Pathophysiologic mechanisms in pericardial disease.

The pericardium influences cardiac performance indirectly, but pathologic conditions may have profound effects on cardiac function. In recent years, several imaging modalities have been useful, both clinically and in understanding the pathophysiology of pericardial diseases. Rising pericardial pressures progressively reduce the average transmural pressure of the right and subsequently left cardiac chambers, compromising filling and output. This has become more relevant today, with the increased incidence of cardiac tamponade, attributed to the increased use of antiplatelet agents in combination with a more widespread use of invasive devices. On another front, although an uncommon diagnosis, constrictive pericarditis may be missed despite the excellence of a variety of noninvasive methods, and remains a difficult one to make.Introduction