Pericardial disease can be an important cause of morbidity and mortality in a clinical cardiology practice. However, patients with pericardial disease are not always encountered on a daily basis, and because pericardial disease can mimic other diseases, such as cardiovascular, pulmonary and pleural processes a firm diagnosis may be difficult. Frequently, pericardial involvement can be the initial presentation of a systemic disease process. Disorders of the pericardium can also have a variety of etiologies, including congenital malformations along with infectious, infarction-related, metabolic, autoimmune, traumatic, neoplastic, and idiopathic processes. Additionally, accurate diagnosis of a pericardial disorder may require the use of multiple noninvasive tests or a noninvasive test coupled with an invasive study.
KeywordsCardiac Magnetic Resonance Pericardial Effusion Cardiac Compute Tomography Constrictive Pericarditis Pericardial Disease
Partial Absence of the Pericardium. Axial bright blood view near the level of the pulmonary artery bifurcation showing left atrial appendage herniation through the defect in the pericardium (Video courtesy of Dr. Mark Fogel) (AVI 11605 kb)
Constrictive Pericarditis in a Patient with a Pacemaker. An axial cine image of a patient with constrictive pericarditis. This occurred after a pacemaker lead revision procedure. Note the thickened black pericardium with adherence anterior to the right ventricular free wall. The dark signal void in the right atrium and ventricle are from the right ventricular pacemaker lead. Bilateral pleural effusion are also present (AVI 29727 kb)
Constrictive Pericarditis in a Patient with a Pacemaker using Myocardial Tagging. Adherence of the visceral to parietal pericardium is evident anterior to the right ventricular free wall. The tags do not deform in this area suggesting loss of slippage between the myocardium and pericardium (AVI 29727 kb)
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