Pericardial Disease

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Pericardial Disease Pericardial disease includes a group of conditions that affect the pericardium, the double- layered sac that surrounds the heart. Cleveland Clinic’s Center for the Diagnosis and Treatment of Pericardial Disease serves patients with a variety of pericardial syndromes. The multispecialty approach used at Cleveland Clinic involves cardiologists, surgeons, and imaging specialists, which enhances collaboration in the management of these diseases. Patient Volume 2012 – 2016 In 2016, there were 2120 visits to the center. Volume 2500 New consult 2000 Established 545 1500 1000 1575 Thickened 500 pericardium 0 2012 2013 2014 2015 2016 The number of N = 1232 1444 1754 2027 2120 patients with pericardial disease who come to Outpatient Clinic Volume, New Consult Patients, by Diagnosis (N = 545) Cleveland Clinic for 2016 treatment continues Cleveland Clinic treats patients with all types of pericardial disease. In 2016, the majority of new to grow due to the patients seen in Cleveland Clinic’s pericardial disease outpatient clinic had acute pericarditis. unique diagnosis and treatment Volume options available. 150 100 50 0 Acute 0 or 1 Flare> 1 FlareIntractable Constrictive Effusive Other Small Moderate/LargeChronic Pericarditis Pericarditis Constrictive Pericardial Pericarditis Recurrent Pericarditis Pericarditis Disease Pericardial Effusion N = 123316715631039988712 Sydell and Arnold Miller Family Heart & Vascular Institute 57 Pericardial Disease Etiology (N = 545) 2016 Pericarditis can be caused by a number of conditions; however, the cause is commonly unknown. In 2016, 236 new consult patients seen at Cleveland Clinic had pericarditis of unknown origin or possible viral etiology. 43% idiopathic (N = 236) 100% Fibrous 20% other (N = 106) pericardium Parietal 16% postpericardiotomy syndrome (N = 88) pericardium Pericardial 12% autoimmune (N = 63) cavity 7% infectious (N = 40) 2% radiation (N = 12) Visceral pericardium Endocardium Pericardial Procedures (N = 248) 2016 Effect of Pericarditis The majority of pericardial procedures performed at Cleveland Clinic in 2016 were pericardiocentesis procedures. This percutaneous treatment is used to drain large pericardial effusions. Echocardiography is used during the procedure to improve outcomes. Uremia Neoplastic Radiation 52% pericardiocentesis (N = 129) Source: Klein AL, Abbara S, Agler DA, Appleton CP, Asher CR, Hoit B, Hung J, Garcia MJ, Kronzon I, Oh JK, Rodriguez ER, 100% Schaff HV, Schoenhagen P, Tan CD, White RD. American Society of Echocardiography 31% window (N = 76) clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society 17% pericardiectomy (N = 43) for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013 Sep;26(9):965-1012. 58 Outcomes 2016.

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Chapter Xi the Circulatory System and Blood
CHAPTER XI THE CIRCULATORY SYSTEM AND BLOOD Page General characterlstlcs______ __ __ _ __ __ __ __ __ __ _ 239 of these organs are independent of the beating of The pericardium ___ __ __ __ 239 the principal heart, and their primary function is The heart. _____ __ __ 240 Physiology of the heart.______________________________________________ 242 to oscillate the blood within the pallial sinuses. Automatism of heart beat. _ 242 The pacemaker system_ 245 THE PERICARDIUM Methods of study of heart beat_____________________________________ 247 Frequency of beat___ __ __ _ 248 Extracardlac regulatlon____ __ __ _ 250 The heart is located in the pericardium, a thin Effects of mineral salts and drugs___________________________________ 251 Blood vessels_ __ ___ _ 253 walled chamber between the visceral mass and the The arterial system______ __ __ ___ __ __ __ __ __ 253 adductor muscle (fig. 71). In a live oyster the The venous system_________________________________________________ 254 location of the heart is indicated by the throbbing The accessory heart._____________ 258 The blood______ __ __ __ __ __ __ __ 259 of the wall of the pericardium on the left side. Color of blood_ __ __ 261 Here the pericardium wall lies directly under the The hyaline cells___________________________________________________ 261 The granular cells .______________________________________ 262 shell. On the right side the promyal chamber Specific gravity of blood____________________________________________ 265 extends down over the heart region and the mantle Serology ___ __________ __________________ ____ __ ______________________ 265 Bibliography __ __ __ __ __ __ __ 266 separates the pericardium wall from the shell. The cavity in which the heart is lodged is slightly A heart, arteries, veins, and open sinuses form asymmetrical; on the right side it extends farther the circulatory system of oysters and other bi along the anterior part of the adductor muscle valves.
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Unit 1 Lecture 2
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Kumka's Response to Stecco's Fascial Nomenclature Editorial
Journal of Bodywork & Movement Therapies (2014) 18, 591e598 Available online at www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/jbmt FASCIA SCIENCE AND CLINICAL APPLICATIONS: RESPONSE Kumka’s response to Stecco’s fascial nomenclature editorial Myroslava Kumka, MD, PhD* Canadian Memorial Chiropractic College, Department of Anatomy, 6100 Leslie Street, Toronto, ON M2H 3J1, Canada Received 12 May 2014; received in revised form 13 May 2014; accepted 26 June 2014 Why are there so many discussions? response to the direction of various strains and stimuli. (De Zordo et al., 2009) Embedded with a range of mechanore- The clinical importance of fasciae (involvement in patho- ceptors and free nerve endings, it appears fascia has a role in logical conditions, manipulation, treatment) makes the proprioception, muscle tonicity, and pain generation. fascial system a subject of investigation using techniques (Schleip et al., 2005) Pathology and injury of fascia could ranging from direct imaging and dissections to in vitro potentially lead to modification of the entire efficiency of cellular modeling and mathematical algorithms (Chaudhry the locomotor system (van der Wal and Pubmed Exact, 2009). et al., 2008; Langevin et al., 2007). Despite being a topic of growing interest worldwide, This tissue is important for all manual therapists as a controversies still exist regarding the official definition, pain generator and potentially treatable entity through soft terminology, classification and clinical significance of fascia tissue and joint manipulative techniques. (Day et al., 2009) (Langevin et al., 2009; Mirkin, 2008). It is also reportedly treated with therapeutic modalities Lack of consistent terminology has a negative effect on such as therapeutic ultrasound, microcurrent, low level international communication within and outside many laser, acupuncture, and extracorporeal shockwave therapy.
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Ta2, Part Iii
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Pericardium, Myocardium and Endocardium
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Fascia: a Morphological Description and Classification System Based on a Literature Review Myroslava Kumka, MD, Phd* Jason Bonar, Bsckin, DC
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