欢迎来到天天文库
浏览记录
ID:10085513
大小:1.58 MB
页数:27页
时间:2018-05-12
《周京敏-心包疾病精品医学ppt课件》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
心包疾病中山医院周京敏 GeneralIncidence:low1.5-6%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 InflammationofvisceralandparietalcardiacsacEffusionChronicrestrictivepericarditisCardiactamponadefluiddyspneaChestpainresolvedfibrousSurgeryHeartFailureeffusionDyspnea,JVdistension,BP↓ AcutepericarditisC-Constr-PericNon-specific+++++++Tumor++++TB++++++Radiationtherapy-+++Systemdisease++Physicalandchemicalfactors++Etiology ClinicalManifestation---SymptomsAcutepericarditisC-Constr-PericChestpain++++fibrousPleurotic,Postural-Dyspnea+---+++fluidFastandthin++++GeneralFever----++-fatigue-+++ascites-+++wasting-++ AcutepericarditisC-Constr-PericFrictionrub++++transient-Enlargementonpercussion-----+++-Edema,ascites----++----++++Pulsusparadoxus(>10mmHg)----+++----+Jugularveindistension----+++----++ClinicalManifestation---Signs AcutePericarditisC-ConstrPericLabfindingsBloodWBCincreaseanemiaAscitesrarelyLeak-outHepatic:normalimpairCK-MborcTNT↑:myocardiuminjurynormal AcutePericC-ConstrPericElectrocardiologyPwaveNormal50%:notchAbnormalqwaveNoWidespreadcalcificationQRSVoltage↓↓ST-TConvex↑exceptinavR(V1)Non-specificArrhythmiaSinustachycardiaAfib,A-Vblock AcutePericC-ConstrPericEchofluidNormal,rarelycalcificationChestX-rayEnlargedshadowBottle-likeNormal,Smallandstraight,CalcificationCTorMRIFluidPericardiumthickeningEtiologydiagnosis EchocardiographyAcutePericarditis:Mostimportant,useful,sensitiveConfirmthediagnosisSemi-quantitythevolumeAssesstheefficacyofmanagementGuidethepericardiocentesisChronicRestrinctivePericarditisnormal PE 12-LeadECGfromaPatientwithAcutePericarditis,DemonstratingWidespreadST-SegmentElevationandPR-SegmentDepression. CardiacTamponade ChronicConstrictivePericarditis AcutePericarditisC-ConstrPericPericardiocentesisEtiologydiagnosisReliefsymptoms__Catheterization__Pressurecurvechange心包镜Etiologydiagnosishard DiagnosisandDifferentialDiagnosisAcutePericarditisC-ConstrPericDiagnosisChestpain+dyspnea+frictionrubAscites+jugularveindistensionDifferentialDiagnosisMIAcuteAbdomenRestrictiveCMLiverdisease ManagementandPrognosisAcutePericarditisC-ConstrPericManagementDiureticsDiureticsPericardiocentesisPrudenttochooseSurgeryAsearlyaspossiblePrognosisCompletelyresolvedChronicCons-PericCompletelyresolvedHeartfailure AcutePericarditis:SpecificFormsFeaturesViralFollowingupperrespiratoryinfectionTuberculosisNightsweats,Anti-TBeffectiveBacterialToxicillNeoplasticCytologicexam,nearbytumorOtherssystematicdiseasesDressler’sSyndromeRadiationUremic InterestingCaseA64-year-oldmanwithprogressivelyworseningedemaofthelegsPE:Jugularvenousdistention,anenlargedliver,pittingedemaECG:low-voltageandATChestfilm:thickenedpericardiumCT:dilatedSVC,anormalaorticarch(AA)andDA,andathickenedpericardium. Simultaneousrightandleftcatheter:diastolicLV=RVRightheartcatheter:indiastole:RA=RV=PA=PCWP pericardialstripping:markedpericardialthickening(P) Histologicanalysis:nocausewasidentifiedEdemadecreasedmarkedlyafterpericardialstripping 60ysmale,hypertensionfor30ysEdema4-5yearsECG,ChestX-ray,Echcardiography:normalWhatisthediagnosis?Hypertension,HeartFailure,NYHAIII CT:thickeningofthePericardiumAnti-TB:3monthsPericardialStripping:TB
此文档下载收益归作者所有
举报原因
联系方式
详细说明
内容无法转码请点击此处