A thin covering that separates the heart from mediastinal structures.

The pericardium, also called pericardial sac.



A double-walled sac containing the heart and the roots of the great vessels. 



The pericardial sac has two layers, a serous layer and a fibrous layer. 



It encloses the pericardial cavity which contains pericardial fluid.


It protects the heart it from infections coming from other organs, and 

prevents excessive dilation of the heart in cases of acute volume overload.

The pericardium lubricates the heart



It fixes the heart to the mediastinum, gives protection against infection and provides lubrication for the heart. 


The right phrenic nerve passes to the right of the pericardium.

The left phrenic nerve passes over the pericardium of the left ventricle.

Pericardial arteries supply blood to the dorsal portion of the pericardium.

The pericardium sets the heart in the mediastinum and limits its motion.



It covers the heart.



The space between the two layers of serous pericardium, the pericardial cavity, is filled with serous fluid which protects the heart from any kind of external jerk or shock. 



The pericardial sac has 2 layers: the outermost fibrous pericardium and the inner serous pericardium.



The fibrous pericardium is the most superficial layer of the pericardium, and 


is made up of dense and loose connective tissue.



The fibrous pericardium protects the heart, anchoring it to the surrounding walls, and prevents it from overfilling with blood. 



The fibrous pericardium is continuous with the outer adventitial layer of the neighboring great blood vessels.



The serous pericardium, itself is divided into two layers, the parietal pericardium, which is fused to and inseparable from the fibrous pericardium, and the visceral pericardium, which is part of, or is synonymous with, the epicardium.



Both of these layers function by lubricating the heart to prevent friction during heart activity.



The visceral layer extends to the beginning of the great vessels becoming one with the parietal layer of the serous pericardium. 



In between the parietal and visceral pericardial layers there is a space called the pericardial cavity.



The pericardial cavity contains lubricating serous fluid known as the pericardial fluid. 

There are 2 layers of the sac, an outer fibrous pericardium and a double layered inner sac, the serous pericardium.

The serous pericardium includes the visceral layer, the epicardium, covering the heart and its proximal great vessels.

The visceral pericardium layer is reflected to form the parietal pericardium, which lines the fibrous pericardium.

The visceral and parietal layers are separated by the pericardial cavity.

There are recesses in the pericardial cavity, and when filledwith fluid may mimick mediastinal lymphadenopathy.



The visceral layer of serous pericardium comes into contact with heart, it is known as the epicardium. 



The epicardium is the layer immediately outside of the heart muscle.



The epicardium is largely made of connective tissue.



The epicardium and functions as a protective layer. 



During ventricular contraction, depolarization moves from the endocardial to the epicardial surface.

The pericardial cavity contains 15-50 cc of plasma ultrafiltrate.

Provides structural support and has substantial impact on the hemodynamics of the atria and ventricles.

Provides mechanical protection for the heart.

Reduces friction between heart and surrounding structures.

Not an essential structure, so in its absence cardiac function may be normal.

Diseases involving the pericardium include: pericarditis, acute or chronic, pericardial effusion, cardiac tamponade, and pericardial constriction.

Inflammation of the pericardium is called pericarditis. 



((Pericarditis)) typically causes chest pain that spreads to the back that is worsened by lying flat. 



Pericarditis may be associated with a pericardial friction rub.



Pericarditis is often caused by a viral infection, or more rarely with a bacterial infection, but may also occur following a myocardial infarction. 



Pericarditis is usually a short-lived condition that can be treated with painkillers, anti-inflammatory drugs.



In some cases, pericarditis can become a long-term condition causing restrictive scarring of the pericardium known as constrictive ((pericarditis)).



Constrictive pericarditis may require a pericardiectomy.


Fluid build up within the pericardial sack, referred to as a ((pericardial effusion)) often occur secondary to pericarditis, kidney failure, or tumors and frequently do not cause any symptoms. 

Large effusions or effusions that accumulate rapidly can compress the heart: cardiac tamponade, causing breathlessness and potentially fatal low blood pressure. 

Diseases of the pericardium associated with viral and bacterial organisms, malignancies, collagen-vascular diseases, renal failure, myocardial infarction, prior cardiac surgery, aortic dissection, radiation exposure, and rarely drugs.

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