Pericarditis pathophysiology: Difference between revisions
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==Overview== | |||
Pericarditis is inflammation of the [[pericardium]], the double-walled sac that contains the heart and the roots of the great vessels. There can be an accompanying accumulation of fluid that can be either [[serous]] (free flowing fluid) or fibrinous (an [[exudate]], which is a thick fluid composed of proteins, [[fibrin]] strands, inflammatory cells, cell breakdown products, and sometimes [[bacteria]]). Vascular congestion of the [[pericardium]] is also present. The underlying [[myocardium]] may or may not be inflammed as well. If the myocardium is involved in the [[inflammatory process]], then this is called myopericarditis, and the [[CK]] and [[troponin]] may be elevated. | |||
==Classification== | ==Classification== | ||
Revision as of 15:24, 26 June 2011
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Pericarditis Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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Pericarditis pathophysiology On the Web |
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American Roentgen Ray Society Images of Pericarditis pathophysiology |
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Risk calculators and risk factors for Pericarditis pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pericarditis is inflammation of the pericardium, the double-walled sac that contains the heart and the roots of the great vessels. There can be an accompanying accumulation of fluid that can be either serous (free flowing fluid) or fibrinous (an exudate, which is a thick fluid composed of proteins, fibrin strands, inflammatory cells, cell breakdown products, and sometimes bacteria). Vascular congestion of the pericardium is also present. The underlying myocardium may or may not be inflammed as well. If the myocardium is involved in the inflammatory process, then this is called myopericarditis, and the CK and troponin may be elevated.
Classification
Pericarditis can be classified according to the composition of the inflammatory exudate or the composition of the fluid that accumulates around the heart.
Types include:
Acute Versus Chronic Pericarditis
Depending on the timing of presentation and duration, pericarditis is divided into "acute" and "chronic" forms. Clinically, acute pericarditis presents within 6 weeks of the disease onset; subacute pericarditis presents within 6 weeks to 6 months of the disease onset; and chronic pericarditis manifests after 6 months of the disease onset.Acute pericarditis is more common than chronic pericarditis, and often occurs as a complication of viral infections, immunologic conditions, or as a result of a heart attack (myocardial infarction). Chronic pericarditis is less common, which may manifest as scarring of the pericardium a condition known as constrictive pericarditis.
Gross Pathology Images
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Fibrinous pericarditis: Gross, natural color, an excellent example of bread and butter appearance. Uremia, chronic glomerulonephritis and sepsis.
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Fibrinous pericarditis: Gross, a good example (bread and butter appearance).
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Fibrinous pericarditis: Gross, an excellent example.
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Fibrinous pericarditis: Gross, an excellent example, close-up view of fibrin.
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Fibrinous pericarditis: Gross, an excellent example, close-up view.
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Fibrinous pericarditis: Gross, an excellent example.
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Fibrinous pericarditis: Gross, external view of localized pericarditis over an acute infarction
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Fibrinous pericarditis: Gross, intact heart, good example
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Fibrinous pericarditis: Gross, good example, mild, with small amount of fibrin
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Fibrinous pericarditis: Gross, close-up, an excellent example of color and detail
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Fibrinous pericarditis: Gross, a good example
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Fibrinous pericarditis: Gross, a good example, very mild case
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Fibrinous pericarditis: Gross, an excellent example.
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Fibrinous pericarditis: Gross, a close-up view, an excellent illustration of fibrinous exudate.
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Pericarditis in uremia
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Fibrinous pericarditis: Gross, fixed tissue (note to color changes), a close-up view of fibrin on epicardial surface of heart. A typical example.
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Fibrinous pericarditis: Gross, natural color, large right atrial thrombus and fibrinous pericarditis. Normal tricuspid valve with some aging changes (good example)
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Fibrinous pericarditis: Gross, natural color
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Fibrinous pericarditis: Gross, natural color, an excellent example
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Fibrinous pericarditis: Gross, natural color, very close-up photo showing fibrinous exudate simulating frost (an excellent example)
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Rheumatoid fibrinous pericarditis: Gross, natural color, a typical lesion in 22 years old white female due to juvenile rheumatoid arthritis.
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Fibrinous pericarditis: Gross, natural color, close-up view of minimal fibrinous exudate on epicardial surface due to terminal renal failure
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Fibrinous pericarditis: Gross, natural color, anterior view of heart with mild fibrinous exudate over epicardium due to terminal renal failure
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Tuberculous pericarditis: Gross, natural color, shaggy hemorrhagic exudate. This case is much more hemorrhagic than the typical tuberculous pericarditis.
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Heart transplant: Gross, natural color, external view of heart. Two months after transplantation with fibrinous pericarditis
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Neoplastic pericarditis: Gross, natural color, shaggy pericarditis. Primer is adenocarcinoma of the lung.
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Heart: Septic pericarditis
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Hemopericardium: Gross, an excellent in situ view
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Hemopericardium: Gross, in situ, unopened pericardium (a very good example)
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Hemopericardium: Gross, natural color, heart in situ with opened pericardium and filled with red blood clot (quite good example) dissecting aneurysm
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Hemopericardium due to Needle Puncture: Gross, natural color, external view of heart covered by blood
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Needle Puncture Mark in Epicardium: Gross, natural color, close-up of needle puncture marks tap resulted in hemopericardium
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Hemopericardium: Hemopericardium caused by pericardiocentesis: Gross, natural color, close-up view of apex of the heart. Needle apparently entered the distal posterior descending artery.
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Hemopericardium: Hemopericardium caused by pericardiocentesis: Gross, natural color, view of apex of the heart. Needle apparently entered the distal posterior descending artery
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Hemopericardium: Hemopericardium due to pericardiocentesis: Gross, fixed tissue, close-up view of slice through distal posterior descending artery showing periarterial hemorrhage
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Hemopericardium: Liver: Gross, natural color, typical shock liver case of death due to hemopericardium secondary to pericardiocentesis
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Hemopericardium in newborn: Gross, natural color, opened body with large collection blood in pericardial sac. Cause uncertain. A 26 week premature with hyaline membrane disease and DIC
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Hemopericardium: Myocardial Infarction and Ventricular Rupture
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Hemopericardium: Infarct rupture after 7 days of chest pain onset.
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Hemopericardium in dissecting aneurysm: Gross, heart with root of aorta to show hemorrhage into pericardium (very good example)
Microscopic Pathology Images
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Tuberculous pericarditis.
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Tuberculous pericarditis.
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Tuberculous pericarditis: Micro oil acid fast stain. The organism easily seen.
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Tuberculous pericarditis: Micro oil acid fast stain. The organism easily seen.
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Uremic pericarditis: Micro med mag, H&E. A good example
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Tuberculous pericarditis: Micro med mag, H&E, a typical lesion
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Fibrinous pericarditis.
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Pericarditis fibrinosa (Fibrinous pericarditis).
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Malignant Mesothelioma, Biphasic Type: Pericardium: This tumor has epithelioid cells (lower half) surrounded by spindled cells. The patient was a 46-year-old woman with constrictive pericarditis; the pericardium was studded with coalescing tumor nodules.
- <Youtube v=AKS7kSl4x5k/>
- Acute fibrinous pericarditis
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