perikardiaa

The pericardium is a double-walled fibroserous sac that encloses the heart and roots of the great vessels. It consists of two layers: the visceral pericardium (epicardium), which covers the heart surface, and the parietal pericardium, which lines the fibrous pericardial sac. Between them is the pericardial cavity, containing a small amount of lubricating serous fluid, normally up to about 50 milliliters, that reduces friction during cardiac movements.

Its functions include protecting the heart from infection and excessive movement, lubricating the heart to minimize friction, and limiting acute distension during sudden venous return increases, helping to hold the heart in the mediastinal position.

The pericardium can be involved in several diseases. Pericarditis is inflammation of the pericardium, often causing chest pain and a characteristic ECG pattern. Pericardial effusion is accumulation of fluid in the pericardial space and can lead to cardiac tamponade if severe. Constrictive pericarditis results from scarring or thickening that restricts heart filling. Common causes include infections (viral, tuberculosis), autoimmune conditions, malignancy, uremia, trauma, and post-myocardial infarction syndromes.

Diagnosis typically relies on echocardiography to assess effusion or constriction, with supporting findings on ECG, chest radiography, and chest CT or MRI as needed.

Treatment depends on the condition. Mild pericarditis may improve with anti-inflammatory therapy such as NSAIDs and colchicine. Treatment of underlying causes is essential. Large effusions or tamponade require urgent pericardiocentesis or surgical drainage. Constrictive pericarditis may require pericardiectomy or other surgical interventions.