**Abstract**

The pericardium is a double-walled, fibrous sac typically containing 20–50 mL of fluid surrounding the heart and great vessels. In addition to its known anatomical and physiological functions, the pericardium also serves an active immunological role that is the focus of interest pertaining to inflammatory cardiac conditions such as pericarditis and myocarditis. In the geriatric population, the pericardium also undergoes age-related changes similar to other anatomical structures; however, in contrast to common cardiac diseases such as coronary artery disease, heart failure, valvular disease, etc., data from randomized trials regarding the management of pericardial diseases are limited, especially in the elderly population. In this chapter, we will discuss age-related pericardial anatomical changes, various pericardial diseases (acute, recurrent and constrictive pericarditis, pericardial effusion, cardiac tamponade, etc.) along with their clinical impact, and evidence-based management.

**Keywords:** pericardial disease, elderly, acute pericarditis, constrictive pericarditis, recurrent pericarditis, cardiac tamponade, pericardium, myocarditis
