title: Anesthesia and the patient with pericardial disease.
abstract: OBJECTIVE
  Pericardial diseases present unique perioperative considerations for the anesthesiologist. The purpose of this review is to provide a summary of the pertinent issues related to the etiology, diagnosis, pathophysiology, and perioperative management of patients presenting for operative treatment of pericardial disease.
  
  
  METHODS
  A selective search of the anesthesia, cardiology, and cardiothoracic surgical literature was carried out with particular emphasis on acute pericarditis, effusion, tamponade, and constrictive pericarditis.
  
  
  RESULTS
  The anesthesiologist needs to be well versed in the etiology (i.e., differential diagnosis), pathophysiology, and diagnostic modalities in order to best prepare the patient for surgery. Diagnosis and guidance of management requires a working knowledge of the specific associated hemodynamic consequences, particularly of the impaired diastolic function that can occur. Echocardiography is essential in the diagnosis and management of these patients.
  
  
  CONCLUSIONS
  Patients with acute and chronic pericardial diseases often require the need for surgical intervention. Several unique features of acute tamponade and constrictive pericarditis require careful perioperative consideration. With proper preparation and pre-anesthetic optimization, patients with a variety of pericardial diseases can be safely managed before, during, and after their surgical intervention.
authors.affiliation: Department of Anesthesia, University of Manitoba, CR3008-369 Tache Avenue, Winnipeg, MB R2H 2A6, Canada. hgrocott@sbgh.mb.ca
authors.forename: Hilary P
authors.initials: HP
authors.lastname: Grocott
authors.forename: Harleena
authors.initials: H
authors.lastname: Gulati
authors.forename: Sadeesh
authors.initials: S
authors.lastname: Srinathan
authors.forename: G Burkhard
authors.initials: GB
authors.lastname: Mackensen
mesh_terms: D000208:Acute Disease; D000758:Anesthesia / Q000379:methods*; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D006801:Humans; D010490:Pericardial Effusion / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D010493:Pericarditis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods