The heart is made up of different layers. The outermost layer of the heart wall is the epicardium (outer skin of the heart). The epicardium is firmly fused with the underlying myocardium (heart muscle tissue).

Structure / histology

In order to understand the entire structure of the layers, it is best to look again at the entire heart. That lies entirely within Endocardium, above the thickest layer, the muscle layer (Myocardium). This is what lies on top of it as a "coating" Epicardium. The whole heart is in turn from Pericardium, the Pericardium coated, which consists of two leaves, the inner and the outer.

The epicardium (outermost layer of the heart) is at the same time that inner leaf of the pericardium (Pericardium), which one too Lamina visceralis is called. The outer sheet of the pericardium is the Lamina parietalis. There is a narrow space between the epicardium / lamina visceralis and the lamina parietalis, the Cavitas pericardiiin which there is a film of liquid. The epicardium / the visceral lamina can itself be divided into two layers. The outermost one facing the gap is that Mesothelium. Below is the Subserosa. It is very narrow and consists of connective tissue. Below that is still that epicardial adipose tissue, where the initial part of the coronary arteries is embedded.

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Figure pericardium

Figure pericardium
  1. Pericardium -
    Pericardium fibrosum
  2. Apex of the heart - Apex cordis
  3. Coronary artery right -
    Coronary artery dextra
  4. Left coronary artery -
    Left coronary artery
  5. Right atrial - Atrium dextrum
  6. Right ventricle -
    Ventriculus dexter
  7. Left atrium - Atrium sinistrum
  8. Left ventricle -
    Ventriculus sinister
  9. Aortic arch - Arcus aortae
  10. Superior vena cava -
    Superior vena cava
  11. Lower vena cava - Inferior vena cava
  12. Pulmonary artery trunk -
    Pulmonary trunk
  13. Left pulmonary veins -
    Venae pulmonales sinastrae
  14. Right pulmonary veins -
    Venae pulmonales dextrae

You can find an overview of all Dr-Gumpert images at: medical illustrations

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The epicardium can be called the Pericardial fluid produce who the Liquid in the gap (Cavitas pericardii) between the epicardium and the adjacent leaf of the Heart sac forms. It is about a serous fluid. The amount of liquor pericardii is about 10-12 ml.

Their function is to reduce the friction between the two sheets of the pericardium during the Cardiac activity. The epicardium is thus for the good movability of Heart responsible towards his environment.


Will the minor Exceeded amount of pericardial liquor in the pericardial cavity, one speaks of a Pericardial effusion. This can be done as part of a Pericarditis or. Perimyocarditis occurrence. The more fluid that accumulates, the more likely it is that the pumping function of the heart may be impaired, as this heart can no longer expand properly and thus fill. With large pericardial effusions Shortness of breath (Dyspnea) felt. At a Tamponing of the pericardium it can already be 100-200ml fluid build-up come. Means Sonography one can diagnose a pericardial effusion. Relief brings one Pericardial puncture.

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