Pericardial involvement in diseases of the heart and other contiguous structures: part II: pericardial involvement in noncardiac contiguous disorders.

Active contiguous abnormalities can frequently involve the pericardium. Prominent among these are cardiac conditions which encroach on the pericardium, particularly transmural myocardial infarction (newly always with Q-waves). Complications of infarctions, notably myocardial pseudoaneurysm, have one wall which is pericardium. Furthermore, dissecting aneurysm of the aorta and the intramural aortic hemorrhage may rupture into the pericardium with tamponade, or, if limited, mimic acute pericarditis. Diseases of the lungs and pleura, including the diaphragmatic pleura, also result in pulmonary embolism which can produce several syndromes. Mediastinal diseases, notably inflammation and malignancy, especially involving the lymph nodes, induce mediastinal inflammation and fibrosis. Many esophageal disorders can penetrate or produce a fistula usually with pneumopericardium. Rarely, primarily pericardial disorders like purulent pericarditis, malignancies, and rough pericardial calcifications affect the contiguous tissues. We discuss the many syndromes and disorders under each of these topics.