Merck Manual

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Overview of Pericardial Disease


The Manual's Editorial Staff

Last full review/revision Oct 2019| Content last modified Oct 2019
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What is the pericardium?

"Peri" means all around, and "cardiac" refers to your heart. So, the pericardium is the sac that goes around your heart. The pericardium helps:

  • Keep the heart in position

  • Prevent the heart from overfilling with blood

  • Protect the heart from being damaged by chest infections

Even though the pericardium is useful, you don't need it to live. If your pericardium is removed, your heart keeps working.

The pericardium is made of 2 thin layers. The space between the 2 layers has some fluid that helps the layers slide easily over one another.

What disorders affect the pericardium?

Rarely, the pericardium is missing at birth or has defects, such as weak spots or holes. These defects can be dangerous because the heart or a major blood vessel may bulge (herniate) through a hole and become trapped. Doctors do surgery to fix the hole or remove the pericardium.

Infections, injuries, and the spread of cancer can trigger disorders affecting the pericardium.

The most common disorder is

Pericarditis may be:

  • Acute—inflammation starts shortly after the triggering illness

  • Subacute—inflammation starts a few weeks to a few months after a triggering illness

  • Chronic—inflammation that lasts longer than 6 months

Other disorders of the pericardium include:

  • Pericardial effusion—too much fluid stays in the pericardial space, which can stop the heart from properly filling with blood

  • Constrictive pericarditis—the fluid in the pericardium becomes thick and fibrous and causes the layers of the pericardium to stick together

  • Fibrosis of the pericardium—the pericardium gets thick and scarred

  • Hemopericardium—blood gets in the pericardial space and can cause pericarditis or scarring

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