10th May 2025

Background

Pericardial disease is a relatively common cause of chest pain seen in clinical practice, and can be seen  either as an isolated disease, or as a secondary cause of another systemic pathology. The pericardium  consists of a fibrous conical shaped sac (fibrous pericardium), and a layer of serosa that lines the fibrous  pericardium, as well as the great vessels and heart (serous pericardium). These are separated by a potential  space (estimated to be around 15 – 50ml) of plasma in healthy individuals. The pericardium keeps the  heart in a stable location attached to the mediastinum, as well as providing a lubricated surface for the  heart to beat in, equalise hydrostatic, gravitational, and inertial forces to maintain the correct geometry of  the cardiac chambers (most notably the left ventricle), and is a barrier against infection. This chapter will  concentrate on the main pathologies involving the pericardium. all of which are interconnected, with one  pericardial disease possibly resulting in another.