Pericardial Mesothelioma Symptoms

Quick Summary

As with all forms of mesothelioma, pericardial mesothelioma symptoms are difficult to identify in the early disease stages. By the time patients do notice serious symptoms, the cancer may have already metastasized (spread) significantly. If you’ve been exposed to asbestos in your past, then it’s important to be aware of the signs and symptoms of pericardial mesothelioma. Early-detection can lead to an accurate diagnosis, allowing you to undergo potentially life-extending treatments.

Pericardial Mesothelioma Symptoms Overview

  • Pericardial mesothelioma symptoms have a long latency period and don’t develop until 10-50 years after initial asbestos exposure
  • Pericardial mesothelioma is rare, and early symptoms can be mistaken for more common conditions
  • One of the key signs of pericardial mesothelioma is fluid buildup in the heart (pericardial effusions)
  • Patients may notice that symptoms of pericardial mesothelioma advance rapidly after the initial presentation
  • Pericardial mesothelioma patients can undergo treatment to manage symptoms and control metastasis through multimodal therapies and palliative surgery

Pericardial Mesothelioma Symptom Latency

One of the most important things anyone with a history of asbestos exposure needs to know about mesothelioma is its latency period.

All forms of mesothelioma—pericardial, pleural, peritoneal and testicular—have a delayed onset of symptoms. It can take anywhere from 10-50 years, depending on the person, for signs of mesothelioma to appear after the patient was initially exposed to asbestos.

Additionally, even when symptoms become detectable, it can take another extended period for doctors to reach an accurate diagnosis.

Because pericardial mesothelioma is so rare—only accounting for around 1% of all mesothelioma cases—general practitioners and oncologists don’t typically have the expertise to identify the symptoms of such an uncommon condition. Instead, patients may be told their symptoms are due to heart disease or conditions that cause heart inflammation (pericarditis).

If doctors do suspect malignancy (cancer) is involved, then they may attribute it to more common cancers such as lung, breast, melanoma or lymphoma. These cancers all require different treatments than mesothelioma, so an accurate diagnosis is critical.

Only around 20% of pericardial mesothelioma cases are diagnosed before the patient dies. Most cases of pericardial mesothelioma are diagnosed during an autopsy.

How Pericardial Mesothelioma Symptoms Develop

There are only roughly 150 known cases of pericardial mesothelioma that have ever been reported or described. Because it’s such an uncommon condition, it’s difficult for specialists to identify a specific set of warning signs. However, there are a few key symptoms that patients present in cases of pericardial mesothelioma.

The majority of symptoms have to do with how pericardial mesothelioma develops and grows. As tumors build in the pericardium—the protective lining covering the heart sac—they irritate and inflame healthy tissues. Pericardial inflammation (pericarditis) causes the pericardial layers to thicken, constricting the heart muscle.

Eventually, fluid starts to accumulate in response to inflammation, leading to a condition called pericardial effusions. The combination of pericardial thickening and effusions creates stress on the heart and leads to pericardial mesothelioma symptoms.

Primary Pericardial Mesothelioma Symptoms

Primary Symptoms Update

Most patients are asymptomatic (showing no signs of symptoms) in the early stages of pericardial mesothelioma. With the majority of symptoms not appearing until advanced stages with significant metastasis, pericardial mesothelioma symptoms can’t effectively be broken down into early-stage vs. late-stage as they can with pleural or peritoneal mesothelioma.

Here are the primary symptoms associated with pericardial mesothelioma:

  • Chest pain
  • Difficulty breathing (dyspnea)
  • Persistent cough
  • Fever
  • Night sweats
  • Fatigue
  • Fluid buildup in the heart (pericardial effusions)
  • Irregular heartbeat or heart palpitations (arrhythmia)
  • Heart murmurs
  • Pericardial bleeding

The primary symptom that patients report with pericardial mesothelioma is chest pain. Chest pain results from the constriction of the heart muscle due to the pericardial inflammation and thickening. Constriction of the heart muscle can also cause difficulty breathing, which is why many patients report dyspnea as a symptom as well.

