The pericardial diseases result in cardiovascular perturbations ranging from asymptomatic electrocardiographic findings (in pericarditis of end-stage renal disease) to circulatory shock (in acute hemorrhagic pericardial tamponade). Despite of clinical features that resemble right-, or left-side failure, the clinical management of pericardial pathology may differ significantly from those of ventricular systolic or diastolic dysfunction. Therefore, prompt diagnosis and appropriate medical or surgical therapy is imperative.