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This review presents a morphologic classification for pericardial heart disease, a condition often unrecognized clinically. It clarifies that "pericarditis" is often inaccurate as many pericardial diseases are noninflammatory.
Area of Science:
- Cardiology
- Pathology
Background:
- Pericardial heart disease is clinically uncommon and often undiagnosed during life.
- The term "pericarditis" is frequently inaccurate, as most pericardial diseases are noninflammatory.
- A comprehensive classification integrating clinical, etiologic, and morphologic features is currently lacking.
Purpose of the Study:
- To review the morphologic aspects of pericardial heart disease.
- To present a novel morphologic classification for pericardial heart disease.
Main Methods:
- Review of existing literature on pericardial heart disease.
- Analysis of morphologic features relevant to classification.
Main Results:
- Morphologic classification of pericardial heart disease is proposed.
- Chronic pericardial disease can present as acute illness.
- Cardiac dysfunction (constriction) results from increased pericardial fluid or tissue.
Conclusions:
- A morphologic classification aids in understanding pericardial heart disease.
- Treatment strategies differ based on whether increased fluid (drainage) or tissue (excision) is the cause of constriction.
- Etiology often remains unclear even after histologic examination.
Abstract:
This report reviews morphologic aspects of pericardial heart disease. A morphologic classification for this condition is presented. An ideal classification of pericardial heart disease obviously would take into account clinical, etiologic and morphologic features of this condition but a single classification combining these 3 components is lacking. Pericardial heart disease is relatively uncommon clinically and when present at necropsy it usually had not been recognized during life. The term "pericarditis" is inaccurate because most pericardial diseases are noninflammatory in nature. Morphologically chronic pericardial heart disease may present clinically as an acut eillness. Even when clinical symptoms are present, however, fewpatients develop evidence of cardiac dysfunction (constriction). When pericardial "constriction" occurs, it is the result of increased pericardial fluid or increased pericardial tissue or both. Increased fluid is treated by drainage; increased tissue is treated by excision. In most patients with chronic constrictive "pericarditis," the etiology is not apparent even after histologic examination of pericardia.