小结
定义
病史和体格检查
关键诊断因素
- malignancy
- presence of other risk factors
- dyspnea
- elevated jugular venous pressure (JVP)
- distant heart sounds
- pulsus paradoxus
- hypotension
- tachycardia
- recent cardiac surgery or intervention
- Beck triad: hypotension, distant heart sounds, and elevated JVP
其他诊断因素
- chest pain
- abdominal pain
- fever
- pericardial rub
危险因素
- malignancy
- aortic dissection
- purulent pericarditis
- large idiopathic chronic pericardial effusion
- post-cardiac surgery or intervention
- tuberculosis (TB)
- autoimmune disease
- hypothyroidism
- end-stage renal failure
- anticoagulation
诊断性检查
首要检查
- ECG
- transthoracic echocardiogram
- CXR
- CBC
- erythrocyte sedimentation rate/CRP
- cardiac enzymes
需考虑的检查
- cardiac CT
- cardiac MRI
- cardiac catheterization
- pericardiocentesis fluid for culture and cytology
治疗流程
without hemopericardium, trauma, or purulent effusion
with hemopericardium, trauma, or purulent effusion
撰稿人
作者
Antonio Abbate, MD, PhD
Ruth C. Heede Professor of Cardiovascular Medicine
Division of Cardiovascular Medicine
Berne Cardiovascular Research Center
University of Virginia School of Medicine
Charlottesville
VA
利益声明
AA has received consultant fees from Kiniksa Pharmaceuticals. He is an author of references cited in this topic.
鸣谢
Dr Antonio Abbate would like to gratefully acknowledge Dr Vaikom S. Mahadevan, Dr Harsh Agrawal, Dr Jonathan Bella, Dr Liran Blum, and Dr Michael Spinelli, previous contributors to this topic.
利益声明
VSM declares that he is a proctor for Edwards Lifesciences for transcatheter valves and also a proctor for Abbott for closure devices. HA, JB, LB, and MS declare that they have no competing interests.
同行评议者
Ramon Castello, MD
Professor of Medicine
Director of Echocardiography
Mayo Clinic
Jacksonville
FL
利益声明
RC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013 Sep;26(9):965-1012.全文 摘要
Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015 Nov 7;36(42):2921-64.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Constrictive pericarditis
- Restrictive cardiomyopathy
- Cardiogenic shock
更多 鉴别诊断指南
- 2015 ESC guidelines on the diagnosis and management of pericardial diseases
- American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease
更多 指南患者教育信息
Heart attack
Heart failure
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