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Pathophysiologic mechanisms in pericardial disease
Alejandro Vasquez1, Samuel M Butman
1Sarver Heart Center, 1501 North Campbell Avenue, Room 5152, Tucson, AZ 85724, USA. sbutman@aol.com
Insights
Pericardial diseases significantly impact heart function, affecting cardiac output and filling pressures. Advanced imaging aids in diagnosing conditions like cardiac tamponade and constrictive pericarditis.
Area of Science:
- Cardiology
- Medical Imaging
- Pathophysiology
Background:
- The pericardium, a sac surrounding the heart, indirectly influences cardiac performance.
- Pathologic pericardial conditions can profoundly affect cardiac function.
- Imaging modalities are crucial for understanding pericardial disease pathophysiology.
Purpose of the Study:
- To highlight the impact of pericardial diseases on cardiac function.
- To emphasize the role of imaging in diagnosing pericardial conditions.
- To discuss the increasing relevance of cardiac tamponade and challenges in diagnosing constrictive pericarditis.
Main Methods:
- Review of clinical and pathophysiological understanding of pericardial diseases.
- Discussion of imaging modalities used in diagnosis.
- Analysis of factors contributing to cardiac tamponade and constrictive pericarditis.
Main Results:
- Rising pericardial pressures reduce cardiac chamber transmural pressures, compromising filling and output.
- Increased incidence of cardiac tamponade is linked to antiplatelet agents and invasive devices.
- Constrictive pericarditis remains a diagnostic challenge despite advanced noninvasive methods.
Conclusions:
- Pericardial diseases significantly impair cardiac performance.
- Accurate diagnosis of pericardial conditions, particularly constrictive pericarditis, requires careful evaluation.
- Imaging plays a vital role in managing pericardial diseases.
Abstract:
The pericardium influences cardiac performance indirectly, but pathologic conditions may have profound effects on cardiac function. In recent years, several imaging modalities have been useful, both clinically and in understanding the pathophysiology of pericardial diseases. Rising pericardial pressures progressively reduce the average transmural pressure of the right and subsequently left cardiac chambers, compromising filling and output. This has become more relevant today, with the increased incidence of cardiac tamponade, attributed to the increased use of antiplatelet agents in combination with a more widespread use of invasive devices. On another front, although an uncommon diagnosis, constrictive pericarditis may be missed despite the excellence of a variety of noninvasive methods, and remains a difficult one to make.Introduction