Pericardial ligaments

Last revised by Jason Ma on 4 Apr 2023

The pericardial ligaments is a name given to a group of variable fibrous ligaments or adhesions that connect the pericardium to adjacent structures. These ‘ligaments’ tether the fibrous pericardium to its surrounds, hence movements of the chest wall and diaphragm influence the position of the heart and pericardium in the mediastinum.

There are 2 main ligaments described in standard texts with differing importance:

  • pericardiophrenic ligaments: these are strong adhesions where the floor of the fibrous pericardium is firmly attached (and some authors say blended with) the central tendon of the diaphragm.

  • sternopericardial ligaments: these are weak adhesions that are variably present that connect the anterior fibrous pericardium to the posterior surface of the upper and lower sternum.

The fibrous pericardium also blends with the tunica adventitia of the ascending aorta, pulmonary trunk and superior vena cava in the superior mediastinum. There are also un-named adhesions that loosely fix the fibrous pericardium to the posterior mediastinum.

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