Pericardial disease, or pericarditis, is an inflammation of any layer of the pericardium. The pericardium is a clash of thin tissue around the heart and includes: Visceral pericardium: the inner layer that covers the entire heart. Fluid layer between the visceral pericardium and parietal pericardium to avoid friction Parietal pericardium: the outer layer made of fibrous tissue. Causes Pericardial effusion is caused by inflammation of the pericardium (pericarditis) in response to illness or injury. Pericardial effusion also occurs when the flow of pericardial fluid is blocked or blood collects at the pericardium from a chest injury. Sometimes the cause cannot be determined (idiopathic pericarditis). Causes of pericardial effusion: Inflammation of the pericardium after heart surgery or a heart attack. Autoimmune disorders such as rheumatoid arthritis or lupus Cancer (metastasis), especially lung cancer, breast cancer, melanoma, leukemia, non-Hodgkin's lymphoma, or Hodgkin's disea