One of the key signs that can alert doctors to pericardial mesothelioma in their patients is pericardial effusions. Most patients diagnosed with pericardial mesothelioma exhibit a certain amount of fluid buildup in the pericardium. Pericardial thickening is also a key sign of advanced pericardial mesothelioma.

In some postmortem investigations, doctors have found significant thickening of the pericardium that extends up into the aorta and into the lungs arteries.

Pericardial Mesothelioma Symptom Management

For patients who receive a pericardial mesothelioma diagnosis, managing painful symptoms is critical. Chest pain and the inability to breathe are debilitating symptoms that can be mitigated with treatment.

While pericardial mesothelioma has the worst prognosis of all mesothelioma locations (a median life expectancy of 6 months), there are still important treatments that patients can undergo to improve their quality of life.

Palliative care is the primary focus of pericardial mesothelioma treatment and doctors treat peritoneal mesothelioma symptoms by:

  • Draining fluid buildup in the heart
  • Removing tumors
  • Removing parts of the diseased pericardium
  • Controlling metastasis
  • Providing pain-relieving medications

Doctors decide which pain-management approaches are best for the patient based on several factors. One of the primary considerations in pericardial mesothelioma treatment is whether or not the patient is healthy enough to undergo radical surgery. Otherwise, doctors may recommend other treatment forms that don’t involve surgical risks.

Pericardial mesothelioma symptom-management treatments can include a combination of the following:

  • Pericardiectomy: A radical surgical procedure, the pericardiectomy involves removing part or all of the diseased pericardium as well as any visible tumors. Removing the pericardium and tumors alleviates the constriction around the heart muscle to reduce chest pain and improve breathing.
  • Pleurocentesis: If doctors find fluid buildup in the heart, they can drain the fluid using a minimally-invasive procedure called a pleurocentesis. Doctors locate the pericardial effusion, insert a needle into the tissue and use a catheter to withdraw fluid. Depending on the case, this procedure may need to be performed a few times, as fluid continues to build up.
  • Chemotherapy: An important treatment for patients diagnosed with pericardial mesothelioma is the chemotherapy drug combination of gemcitabine, cisplatin, and vinorelbine. Chemotherapy using these drugs has shown to help slow down metastasis and potentially increase life expectancy. More research into the effectiveness of chemotherapy for pericardial mesothelioma is currently underway.

While the prognosis for pericardial mesothelioma is poor, there have been some cases where patients have lived 2 years with their diagnosis thanks to the above treatments that not only managed symptoms but extended life expectancy as well.

Pericardial mesothelioma patients can also undergo clinical trials that test novel therapies and new drugs. Chemotherapy drugs combinations are also being tested to help extend and save the lives of pericardial mesothelioma patients. All patients are encouraged to ask about participating in clinical trials to open up new treatment options for them.

Seeing a Specialist About Pericardial Mesothelioma Symptoms

Though pericardial mesothelioma is a rare and difficult cancer to treat, all patients should be aware that treatments do exist. As research into mesothelioma progresses, more and more treatments are being developed to manage symptoms and effectively improve the quality of life.

If you have a known history of asbestos exposure and you are experiencing any of these pericardial mesothelioma symptoms, then it’s important to see a mesothelioma specialist to obtain an accurate diagnosis. Unlike general oncologists, only mesothelioma specialists have the experience that’s required to diagnose this rare cancer type.

Contact one of our Patient Advocates today to find out how to work with the top pericardial mesothelioma specialists in the country.

View Author and Sources

  1. Heart, “Primary pericardial mesothelioma presenting as pericardial constriction: a case report”
    Retrieved from: Accessed on December 26, 2017.
  2. Case Reports in Oncological Medicine, “Primary Pericardial Mesothelioma: A Rare Entity” Retrieved from: Accessed on December 26, 2017.

Last modified: December 18, 2018