It is fluid which is present
in the pericardial cavity of
heart b/w parietal pericardium n visceral pericardium.
The pericardial cavity is a
potential space lined by
mesothelium of the visceral n parietal pericardium.
1. Ms Ankita R Bhatiya
Assistant Professor
Shree P.M.Patel COLLEGE OF PARAMEDICAL
SCIENCE N TECHNOLOGY
2. It include:
1.What is Pericardial fluid?
2.Function of Pericardial fluid.
3.Collection of Pericardial fluid.
4. Examination of Pericardial fluid.
3. Introduction:
It is fluid which is present
in the pericardial cavity of
heart b/w parietal pericardium n visceral pericardium.
The pericardial cavity is a
potential space lined by
mesothelium of the visceral n parietal pericardium.
Pericarial fluid Formation:
Pericardial fluid is a selective ultra filtrate of plasma.
Small amount of the Pericardium fluid is also formed
from the cells lining the pericardium and other by capillaries.
There is about 10-60 ml of pericardium fluid at any one time
and about 125 ml is generated every day.
4. Composition of Pericardial fluid:
o Volume: 60-70 ml
o Cell/mm3: 1000-3000
Monocyte:30 %
Lymphocyte: 5%
Neutrophil: 5%
o Protein: up to 3 gm/dl
o Glucose: Same as plasma
o LDH:70-140 U/L
5. Function of Pericardial fluid:
Protection: It helps to protect the heart from
the sudden injury n damaged.
Also acts as a medium for the transfer of
substances from the heart tissue to blood .
Nutrition :
Removal of waste :
Lubrication :
6. Collection of Pericardial fluid:
Peracardiocentesis is a process by
which pericardial fluid is collected.
A needle is placed through the
skin and muscles of the chest wall into
the pericardial space.
8. Procedure:
1.Take consent of a patient.
2.Position of patient: The patient is sitting in an upright
position with arms & head extended to over bed table.
3.Proper aseptic precautions are taken
with the help of spirit –iodine-spirit.
4.Before puncture give injection of atrophin
intramuscularly to prevent vasovagal shock.
5.Give xylocane injection as local anesthesia before puncture.
9. 6.Then insert the needle b/w intercostal space & allow the
fluid to flow in container.
7. Pleural fluid is collected in 3 tubes:
1. EDTA Bulb: Cell count n differential count.
2. Fluorides Bulb: For glucose examination.
3. Plain Bulb: Chemical n immunology study
10. Examination of Pericardial fluid:
1. Physical examination:
2. Chemical examination:
3. Microscopic examination:
11. Physical examination of Pericardial fluid:
1.Volume:
Normally: 10 to 60 ml
Transudates– 100 to 150 ml
Condition: Increase hydrostatic pressure
Decrease plasma oncotic pressure
Congestive heart failure
Hepatic cirrhosis
Hypoproteinemia
Exudates– More than 150 ml
Condition: Pericardiatis( Bacterial, Viral, Fungal)
Tuberculosis
Metastatic carcinoma,
Lymphoma,
Myocardial infract
Rheumatoid disease
Systemic lupus erythreomatous
Uremia, Myxodema, Hypothyrodism
HIV Infected patient
12. 2. color:
Normally: colorless
Transudates: Colorless
Exudates:
Reddish: Presence of blood (Bacterial pneumonia,
Cancer, Pancreatitis.),Tuberculosis, SLE, Post MI
syndrome
Straw clr; Pale yellow or straw clr
Milky white:Presence of chlye
13. 3.Appreance:
Normally: Clear or transparent
Transudate: Clear or transparent
Exudate:
Turbid: Bacterial n viral Pericardiatis,TB, Malignancy
Cloudy: Bacterial n fungal pericardiatis ,Post MI
syndrome, septic condition ,Rheumatoid inflammation
Milky :Chylous effusion
17. 3. Lipid: (Tg)
Normal range: 50-110 mg/dl
Transudate: Normal
Exudate: Above 110U/L
Method:
1.Colorimetric method
Condition for Increase protein:
Chylous effusion
18. 4. LDH:
Normal range: 140 U/L
Transudate: Normal
Exudate: Above 140 U/L
Method:
1.Colorimetric method
2. U.V.Kinetic method
Condition for Increase protein:
Pericardiatis
Melingancy
19. 5.Creatinen kinase:
Ck-mb level is increase in heart disease.
Mainly in Myocardial injury.
6.ADA(Adenosine deaminase):
Increase in Tb pericardiatis.
20. 7.PH:
Normally:7.64
Decrease ph in :7.20-7.30
Condition:
Malignancy
Uremia
TB
Idiopathic disorder
8.Interferon gamma:
Increase level in Tuberculous pericardiatis.