The pericardium is a fluid-filled doubled-walled membrane sac that surrounds the heart. The fluid is separated by two layers, the fibrous and serous pericardium. The fibrous pericardium is the outer layer and holds the heart in place and protect it from surrounding infections. It is composed of thick connective tissue. The serous pericardium has two layers, the visceral and parietal layers. The visceral pericardium helps to minimize friction, and the parietal pericardium provides additional defense.  The pericardium can develop an inflammatory process for a variety of reasons and is morphologically classified as follows: Fibrinous. Purulent. Serous. Caseous. Hemorrhagic. The normal pericardium is shiny, glistening, and smooth. In fibrinous pericarditis, the pericardial texture is rough, granular, and has many fibrous adhesions. Fibrinous pericarditis is usually caused by trauma, surgery, acute myocardial infarction, uremia, collagen vascular disorders, and malignancies.