ABSTRACT
The pericardium can be the source of numerous primary and secondary diseases. The double sac (parietal and visceral) fibrous structure is normally separated by 15 to 50 cc of plasma-derived fluid. It serves important anatomic and physiologic functions, even though it is not necessary for survival. The commonest pathologic abnormality affecting the pericardium is acute pericarditis. The commonest cause of pericarditis, in general, is idiopathic acute pericarditis, usually of viral etiology. The inflammation may be fibrinous, effusive, or hemorrhagic. Pericardial involvement due to blunt chest trauma is often overlooked. Partial absence of the pericardium (congenital pericardial defects) have been known to cause cardiac and vascular herniation, strangulation of the left atrium, and sudden death. The pericardium serves as a communicative crossroad for pathology produced by many diseases. These include viral, bacterial, and protozoal pathogens; numerous drugs; primary and secondary neoplasms; chemical toxins; metabolic diseases; rheumatoid (collagen) vascular diseases; radiation; and secondary immune states (postmyocardial infarction syndrome, postpericardiotomy syndrome).
