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Located within the mediastinum between the third and sixth costal cartilages, the heart functions to supply tissues throughout the body with oxygenated blood. While the exact position is variable among patients, the heart tends to lie fairly horizontally, with the apex directed toward the patient’s left side. In order to maintain proper function, the heart and roots of the great vessels are encased within a double-walled fibrous sac termed the pericardium. On each side of the heart, the pericardium acts as the medial border of the pleural space. The most superficial layer, the fibrous pericardium, is robust and composed of many layers of connective tissue. The serous pericardium is divided into the parietal pericardium, which is directly fused with the fibrous pericardium, and the visceral pericardium, which adheres directly to the heart. In addition to the collagen and elastic fibers that make up the parietal pericardium, the visceral pericardium is also composed of mesothelial cells. The 2 layers are directly connected at the great vessels, where the pericardium reflects back on itself.[1][2][3]