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 Safeheart® (pimobendan) is not usually the first-line treatment for pericardial effusion in dogs — and in some cases, it’s not appropriate at all. Here’s why: 1. What Safeheart Does Pimobendan is an inodilator — increases heart contractility (positive inotrope) and causes peripheral vasodilation. It’s excellent for congestive heart failure due to DCM, MMVD, or some other myocardial diseases . 2. What Happens in Pericardial Effusion The problem is mechanical compression of the heart by fluid in the pericardial sac (tamponade), not weak heart muscle. The heart can’t fill properly during diastole because of the pressure — even if contractility is boosted, there’s not enough filling volume to pump. Giving an inotrope like pimobendan won’t fix the main issue — the “squeeze” is fine; the “fill” is the problem. 3. Risks Vasodilation from pimobendan can drop blood pressure in a patient already struggling with low cardiac output. It may worsen collapse ...