Pericardial Diseases

31 Pericardial Diseases


With Christian J. Kellenberger



  • image Pericardial diseases include the following:

    • • Congenital pericardial defects
    • • Pericarditis and pericardial effusion
    • • Pneumopericardium
    • • Pericardial mass

image Congenital Pericardial Defects


Classification



  • image Total or partial defects
  • image Left-sided defects more common when partial
  • image Small percent associated with intracardiac anomalies

Clinical Manifestations



  • image Complete defects almost always asymptomatic
  • image Partial defects may present with intermittent chest pain, and rarely herniation of the left atrial appendage may become incarcerated, which is life threatening.

Chest Radiographic Findings



  • image In complete absence of the pericardium, the heart is rotated leftward and is displaced away from the sternum and diaphragm.
  • image Prominence of main pulmonary artery
  • image Lung wedges between aorta and pulmonary artery
  • image Lung interposed between heart and hemidiaphragm
  • image Normal position of trachea and descending aorta
  • image Partial defects: focal prominence of left atrial appendage along the left upper heart border

image Pericardial Effusions and Pericarditis


Pathophysiology



  • image Most common causes of pericardial effusions are infectious and iatrogenic.
  • image Less common causes of pericardial effusions are neoplastic and connective tissue disorders.
  • image Infectious pericarditis most commonly viral, less commonly bacterial, tuberculous, or fungal
  • image Large pericardial effusion caused by bacterial pericarditis, malignancy, immune disorders, and sometimes never determined
  • image Constrictive pericarditis with adherent, thickened, fibrotic pericardium restricting diastolic filling of all chambers
  • image Pericardial effusion may complicate postoperative course with an unexplained enlargement of the cardiac silhouette size in a short interval.
  • image Postpericardotomy syndrome is postulated to be an autoimmune response, perhaps triggered by a viral infection, 1 to 6 weeks following surgery in which the pericardial cavity has been entered with development of pericardial effusions.

Clinical Manifestations

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Jan 14, 2016 | Posted by in RESPIRATORY IMAGING | Comments Off on Pericardial Diseases

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