CURRENT Diagnosis & Treatment: Cardiology, 3e
Chapter 17. Pericardial Diseases
Sections: General Considerations, Pathogenesis, Acute Pericarditis, Pericardial Effusion, Cardiac Tamponade, Constrictive Pericarditis, Effusive-Constrictive Pericarditis.
Topics Discussed: pericardial disease.
Excerpt:"The pericardium consists of two layers: a serous visceral layer, which is intimately adherent to the heart and epicardial fat, and
a fibrous parietal layer. The pericardium encloses the greater part
of the surface of the heart, the juxtacardial portions of the pulmonary
and systemic veins, and the proximal segments of the great vessels.
A significant portion of the left atrium, however, is not enclosed
within the pericardium. The pericardium is attached by ligaments
to the manubrium sterni, the xiphoid process, the vertebral column,
and the central tendon of the diaphragm. The pericardium is not essential
for sustaining life or health, as evidenced by preservation of cardiac
function even if the pericardium is congenitally absent or surgically
removed. The pericardium does play a role in normal cardiovascular
function, however, and can be involved in a number of important
disease states. The normal functions of the pericardium include
maintaining an optimal cardiac shape, promoting cardiac chamber
interaction, preventing the overfilling of the heart, reducing friction
between the beating heart and adjacent structures, providing a physical
barrier to infection, and limiting displacement during the cardiac
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