.

Researchers are looking for new and more accurate ways to test for mesothelioma. New methods may make the chances of early detection more likely.

Treating Pericardial Mesothelioma

Treatment can begin after a confirmed diagnosis of pericardial mesothelioma. Since there is no cure for mesothelioma, treatment is limited to procedures that may prolong the patient’s life and make the patient more comfortable in the remaining time.

Treatment options for pericardial mesothelioma include radiation and chemotherapy. Surgery can be done to remove the tumors that develop around the heart.

There are also surgical procedures such as thoracentesis that are used to remove the fluid that has built up in the lining of the heart. While they do not treat the disease itself, these procedures are successful in relieving the pain that the fluid can cause.


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