Your pericardium is a fluid-filled sac that surrounds your heart and the roots of the major blood vessels that extend from your heart. Conditions that affect your pericardium include pericarditis, pericardial effusion and constrictive pericarditis. Symptoms of pericardial problems include chest pain, shortness of breath and heart palpitations.


What is the pericardium?

Your pericardium is a protective, fluid-filled sac that surrounds your heart and helps it function properly.

Your pericardium also covers the roots of your major blood vessels as they extend from your heart. These are known as your “great vessels,” and they include your:


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What are the functions of the pericardium?

Your pericardium has several important functions. These include:

  • Cushioning your heart from outside forces and pressure.
  • Holding your heart in place.
  • Keeping your heart from expanding too much and filling with too much blood.
  • Protecting your heart from infections.
  • Providing lubrication to reduce friction between your heart and surrounding tissues.


Where is the pericardium located?

Your pericardium is located in your chest, where it surrounds your heart. Your heart is located in the front of your chest, slightly to the left of your breastbone (sternum). If you have dextrocardia, your heart is slightly to the right of your breastbone.


What are the layers of the pericardium?

Your pericardium has two main layers:

  • Fibrous pericardium: This is the tough, outermost layer of your pericardium. It’s made of connective tissue that prevents your heart from expanding too much. It attaches to your great vessels (at the top of your heart) and to the central tendon of your diaphragm (at the bottom of your heart). At the front of your chest, ligaments connect this layer to your breastbone.
  • Serous pericardium: This is the inner layer of your pericardium. It’s actually made of two layers, described below. Your serous pericardium produces pericardial fluid that lubricates your heart as it beats.

Your serous pericardium is made of two layers:

  • Parietal layer of the serous pericardium: This is the outer layer that’s firmly attached to your fibrous pericardium. There’s no space between them.
  • Visceral layer of the serous pericardium: This is the innermost layer of your pericardium. It directly covers your heart and the roots of your great vessels. The portion that covers your heart is also known as your epicardium.

Your pericardial cavity is the space between the two layers of your serous pericardium. This space holds your pericardial fluid.

Conditions and Disorders

Illustration of the layers of your pericardium.
Your pericardium has two main layers that surround your heart. The inner layer (serous pericardium) is itself made of two layers with pericardial fluid in between.

What conditions and disorders affect the pericardium?

Conditions and disorders that affect the pericardium include:

  • Pericarditis: Inflammation of your pericardium. It’s usually acute but can also be chronic.
  • Constrictive pericarditis: A condition in which your pericardium becomes too thick or stiff.
  • Pericardial effusion: A buildup of fluid (more than there should be) in your pericardium.
  • Cardiac tamponade: A dangerous condition that happens when fluid builds up and puts pressure on your heart. This outside pressure on the heart prevents it from filling properly.
  • Pericardial cysts: Growths that may cause no problems but can sometimes put pressure on your heart or lungs.


What happens if the pericardium is damaged?

Normally, your pericardium is flexible and stretchy. It can easily expand with the heart as the heart fills up with blood and then contracts to pump the blood out to your body. Pericardial conditions and disorders prevent your heart from expanding as it should. As a result, your heart can’t fill and pump blood efficiently to the rest of your body. This can lead to dangerous complications, including heart failure and cardiogenic shock.

What are the symptoms of pericardial problems?

Symptoms depend on the specific condition but generally can include:

What tests diagnose pericardial problems?

Your provider may run one or more of the following tests to diagnose pericardial problems:

What are common treatments for pericardial conditions and disorders?

Treatment depends on your condition and its severity. Your provider will talk with you about your treatment options and the urgency of your situation. Some common options include:


How can I care for my pericardium?

Following a heart-healthy lifestyle is one of the best things you can do. Conditions like heart attacks and heart failure can cause pericarditis and pericardial effusion. So, lowering your risk of those conditions can help you keep your pericardium healthy, too.

Tips for following a heart-healthy lifestyle include:

Other medical conditions and diseases can cause pericardial problems. If you have any of these diagnoses, talk with your provider about how they might affect your heart:

Certain medical procedures and treatments can also cause pericardial problems. Talk with your provider about your risk for pericardial issues after:

In general, do as much as you can to be an active partner in your medical care. Talk with your provider about your risks for cardiovascular disease and how you can reduce them.

A note from Cleveland Clinic

Your pericardium is one part of the complex organ known as your heart. You don’t need to learn every detail about your heart anatomy. But learning the basics about your heart and how it works can help you talk with your provider and understand any diagnosis you might receive. This knowledge can also help you navigate treatment plans and make decisions for yourself and your loved ones.

If you have concerns about your pericardium or your overall heart health, call your provider. And don’t hesitate to ask for resources to help you learn more.

Medically Reviewed

Last reviewed on 07/19/2022.

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