周京敏－心包疾病.ppt

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

2、cal Manifestation - Symptoms,Clinical Manifestation - Signs,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,PE,12-Lead ECG fro

3、m a Patient with Acute Pericarditis, Demonstrating Widespread ST-Segment Elevation and PR-Segment Depression.,Cardiac Tamponade,Chronic Constrictive Pericarditis,Diagnosis and Differential Diagnosis,Management and Prognosis,Acute Pericarditis: Specific,Interesting Case,A 64-year-old man with progres

4、sively 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.,Simultaneous right and left catheter: diastolic LV = RV Right h

5、eart catheter: in diastole: RA = RV = PA =PCWP,pericardial stripping: marked pericardial thickening (P),Histologic analysis: no cause was identified Edema decreased markedly after pericardial stripping,60ys male, hypertension for 30ys Edema 4-5years ECG, Chest X-ray, Echcardiography: normal What is the diagnosis?,Hypertension, Heart Failure, NYHA I