Hello Joan, and thank you for your question! Regarding your concern I would like to know if there was an etiological cause for your pericardial effusion? Was is a systemic diseases, inflammation or infection (such as TBC or viral one, etc), endocrine or something else? Frequently there is the primary disease that depicts the clinical picture of the patient and in that context causes also pericarditis. I don t know exactly your pleural effusion was treated by pericardiocentesis; or is was a constrictive-effusive pericarditis and for this reason was treated surgically. So, please if you have any additional information about the exact definition of your problem (for example a medical report) send it to me for a more objective reasoning. From the other side you suffer from Pulmonary hypertension and are under treatment with sildenafil; Pulmonary hypertension affects negatively the right side of your heart, and depending on its severity and its time prolongation may produce right heart failure (may even contribute to pericardial effusion); contributing that way to clinical scenario of extreme body weakness. So to cut it clear and short in your situation there are some reasons for extreme weakness presence; which cause rely mostly on the primary reason of your pericardial diseases and your prior health problems (Pulmonary hypertension). You have to talk to your doctor about the severity of pulmonary hypertension and the etiology of pericarditis (if it is determined how is it being treated and to schedule the correct follow up). Hope to have been helpful to you. Feel free to ask me if you have additional information. Greetings from Dr. Iliri