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Pericardium
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Found between the outer and inner serous layers is the pericardial cavity, which contains a small amount of lubricating serous fluid. The serous fluid serves to minimize the friction generated by the heart as it contracts.
A lorry driver with chest pain
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
This condition is a medical emergency. Cardiac tamponade occurs when fluid (either blood or a pericardial effusion) collects between the visceral and parietal pericardium. As the outer fibrous pericardium is relatively inelastic, the heart volume is compromised by the fluid collection within the pericardial cavity. The rising intrapericardial pressure gradually reduces ventricular filling, and thus cardiac output. Eventually mechanical pump failure and death ensue.
The Cardiovascular System and its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The heart beats or contracts with a wringing action that requires a freedom of movement within the crowded confines of the mediastinal partition. To separate the heart from its surrounding structures, the pericardium(peri-: around) forms an envelope around the heart. The pericardial cavity, which lies between the outer surface of the heart and the inner surface of the pericardium, is filled with pericardial fluid that lubricates the beating action.
Pericardial Anatomy, Interventions and Therapeutics: A Contemporary Review
Published in Structural Heart, 2021
Reza Reyaldeen, Nicholas Chan, Saberio Lo Presti, Agostina Fava, Chris Anthony, E. Rene Rodriguez, Carmela D. Tan, Walid Saliba, Paul C Cremer, Allan L. Klein
The pericardial cavity typically consists of a reserve amount of fluid <50 mL generated by the mesothelial lining.1 This serous fluid, produced as a plasma ultrafiltrate and drained by the lymphatic vessels, permits the unimpeded expansion, within a protective range, of the ventricle during diastole.10 Any pathologic process that inflames, injuries, or impairs the lymphatic drainage, such as acute pericarditis, pericardial effusion, and constrictive pericarditis, alters the Starling forces of dynamic fluid exchange and may result in a substantial increase in pericardial fluid. In such cases, the pericardium readily transmits changes in intrathoracic pressures to the heart with important hemodynamic consequences. Pericardial constraint with associated ventricular interdependence, the mechanism by which pressure-volume changes in one ventricle intimately affect the other, are important components in the physiology underlying cardiac tamponade and constriction.1 The pressure–volume curve of the parietal pericardium has a non-linear association in the acute setting, which is related to the degree of inherent distensibility. Only a limited amount of extra fluid is accommodated without significant increase in the intrapericardial pressures. However, rapid accumulation of fluid around 100–200 ml, exponentially increases the intrapericardial pressures to 20–30 mm Hg with ensuing cardiac tamponade physiology. On the contrary, slow accumulation of fluid enables progressive pericardial stretch and distension, to accommodate even up to 2 L, prolonging the critical threshold.1,11–13
Therapeutic advances in cardiac targeted drug delivery: from theory to practice
Published in Journal of Drug Targeting, 2021
Cuican Li, Muhammad Naveed, Kashif Dar, Ziwei Liu, Mirza Muhammad Faran Ashraf Baig, Rundong Lv, Muhammad Saeed, Chen Dingding, Yu Feng, Zhou Xiaohui
The pericardium is a double-layered sac that wraps around the heart and blood vessels [60]. The space between the parietal and visceral pericardium is called the pericardial cavity that contains pericardial fluid. Intrapericardial injection is mostly completed by pericardiocentesis, and the drugs are stored in the pericardial cavity after intrapericardial injection to achieve the purpose of TDD. Pericardiocentesis is typically used in patients with pericardial effusion and is performed via the subxiphoid route, where a small amount of contrast medium is injected into the pericardium by a puncture needle [61]. For better safety, efficacy, and accuracy in clinical applications, many advanced scientific and technological tools were developed to assist in completing pericardiocentesis [62,63]. The development of these techniques serves as a basis for intrapericardial injection.
Postpericardiotomy syndrome after cardiac surgery
Published in Annals of Medicine, 2020
Joonas Lehto, Tuomas Kiviniemi
The first descriptions of PPS date back to 1950s, shortly after the establishment of the first surgical cardiac valve procedures, but before the introduction of cardiopulmonary bypass (CPB). In the year 1952, Janton and colleagues reported the results of their first 100 consecutive commissurotomies for mitral stenosis [3]. The authors observed unpredictable pleuropericardial pain unresponsive to salicylates, antibiotics, and ordinary doses of narcotics in about 30 percent of the patients. The symptoms occurred typically during the second postoperative week. The episodes were considered to be possible manifestations of smouldering rheumatic activity, though only one sixth of all patients had microscopic evidence of active rheumatic infection in the left auricular appendage. Soloff and colleagues investigated the syndrome further and observed an incidence of 24% after consecutive mitral commissurotomies [4]. Because of the misunderstood causality, the syndrome was named “postcommissurotomy syndrome” until 1958, when an identical state was detected following cardiac surgery in patients without rheumatic heart disease [17]. The syndrome was only observed when the pericardial cavity was entered, and consequently it was renamed “postpericardiotomy syndrome”.