Pericardial Disease

Anatomy

  • Tissue sac surrounding heart & proximal great vessels; 2 layers (parietal & visceral)

Disease states

  • Inflammation (w/ or w/o fluid accumulation) → pericarditis
  • Fluid accumulation → effusion ± tamponade
  • Decrease in compliance (sequela of inflammation) → constrictive pericarditis
  • Tamponade and constriction characterized by increased ventricular interdependence

Pericarditis and Pericardial Effusion

Etiologies of Acute Pericarditis (JAMA 2015;314:1498; EHJ 2015;36:2873)
Idiopathic (>80%) Most presumed to be undiagnosed viral etiologies
Infectious (<5% can be confirmed infectious) Viral: Coxsackie, echo, adeno, EBV, VZV, CMV, parvo, HIV, flu
Bacterial (from endocarditis, pneumonia, or s/p rdiac surgery):