Pericardial fluid is the

serous fluid In physiology, serous fluid or serosal fluid (originating from the Medieval Latin word ''serosus'', from Latin ''serum'') is any of various body fluids resembling serum, that are typically pale yellow or transparent and of a benign nature. The fl ...

secreted by the serous layer of the

pericardium The pericardium, also called pericardial sac, is a double-walled sac containing the heart and the roots of the great vessels. It has two layers, an outer layer made of strong connective tissue (fibrous pericardium), and an inner layer made ...

into the

pericardial cavity The pericardium, also called pericardial sac, is a double-walled sac containing the heart and the roots of the great vessels. It has two layers, an outer layer made of strong connective tissue (fibrous pericardium), and an inner layer made of ...

. The pericardium consists of two layers, an outer fibrous layer and the inner serous layer. This serous layer has two membranes which enclose the pericardial cavity into which is secreted the pericardial fluid. The fluid is similar to the

cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the ...

of the brain which also serves to cushion and allow some movement of the organ. __TOC__

Function

The pericardial fluid reduces friction within the pericardium by lubricating the epicardial surface allowing the membranes to glide over each other with each heart beat.

Composition

Ben-Horin ''et al.'' (2005) studied the composition of pericardial fluid in patients undergoing

open heart surgery Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to c ...

. They found that the fluid is made up of a high concentration of

lactate dehydrogenase Lactate dehydrogenase (LDH or LD) is an enzyme found in nearly all living cells. LDH catalyzes the conversion of lactate to pyruvate and back, as it converts NAD+ to NADH and back. A dehydrogenase is an enzyme that transfers a hydride from one ...

(LDH), protein and

lymphocytes A lymphocyte is a type of white blood cell (leukocyte) in the immune system of most vertebrates. Lymphocytes include natural killer cells (which function in cell-mediated, cytotoxic innate immunity), T cells (for cell-mediated, cytotoxic ada ...

. In a healthy adult there is up to 50 ml of clear, straw-coloured fluid. However, there is little data on the normal composition of pericardial fluid to serve as a reference.

Ischemic heart disease

In patients with

ischemic heart disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pl ...

there is an accumulation of angiogenic growth factors in the pericardial fluid. These contribute to

angiogenesis Angiogenesis is the physiological process through which new blood vessels form from pre-existing vessels, formed in the earlier stage of vasculogenesis. Angiogenesis continues the growth of the vasculature by processes of sprouting and splittin ...

(the formation of new blood vessels) and arteriogenesis (the increase in diameter of existing arterioles). This helps to prevent myocardial ischemia (lack of oxygen to the heart).

Pericardial effusion

pericardial effusion A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane. The two layers of t ...

is the presence of excessive pericardial fluid, this can be confirmed using an

echocardiogram An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart. It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound. Echocardiography has become routinely used in th ...

. Small effusions are not necessarily dangerous and are commonly caused by infection such as HIV or can occur after cardiac surgery. Large and rapidly accumulating effusions may cause

cardiac tamponade Cardiac tamponade, also known as pericardial tamponade (), is the buildup of fluid in the pericardium (the sac around the heart), resulting in compression of the heart. Onset may be rapid or gradual. Symptoms typically include those of obstructi ...

, a life-threatening complication, that puts pressure on the heart preventing the ventricles from filling correctly.

Pericardiocentesis

Pericardiocentesis Pericardiocentesis (PCC), also called pericardial tap, is a medical procedure where fluid is aspirated from the pericardium (the sac enveloping the heart). Anatomy and Physiology The pericardium is a fibrous sac surrounding the heart composed o ...

is a procedure used to remove the pericardial fluid from the pericardial cavity. It is performed using a needle and under the guidance of an

ultrasound Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...

.Gray H et al. 2002, Lecture notes on cardiology 4th Edition, Blackwell publishing, p.207 It can be used to relieve pressure from pericardial effusions or for diagnostic purposes, showing the cause of abnormalities such as: Cancer, Cardiac perforation, Cardiac trauma, Congestive heart failure, Pericarditis rupture of a ventricular aneurysm.

Pericardial window

This can also be used to treat pericardial effusion or cardiac tamponade.

Additional Images

File:Slide14gggg.JPG, Pericardial fluid

References

{{DEFAULTSORT:Pericardial Fluid Cardiac anatomy Body fluids