Structure and function of the pericardium

The article was professionally consulted by Doctor General Internal Medicine Doctor - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

The pericardium is a protective sac that contains a small amount of lubricant, which limits the movement of the heart in the ribcage and protects the heart from mechanical injury or infection from nearby areas.

The pericardium is a sac that protects the heart, covering the heart and the proximal part of the great arteries and veins that arise from the heart. The heart and pericardium are located behind the sternum, in the middle of the chest cavity, also known as the mediastinum.
Anatomy of the pericardium including parietal and visceral leaves:
Visceral fascia is the inner membrane adjacent to the cardiac epithelium. Parietal leaves include the inner membrane and fibrous membrane. The thickness of the leaves is from 0.8-2.5mm. The pericardium is attached to the sternum, spine, and diaphragm by ligaments. The phrenic nerve, branches of the aorta and mammary artery, and lymphatic vessels are structures that help regulate and nourish the pericardium. Normally, the pericardium contains 15 to 50 ml of fluid, which is secreted by the mesenchyme in the inner membrane of the pericardium.

Functions of the pericardium include:
Keeps the structure of the heart better Limiting the movement of the heart in the ribcage Protects the heart from mechanical injury and infection from the vicinity Prevents the heart from expanding too much when there is a sudden increase in the volume of the heart. Examples include acute aortic or mitral regurgitation Pericardial fluid lubricates and reduces friction on the surface of the heart during cardiac circulation.

The parietal pericardium helps to perform mechanical functions, preventing excessive cardiac chamber expansion in the state of increased circulating volume. This function is not displayed when the circulating volume is normal or decreased.
Mesenchymal cells of the inner membrane continuously secrete prostaglandin E1, eicosanoids, prostacyclin (PGI2), complement (C3, C4, CH5) in response to hypoxia, pericardial tension. output, or increase myocardial work, increase myocardial load.
These substances help change coronary artery tone, increase the work of the heart and prevent platelet adhesion, prevent thrombosis in the coronary arteries.
The pressure in the pericardial sinus is normal from - 5 mmHg to + 5 mmHg, similar to the pressure in the pleural cavity, at the end of inspiration and at the end of expiration, the pericardial sinus pressure is - 6 mmHg and at the end of expiration, respectively. - 3 mmHg, during inspiration, a lot of blood flows to the heart, so the atrial septum and interventricular septum swell slightly towards the left atrium and left ventricle.
In case of heart block or constrictive pericarditis, the heart chambers cannot dilate, so the interventricular septum and atrial septum swell more toward the left chamber, reducing the left heart volume (reverse pulse phenomenon).
Patients may have some diseases in the pericardium such as: pericarditis, pericardial effusion, ... The patient will have chest pain behind the sternum and increase when taking a deep breath, relieve pain when sitting reclining. person in front, low fever, heart palpitations,...
In a nutshell, the pericardium is a protective sac of the heart containing a small amount of lubricant, which helps to limit the movement of the heart in the rib cage and protect heart from mechanical trauma or infection from nearby areas.

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