Chapter 16 - The Pericardium and its Diseases

Abstract

The pericardium, which forms a fibrous sac around the heart, holds the heart in a fixed geometric position and acts as a barrier to the spread of infection or neoplasms from adjacent organs. It also has an impact on cardiac hemodynamics. Pericardial diseases are commonly inflammatory or neoplastic. Pericarditis can be idiopathic or due to almost any microorganism (bacterial, viral, fungal, parasitic). Pericarditis may be associated with significant pericardial effusion and this can be life-threatening. Progression of the pericardial changes can lead to constrictive pericarditis. Pericarditis is often associated with underlying myocardial disease (commonly ischemic heart disease) and may also be iatrogenic and associated with cardiac interventions. Pericardial tumors, like all cardiac tumors, are rare and when they occur are far more likely to be secondary than primary, related to adjacent organs and less often to other organs.