Abstract
The pericardium is a membranous sac surrounding the heart and the roots of the great vessels that is composed of both fibrous and serosal layers (Fig. 1.1). The fibrous layer of pericardium forms a conical-like sac surrounding the heart; superiorly, the fibrous pericardium is attached to and is continuous with the adventitia of the great vessels as well as with the pretracheal fascia. The pericardium is attached anteriorly to the manubrium and xiphoid process by the sternopericardial ligaments, posteriorly to the vertebral column and inferiorly to central tendon of the diaphragm. The pericardium is separated from the anterior thoracic wall by the lungs and pleura but is in direct contact with it at the lower left half of the sternum and the sternal abutments of the left fourth and fifth costal cartilages [1]. The phrenic nerves contained within the pericardiophrenic bundles pass laterally along each side of the heart between the fibrous pericardium and mediastinal pleura. The serosal pericardium consists of two layers, a serous visceral layer (epicardium) that is adherent to the heart and epicardial fat and a serous layer which lines the internal surface of the fibrous pericardium together forming the parietal pericardium.
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References
Standring S, Gray H. Gray’s anatomy: the anatomical basis of clinical practice. 40th ed. Edinburgh: Churchill Livingstone, Elsevier, 2008.
Peebles CR, Shambrook JS, Harden SP. Pericardial diseas–natomy and function. Br J Radiol. 2011;84(3): S324–37.
Little WC, Freeman GL. Pericardial disease. Circulation. 2006;113(12):1622–32.
Ishihara T, Ferrans VJ, Jones M, Boyce SW, Kawanami O, Roberts WC. Histologic and ultrastructural features of normal human parietal pericardium. Am J Cardiol. 1980;46(5):744–53.
Costa R, Scanavacca M, da Silva KR, Martinelli Filho M, Carrillo R. Novel approach to epicardial pacemaker implantation in patients with limited venous access. Heart Rhythm. 2013;10(11):1646–52.
Lachman N, Syed FF, Habib A, Kapa S, Bisco SE, Venkatachalam KL, Asirvatham SJ. Correlative anatomy for the electrophysiologist, part I: the pericardial space, oblique sinus, transverse sinus. J Cardiovasc Electrophysiol. 2010;21(12):1421–6.
Basile A, Bisceglie P, Giulietti G, Calcara G, Figuera M, Mundo E, Granata A, Runza G, Privitera C, Privitera G, Patti MT. Prevalence of “high-riding” superior pericardial recesses on thin-section 16-MDCT scans. Eur J Radiol. 2006;59(2):265–9.
Mahabadi AA, Massaro JM, Rosito GA, Levy D, Murabito JM, Wolf PA, O’Donnell CJ, Fox CS, Hoffmann U. Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study. Eur Heart J. 2009;30(7):850–6.
Bertaso AG, Bertol D, Duncan BB, Foppa M. Epicardial fat: definition, measurements and systematic review of main outcomes. Arq Bras Cardiol. 2013;101(1):e18–28.
Eliskova M, Eliska O, Miller AJ. The lymphatic drainage of the parietal pericardium in man. Lymphology. 1995;28(4):208–17.
Holt JP. The normal pericardium. Am J Cardiol. 1970;26(5):455–65.
Miyazaki T, Pride HP, Zipes DP. Prostaglandins in the pericardial fluid modulate neural regulation of cardiac electrophysiological properties. Circ Res. 1990;66(1):163–75.
Freeman GL, LeWinter MM. Pericardial adaptations during chronic cardiac dilation in dogs. Circ Res. 1984;54(3):294–300.
Hort W. Herzbeutel und herzgrosse. Arch Kreislaufforsch. 1964;44:21–35.
Spodick DH. The normal and diseased pericardium: current concepts of pericardial physiology, diagnosis and treatment. J Am Coll Cardiol. 1983;1(1):240–51.
Klein AL, Abbara S, Agler DA, Appleton CP, Asher CR, Hoit B, Hung J, Garcia MJ, Kronzon I, Oh JK, Rodriguez ER, Schaff HV, Schoenhagen P, Tan CD, White RD. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013;26(9):965–1012.e15.
Shabetai R, Mangiardi L, Bhargava V, Ross Jr J, Higgins CB. The pericardium and cardiac function. Prog Cardiovasc Dis. 1979;22(2):107–34.
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Tabaksblat, M.Y., Halpern, D.G., Argulian, E., Herzog, E. (2014). Anatomy and Physiology of the Pericardium. In: Herzog, E. (eds) Management of Pericardial Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-06124-5_1
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DOI: https://doi.org/10.1007/978-3-319-06124-5_1
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