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Pericardial Heart Disease: Its Morphologic Features and Its Causes

An ideal classification of pericardial heart disease would take into account clinical, etiologic, and morphologic features of this condition, but a single classification combining these 3 components is lacking. Pericardial heart disease is relatively uncommon clinically. When present at necropsy, it usually had not been recognized during life. The term “pericarditis” is inaccurate because most pericardial diseases are noninflammatory. Morphologically, chronic pericardial heart disease symptoms are present; however, few patients develop evidence of cardiac dysfunction (constriction). When pericardial “constriction” occurs, it is the result of increased pericardial fluid or increased pericardial tissue or both. Increased fluid is treated by drainage; increased tissue is treated by excision. In most patients with chronic constrictive “pericarditis,” the etiology is not apparent even after histologic examination of pericardia.