Constrictive Pericarditis
Constrictive Pericarditis
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DOI：
10.1016/j.ccl.2017.07.007
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发表时间：
2017-11-01
影响因子：
2.4
通讯作者：
Oh, Jae K.
中科院分区：
文献类型：
--
作者：
Welch, Terrence D.;Oh, Jae K.
缩窄性心包炎是舒张性心力衰竭的一种潜在的可治疗的原因，它是由于病变的、无弹性的心包限制了心室的舒张期扩张而产生的。受影响的患者表现为以右侧症状和体征为主的心力衰竭。诊断的关键是确定与收缩相关的独特的血流动力学特性：胸腔内和心脏内压力的分离和增强的心室相互作用。综合超声心动图和多普勒成像是有用的，但可能需要有创性血流动力学评估和横断面成像才能确认。心脏MRI提供了评估心包炎症的机会。大多数慢性缩窄症是进行性的和寿命受限的，需要手术切除心包。
Constrictive pericarditis is a potentially treatable cause of diastolic heart failure that arises because a diseased, inelastic pericardium restricts ventricular diastolic expansion. Affected patients present with heart failure with predominant right-sided symptoms and signs. The key to diagnosis is identification of the unique hemodynamic properties associated with constriction: dissociation of intrathoracic and intracardiac pressures and enhanced ventricular interaction. Comprehensive echocardiography with Doppler imaging is useful, but invasive hemodynamic assessment and crosssectional imaging may be required for confirmation. Cardiac MRI provides an opportunity to evaluate for pericardial inflammation. Most cases of chronic constriction are progressive and life limiting, and require surgical pericardiectomy.