The pericardial sac surrounds the heart and is a fluid-filled sac that provides lubrication for the heart
Pericardium, Pericardial Fluid, Pericarditis:
An X-ray showing pericarditis and pericardial fluid (effusion)
An X-ray showing pericarditis and pericardial fluid (effusion)
Pericarditis can be caused by bacteria, viruses, and other things
Cardiac Tamponade Due to Pericardial Effusion:
Cardiac tamponade
Pericardiocentecis: removal of pericardial fluid around the heart
Pericardiocentesis:
This procedure is a "tap" for drawing excess fluid off the heart in order to send it to the lab to test for infection. Fluid is aspirated from the pericardium, the sac which surrounds the heart. This procedure also aids in the diagnosis and treatment of cardiac tamponade, considered to be a medical emergency because excess fluid has built up in the heart (pericardial effusion). This increases pressure in the heart. It cannot fill up normally with blood, which in turn causes hypoxia/hypoxemia, less oxygen being distributed to the tissues of the body, and shortness of breath. This can be fatal. Removal of excess fluid reverses this dangerous condition and is quick.
The pericardial fluid is sent to the lab for analysis for microbial infection, spread of cancerous cells, or autoimmune conditions, including rheumatoid arthritis, rheumatic fever or lupus. This procedure has a low risk for complications. In fact, <1.5% of patients experience complications. If they do, it is typically due to an accidental laceration of an artery during the procedure, or puncture of the left ventricle. This causes inflammation and bleeding. Performing the procedure using echocardiogram (ECG) to guide the needle prevents this from happening. This test is performed under local anesthesia and usually under cardiac catheterization. Careful position of the patient and needle will prevent puncturing of the lungs.
Where drainage is needed, a pericardial window is created by a cardiothoracic surgeon. This is where a chest tube is placed.
Endocarditis:
Endocarditis is inflammation of the endocardium of the heart, the membrane that lines the inside of the heart. This can be caused by bacteria, viruses, cancer or tumors or other conditions. Streptococcus is a common cause of endocarditis, so look for bacterial cocci in pairs and chains to rule out streptococcal endocarditis, along with numerous neutrophils. If it is viral, there will be many monocytes and/or lymphocytes but no bacteria.
Bacterial endocarditis
Bacterial endocarditis
Myocarditis:
Myocarditis is inflammation of the myocardium, the middle, muscular layer of the heart. Viruses, bacteria, cancer, tumors, and other conditions may cause infection. In this case, in the stain, you will see numerous white blood cells, indicating inflammation. If it is bacterial, you will see bacteria and many neutrophils. If it is viral, there will be numerous lymphocytes and/or monocytes, but no bacteria.
Streptococcus epidermidis is the #1 cause of acute infective bacterial endocarditis involving prosthetic valves. Other bacteria can cause these conditions as well, such as Viridans streptococci (S. anginosus and others), Staphylococcus aureus, S. lugdunensis, other bacteria and fungi
Myocarditis may be caused by viruses that attack the muscle layer of the heart