Pericardium

Definition and function

The pericardium, also called pericardium in medicine, is a bag made of connective tissue that surrounds the heart, except for the outgoing vessels. The pericardium serves as a protective cover and prevents the heart from expanding excessively.

Anatomy and position

The pericardium consists of two layers: the layer that lies directly on the heart and an outer layer. In medicine they are called pericardium fibrosum (outer layer), which is made of collagen, and pericardium serosum (inner layer). The pericardium serosum in turn consists of two layers.

One is the lamina parietalis pericardii and the lamina visceralis pericardii, which lies directly on the heart. Between the two inner leaves there is a liquid, pericardial CSF, which is intended to reduce friction between the leaves. The amount of liquid is approximately 10 ml.

The leaves turn around in the area of the large vessels, i.e. the aorta and the vena cava. The pericardium is innervated, which means that it is supplied by nerves. These nerves include the vagus nerve and the phrenic nerve, both of which give off small branches that go to the heart. The blood supply is provided by the arteria thoracia interna via the ast arteria pericardiacophrenia.

Diagnostics

The easiest way to visualize the pericardium is by ultrasound. Ultrasound is the examination method of choice, especially for effusions. In case of fluid accumulation, it is also possible to puncture the pericardium and examine the fluid obtained. In addition, there is also the possibility of examining the pericardium by means of computer tomography. In this way, calcifications, for example, can be made visible.

Pathology

The inflammation of the pericardium is called pericarditis. It can be perceived as rubbing when listening to the heart. The accumulation of fluid in the pericardium is called pericardial effusion.

Failure to treat an increasing accumulation of fluid can lead to pericardial tamponade. Depending on the size of the pericardial tamponade, the heart can no longer expand and cardiogenic shock can occur. The therapy for pericardial tamponade is a puncture with drainage.