■缩窄性心包炎(CP)是心包的病理状况,由于纤维化,疤痕,心包钙化.据报道,尽管存在完整的心包,但其他条件仍可以模拟“收缩生理”。然而,尚无模拟CP血流动力学特征的肺反流(PR)的报道.
一名51岁的女性因严重的右侧心力衰竭而被我们研究所录取。经胸超声心动图显示严重的PR伴随着右侧心脏的显着扩张。还观察到了间隔反弹以及传递和经节膜流入速度的呼吸往复运动,表明心室相互依赖加剧。心脏导管检查显示右心房压力升高,并有明显的y下降,dip,和右心室压力的平台波形,和所有心腔的舒张压均衡,与CP相当一致。在手术检查中,然而,没有心包增厚或粘连,无明显CP迹象。
■心包收缩的结果是心包内体积与心包储备之间的相对关系。当心包内体积超过生理极限时,心腔在固定的心包空间中相互竞争。在这种情况下,严重PR引起的右侧腔室明显扩张导致心包超过心包储备,这导致了类似CP的特征性血液动力学图像。因此,重要的是要认识到术前评估“CP模拟生理学”的诊断缺陷。
UNASSIGNED: Constrictive pericarditis (CP) is a pathological condition of the pericardium, resulting from fibrosis, scarring, and calcification of the pericardium. Other conditions have been reported to mimic \'constrictive physiology\' despite the presence of an intact pericardium. However, there has been no report of pulmonary regurgitation (PR) mimicking the haemodynamic characteristics of CP.
UNASSIGNED: A 51-year-old woman was admitted to our institute because of severe right-sided heart failure. Transthoracic echocardiography revealed severe PR concomitant with significant dilatation of the right-sided heart. Septal bounce and the respiratory reciprocation of the transmitral and transtricuspid inflow velocities were also observed, indicating exacerbated ventricular interdependence. Cardiac catheter examination demonstrated elevated right atrial pressure with a prominent y descent, dip, and plateau waveform in the right ventricular pressure, and equalization of the diastolic pressure of all cardiac chambers, which are quite consistent with CP. On surgical inspection, however, there was no pericardial thickening or adhesion, indicating no obvious signs of CP.
UNASSIGNED: Pericardial constriction results from the relative relationship between intrapericardial volume and pericardial reserve. When the intrapericardial volume exceeds the physiological limit, the cardiac chambers compete with each other in a fixed pericardial space. In this
case, prominent dilation of the right-sided chambers caused by severe PR resulted in overstretching of the pericardium above the pericardial reserve, which led to a characteristic haemodynamic picture that resembled CP. Thus, it is important to recognize the diagnostic pitfall in the preoperative evaluation of a \'CP mimic physiology\'.