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Harrison's Principles of Internal Medicine, 18e
| Part 10. Disorders of the Cardiovascular System > Section 4. Disorders of the Heart > |
Chapter 239. Pericardial Disease
Sections: Pericardial Disease: Introduction, Acute Pericarditis, Chronic Constrictive Pericarditis, Other Disorders of the Pericardium, Further Readings.
Topics Discussed: pericardial disease; pericarditis.
Excerpt:"The normal pericardium is a double-layered sac; the visceral pericardium is a serous membrane that is separated by a small quantity (15–50 mL) of fluid, an ultrafiltrate of plasma, from the fibrous parietal pericardium. The normal pericardium, by exerting a restraining force, prevents sudden dilation of the cardiac chambers, especially the right atrium and ventricle, during exercise and with hypervolemia. It also restricts the anatomic position of the heart, minimizes friction between the heart and surrounding structures, prevents displacement of the heart and kinking of the great vessels, and probably retards the spread of infections from the lungs and pleural cavities to the heart. Nevertheless, total absence of the pericardium, either congenital or after surgery, does not produce obvious clinical disease. In partial left pericardial defects, the main pulmonary artery and left atrium may bulge through the defect; very rarely, herniation and subsequent strangulation of the left atrium may cause sudden death...."
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