Pericarditis-Pericardial fluid

Pericarditis

In inflammation of the serous pericardium, called pericarditis, pericardial fluid may accumulate excessively, which can compress the thin-walled atria and interfere with the filling of the heart during diastole. This compression of the heart is called cardiac tamponade.

Cardiac tamponade can also occur secondary to stab or gunshot wounds when the chambers of the heart have been penetrated. The blood escapes into the pericardial cavity and can restrict the filling of the heart.

Roughening of the visceral and parietal layers of serous pericardium by inflammatory exudate in acute pericarditis produces pericardial friction rub, which can be felt on palpation and heard through a stethoscope.

 

Pericardial fluid can be aspirated from the pericardial cavity should excessive amounts accumulate in pericarditis. This process is called paracentesis. The needle can be introduced to the left of the xiphoid process in an upward and backward direction at an angle of 45° to the skin. When paracentesis is performed at this site, the pleura and lung are not damaged because of the presence of the cardiac notch in this area.