Etiology of pericardial disease
- Brian D Hoit, MD
Brian D Hoit, MD
- Professor of Medicine and Physiology and Biophysics
- Case Western Reserve University and University Hospitals of Cleveland
- Section Editors
- Martin M LeWinter, MD
Martin M LeWinter, MD
- Section Editor — Myopericardial Disease
- Professor of Medicine and Molecular Physiology and Biophysics
- University of Vermont
- Jae K Oh, MD
Jae K Oh, MD
- Section Editor — Myopericardial Disease
- Professor of Medicine
- Mayo Clinic College of Medicine
The pericardium is a fibroelastic sac made up of visceral and parietal layers separated by a (potential) space, the pericardial cavity. In healthy individuals, the pericardial cavity contains 15 to 50 mL of an ultrafiltrate of plasma. Pericardial diseases are relatively common in clinical practice and may have different presentations either as isolated disease or as a manifestation of a systemic disorder.
Although the etiology is varied and complex, the pericardium has a relatively non-specific response to these different causes with inflammation of the pericardial layers and possible increased production of pericardial fluid. Chronic inflammation with fibrosis and calcification can lead to a rigid, usually thickened and calcified pericardium, with possible progression to pericardial constriction. In some cases, the clinical presentation of acute pericardial inflammation predominates, and the presence of excess pericardial fluid is clinically unimportant. In other cases, the effusion and its clinical consequences (ie, cardiac tamponade and constrictive pericarditis) are of primary importance.
Diseases of the pericardium present clinically in one of several ways :
●Acute and recurrent pericarditis
●Pericardial effusion without major hemodynamic compromise
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- SPECTRUM OF CLINICAL PRESENTATION
- Acute pericarditis
- Pericardial effusion
- - Hemorrhagic pericardial effusion
- - Symptomatic pericardial effusion
- Constrictive pericarditis
- Effusive constrictive pericarditis
- ESTABLISHING THE DIAGNOSIS
- Other infectious causes
- POST-CARDIAC INJURY SYNDROMES
- DRUGS AND TOXINS
- SYSTEMIC DISORDERS
- INFORMATION FOR PATIENTS