Pericardial heart disease.

This report reviews morphologic aspects of pericardial heart disease. A morphologic classification for this condition is presented. An ideal classification of pericardial heart disease obviously 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 and when present at necropsy it usually had not been recognized during life. The term "pericarditis" is inaccurate because most pericardial diseases are noninflammatory in nature. Morphologically chronic pericardial heart disease may present clinically as an acut eillness. Even when clinical symptoms are present, however, fewpatients 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.