Pericardial fluid is the serous fluid secreted by the serous layer of the pericardium into the pericardial cavity. The pericardium consists of two layers, an outer fibrous layer and the inner serous layer. This serous layer has two membranes which enclose the pericardial cavity into which is secreted the pericardial fluid. The fluid is similar to the cerebrospinal fluid of the brain which also serves to cushion and allow some movement of the organ. [1]
The pericardial fluid reduces friction within the pericardium by lubricating the epicardial surface allowing the membranes to glide over each other with each heart beat. [2]
Ben-Horin et al. (2005) studied the composition of pericardial fluid in patients undergoing open heart surgery. They found that the fluid is made up of a high concentration of lactate dehydrogenase (LDH), protein and lymphocytes. In a healthy adult there is up to 50 ml of clear, straw-coloured fluid. [3] However, there is little data on the normal composition of pericardial fluid to serve as a reference. [4] [5]
In patients with ischemic heart disease there is an accumulation of angiogenic growth factors in the pericardial fluid. These contribute to angiogenesis (the formation of new blood vessels) and arteriogenesis (the increase in diameter of existing arterioles). This helps to prevent myocardial ischemia (lack of oxygen to the heart). [6]
A pericardial effusion is the presence of excessive pericardial fluid, this can be confirmed using an echocardiogram. [7] Small effusions are not necessarily dangerous and are commonly caused by infection such as HIV or can occur after cardiac surgery. Large and rapidly accumulating effusions may cause cardiac tamponade, a life-threatening complication, that puts pressure on the heart preventing the ventricles from filling correctly.
Pericardiocentesis is a procedure used to remove the pericardial fluid from the pericardial cavity. It is performed using a needle and under the guidance of an ultrasound. [8] It can be used to relieve pressure from pericardial effusions or for diagnostic purposes, showing the cause of abnormalities such as: Cancer, Cardiac perforation, Cardiac trauma, Congestive heart failure, Pericarditis rupture of a ventricular aneurysm. [5]
This can also be used to treat pericardial effusion or cardiac tamponade.
The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication between the membranes, and also to create a pressure gradient.
The pericardium, also called pericardial sac, is a double-walled sac containing the heart and the roots of the great vessels. It has two layers, an outer layer made of strong connective tissue, and an inner layer made of serous membrane. It encloses the pericardial cavity, which contains pericardial fluid, and defines the middle mediastinum. It separates the heart from interference of other structures, protects it against infection and blunt trauma, and lubricates the heart's movements.
Cardiac tamponade, also known as pericardial tamponade, is a compression of the heart due to pericardial effusion (the build-up of pericardial fluid in the sac around the heart. Onset may be rapid or gradual. Symptoms typically include those of obstructive shock including shortness of breath, weakness, lightheadedness, and cough. Other symptoms may relate to the underlying cause.
Pericarditis is inflammation of the pericardium, the fibrous sac surrounding the heart. Symptoms typically include sudden onset of sharp chest pain, which may also be felt in the shoulders, neck, or back. The pain is typically less severe when sitting up and more severe when lying down or breathing deeply. Other symptoms of pericarditis can include fever, weakness, palpitations, and shortness of breath. The onset of symptoms can occasionally be gradual rather than sudden.
Pericardiocentesis (PCC), also called pericardial tap, is a medical procedure where fluid is aspirated from the pericardium.
The peritoneal cavity is a potential space between the parietal peritoneum and visceral peritoneum. The parietal and visceral peritonea are layers of the peritoneum named depending on their function/location. It is one of the spaces derived from the coelomic cavity of the embryo, the others being the pleural cavities around the lungs and the pericardial cavity around the heart.
Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium. It consists of fever, pleuritic pain, pericarditis and/or a pericardial effusion.
The mediastinum is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is an undelineated region that contains a group of structures within the thorax, namely the heart and its vessels, the esophagus, the trachea, the phrenic and cardiac nerves, the thoracic duct, the thymus and the lymph nodes of the central chest.
The serous membrane is a smooth tissue membrane of mesothelium lining the contents and inner walls of body cavities, which secrete serous fluid to allow lubricated sliding movements between opposing surfaces. The serous membrane that covers internal organs is called a visceral membrane; while the one that covers the cavity wall is called the parietal membrane. Between the two opposing serosal surfaces is often a potential space, mostly empty except for the small amount of serous fluid.
A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane. The two layers of the serous membrane enclose the pericardial cavity between them. This pericardial space contains a small amount of pericardial fluid. The fluid is normally 15-50 mL in volume. The pericardium, specifically the pericardial fluid provides lubrication, maintains the anatomic position of the heart in the chest, and also serves as a barrier to protect the heart from infection and inflammation in adjacent tissues and organs.
In physiology, serous fluid or serosal fluid is any of various body fluids resembling serum, that are typically pale yellow or transparent and of a benign nature. The fluid fills the inside of body cavities. Serous fluid originates from serous glands, with secretions enriched with proteins and water. Serous fluid may also originate from mixed glands, which contain both mucous and serous cells. A common trait of serous fluids is their role in assisting digestion, excretion, and respiration.
Acute pericarditis is a type of pericarditis usually lasting less than 6 weeks. It is the most common condition affecting the pericardium.
Electrical alternans is an electrocardiographic phenomenon of alternation of QRS complex amplitude or axis between beats and a possible wandering base-line. It is seen in cardiac tamponade and severe pericardial effusion and is thought to be related to changes in the ventricular electrical axis due to fluid in the pericardium, as the heart essentially wobbles in the fluid filled pericardial sac.
Pericardiectomy is the surgical removal of part or most of the pericardium. This operation is most commonly used to relieve constrictive pericarditis, or to remove a pericardium that is calcified and fibrous. It may also be used for severe or recurrent cases of pericardial effusion. Post-operative outcomes and mortality are significantly impacted by the disease it is used to treat.
Obstructive shock is one of the four types of shock, caused by a physical obstruction in the flow of blood. Obstruction can occur at the level of the great vessels or the heart itself. Causes include pulmonary embolism, cardiac tamponade, and tension pneumothorax. These are all life-threatening. Symptoms may include shortness of breath, weakness, or altered mental status. Low blood pressure and tachycardia are often seen in shock. Other symptoms depend on the underlying cause.
Hemopericardium refers to blood in the pericardial sac of the heart. It is clinically similar to a pericardial effusion, and, depending on the volume and rapidity with which it develops, may cause cardiac tamponade.
The Hs and Ts is a mnemonic used to aid in remembering the possible reversible causes of cardiac arrest. A variety of disease processes can lead to a cardiac arrest; however, they usually boil down to one or more of the "Hs and Ts".
A pericardial window is a cardiac surgical procedure to create a fistula – or "window" – from the pericardial space to the pleural cavity. The purpose of the window is to allow a pericardial effusion or cardiac tamponade to drain from the space surrounding the heart into the chest cavity.
Postpericardiotomy syndrome (PPS) is a medical syndrome referring to an immune phenomenon that occurs days to months after surgical incision of the pericardium. PPS can also be caused after a trauma, a puncture of the cardiac or pleural structures, after percutaneous coronary intervention, or due to pacemaker or pacemaker wire placement.
The pulmonary pleurae are the two opposing layers of serous membrane overlying the lungs and the inside of the surrounding chest walls.