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心 包 疾 病

心 包 疾 病. 中山医院 周京敏. General. Incidence: low 1.5-6% 急性心包炎 慢性缩窄性心包炎 慢性心包积液 粘连性心包炎. Chest pain. resolved. fibrous. Surgery. Inflammation of visceral and parietal cardiac sac. fluid. Chronic restrictive pericarditis. effusion. Effusion. Cardiac tamponade. dyspnea.

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心 包 疾 病

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  1. 心 包 疾 病 中山医院 周京敏

  2. General • Incidence: low • 1.5-6% • 急性心包炎 • 慢性缩窄性心包炎 • 慢性心包积液 • 粘连性心包炎

  3. Chest pain resolved fibrous Surgery Inflammation of visceral and parietal cardiac sac fluid Chronic restrictive pericarditis effusion Effusion Cardiac tamponade dyspnea Heart Failure Dyspnea, JV distension, BP￬

  4. Etiology

  5. Clinical Manifestation --- Symptoms

  6. Clinical Manifestation --- Signs

  7. Echocardiography Acute Pericarditis: • Most important, useful, sensitive • Confirm the diagnosis • Semi-quantity the volume • Assess the efficacy of management • Guide the pericardiocentesis Chronic Restrinctive Pericarditis • normal

  8. PE

  9. 12-Lead ECG from a Patient with Acute Pericarditis, Demonstrating Widespread ST-Segment Elevation and PR-Segment Depression.

  10. Cardiac Tamponade

  11. Chronic Constrictive Pericarditis

  12. Diagnosis and Differential Diagnosis

  13. Management and Prognosis

  14. Acute Pericarditis: Specific

  15. Interesting Case • A 64-year-old man with progressively worsening edema of the legs • PE: Jugular venous distention, an enlarged liver, pitting edema ECG: low-voltage and AT Chest film: thickened pericardium CT: dilated SVC, a normal aortic arch (AA) and DA, and a thickened pericardium.

  16. Simultaneous right and left catheter: diastolic LV = RV • Right heart catheter: in diastole: RA = RV = PA =PCWP

  17. pericardial stripping: • marked pericardial thickening (P)

  18. Histologic analysis: no cause was identified • Edema decreased markedly after pericardial stripping

  19. 60ys male, hypertension for 30ys • Edema 4-5years • ECG, Chest X-ray, Echcardiography: normal • What is the diagnosis? Hypertension, Heart Failure, NYHA III

  20. CT: thickening of the Pericardium Anti-TB: 3 months Pericardial Stripping: TB

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