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Etiology of pericardial disease

Brian D Hoit, MD
Section Editors
Martin M LeWinter, MD
Jae K Oh, MD
Deputy Editor
Brian C Downey, MD, FACC


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 [1,2]:

Acute and recurrent pericarditis

Pericardial effusion without major hemodynamic compromise

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Literature review current through: Oct 2017. | This topic last updated: Jun 23, 2017.
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