Pericardial effusion pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
=== Physiology === | |||
[[Pericardium]] surrounds the heart and it consists of two layers, [[parietal]] and [[visceral]] layers. The space between the layers is known as the [[pericardial cavity]]. It usually contains small amount of fluid, approximately 15-50ml, which acts as a lubricating agent between the layers. This fluid enters the pericardial space from the capillaries into the visceral pericardium. This fluid is drained by [[lymphatics]]. When this fluid production-drainage mechanism is altered, excess fluid accumulates in the pericardial cavity and this is referred to as [[pericardial effusion]]. | [[Pericardium]] surrounds the heart and it consists of two layers, [[parietal]] and [[visceral]] layers. The space between the layers is known as the [[pericardial cavity]]. It usually contains small amount of fluid, approximately 15-50ml, which acts as a lubricating agent between the layers. This fluid enters the pericardial space from the capillaries into the visceral pericardium. This fluid is drained by [[lymphatics]]. When this fluid production-drainage mechanism is altered, excess fluid accumulates in the pericardial cavity and this is referred to as [[pericardial effusion]]. | ||
=== Pathogenesis === | |||
Therefore, pericardial effusion occurs when there is: | Therefore, pericardial effusion occurs when there is: | ||
===Increased Production of Pericardial Fluid=== | ===Increased Production of Pericardial Fluid=== | ||
====1.Increased Capillary Membrane Permeability==== | ====1. Increased Capillary Membrane Permeability==== | ||
[[Infection]] or [[inflammation]] may lead to [[exudative]] fluid or hemorrhagic effusion which have high protein levels. The pericardial effusion observed in the following conditions results from increased permeability of the capillary membrane. | [[Infection]] or [[inflammation]] may lead to [[exudative]] fluid or hemorrhagic effusion which have high protein levels. The pericardial effusion observed in the following conditions results from increased permeability of the capillary membrane. | ||
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*[[Malignancies]] such as [[pulmonary carcinoma]] may metastasize to the [[pericardium]] and can disrupt pericardial anatomy and vasculature | *[[Malignancies]] such as [[pulmonary carcinoma]] may metastasize to the [[pericardium]] and can disrupt pericardial anatomy and vasculature | ||
====2.Increased Microvascular Pressure==== | ====2. Increased Microvascular Pressure==== | ||
Hypervolemic states like [[cardiac failure]] and [[renal failure]]cause pericardial effusion due to increased microvascular pressure. | Hypervolemic states like [[cardiac failure]] and [[renal failure]]cause pericardial effusion due to increased microvascular pressure. | ||
====3.Decreased Plasma Oncotic Pressure==== | ====3. Decreased Plasma Oncotic Pressure==== | ||
Pericardial effusion seen in [[cirrhosis]] and [[nephrotic syndrome]] is due to decreased plasma [[oncotic pressure]] secondary to [[hypoalbuminemia]]. | Pericardial effusion seen in [[cirrhosis]] and [[nephrotic syndrome]] is due to decreased plasma [[oncotic pressure]] secondary to [[hypoalbuminemia]]. | ||
===Decreased Drainage of Pericardial Fluid=== | ===Decreased Drainage of Pericardial Fluid=== | ||
Pericardial effusion may occur in [[malignancies]] and [[hypothyroidism]] due to decreased drainage of the pericardial fluid by the [[lymphatics]]. | Pericardial effusion may occur in [[malignancies]] and [[hypothyroidism]] due to decreased drainage of the pericardial fluid by the [[lymphatics]]. | ||
== Genetics == | |||
Genes involved in the pathogenesis of [disease name] include: | |||
* [Gene1] | |||
* [Gene2] | |||
* [Gene3] | |||
OR | |||
The development of [disease name] is the result of multiple genetic mutations such as: | |||
* [Mutation 1] | |||
* [Mutation 2] | |||
* [Mutation 3] | |||
== Associated Conditions == | |||
Conditions associated with [disease name] include: | |||
* [Condition 1] | |||
* [Condition 2] | |||
* [Condition 3] | |||
== Gross Pathology == | |||
On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name]. | |||
== Microscopic Pathology == | |||
On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name]. | |||
==References== | ==References== | ||
Revision as of 02:45, 2 March 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.
Overview
Pericardial effusion usually results from a disturbed equilibrium between the production and reabsorption of pericardial fluid. This can occur in infections and inflammations where there is increased production of pericardial fluid or in malignancy and hypothyroidism where there is inadequate drainage of the fluid.
Pathophysiology
Physiology
Pericardium surrounds the heart and it consists of two layers, parietal and visceral layers. The space between the layers is known as the pericardial cavity. It usually contains small amount of fluid, approximately 15-50ml, which acts as a lubricating agent between the layers. This fluid enters the pericardial space from the capillaries into the visceral pericardium. This fluid is drained by lymphatics. When this fluid production-drainage mechanism is altered, excess fluid accumulates in the pericardial cavity and this is referred to as pericardial effusion.
Pathogenesis
Therefore, pericardial effusion occurs when there is:
Increased Production of Pericardial Fluid
1. Increased Capillary Membrane Permeability
Infection or inflammation may lead to exudative fluid or hemorrhagic effusion which have high protein levels. The pericardial effusion observed in the following conditions results from increased permeability of the capillary membrane.
- Viral/bacterial infections such as adenovirus infection and tuberculosis
- Autoimmune diseases such as sarcoidosis, SLE and rheumatoid arthritis
- Penetrating trauma which injure the blood vessels and cause hemorrhage into the pericardial space
- Malignancies such as pulmonary carcinoma may metastasize to the pericardium and can disrupt pericardial anatomy and vasculature
2. Increased Microvascular Pressure
Hypervolemic states like cardiac failure and renal failurecause pericardial effusion due to increased microvascular pressure.
3. Decreased Plasma Oncotic Pressure
Pericardial effusion seen in cirrhosis and nephrotic syndrome is due to decreased plasma oncotic pressure secondary to hypoalbuminemia.
Decreased Drainage of Pericardial Fluid
Pericardial effusion may occur in malignancies and hypothyroidism due to decreased drainage of the pericardial fluid by the lymphatics.
Genetics
Genes involved in the pathogenesis of [disease name] include:
- [Gene1]
- [Gene2]
- [Gene3]
OR
The development of [disease name] is the result of multiple genetic mutations such as:
- [Mutation 1]
- [Mutation 2]
- [Mutation 3]
Associated Conditions
Conditions associated with [disease name] include:
- [Condition 1]
- [Condition 2]
- [Condition 3]
Gross Pathology
On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
Microscopic Pathology
On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].