Quraishi Ata ur Rehman, Khan Arif Anis, Kazmi Khawar Abbas, Najaf Syed Muhammad, Basir M Najib, Shafquat Azam, Jafary Fahim, Dhakan Sajid
Section of Cardiology, Department of Medicine, The Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2005 Feb;55(2):66-70.
Clinical and echocardiographic features of significant pericardial effusion (PE) have been reported from the west. Currently there is lack of published data from this part of the world, we reviewed all consecutive cases of significant PE requiring echocardiographic assisted pericardiocentesis to analyze the clinical and echocardiographic features of these patients.
Forty four consecutive patients who underwent echocardiography assisted pericardiocentesis at the Aga Khan University Hospital (AKUH) between January 1988 and May 2001" re included in this review.
Most common presenting symptoms were dyspnea (89%) and fever (36%). Elevated JVP and pulsus paradoxus were documented in 59% and 41% of patients respectively. Sinus tachycardia (75%) and low voltage (34%) were the most common ECG findings. Malignancy (45-51%) and tuberculosis (27%) were among the most frequent causes of PE. One patient died during echocardiography-assisted pericardiocentesis.
The symptoms and physical findings of haemodynamically significant PE are frequently nonspecific. Transthoracic echocardiography is the gold standard for rapid and confirmatory diagnosis of PE and cardiac tamponade. The most common cause of PE was malignancy followed by tuberculosis. Pericardiocentesis under echocardiographic guidance is a safe and effective treatment for significant PE.
西方已报道了大量心包积液（PE）的临床和超声心动图特征。目前世界上这一地区缺乏已发表的数据，我们回顾了所有需要超声心动图辅助心包穿刺术的大量PE连续病例，以分析这些患者的临床和超声心动图特征。
本回顾纳入了1988年1月至2001年5月在阿迦汗大学医院（AKUH）接受超声心动图辅助心包穿刺术的44例连续患者。
最常见的症状是呼吸困难（89%）和发热（36%）。分别有59%和41%的患者记录到颈静脉压升高和奇脉。窦性心动过速（75%）和低电压（34%）是最常见的心电图表现。恶性肿瘤（45%-51%）和结核病（27%）是PE最常见的病因。1例患者在超声心动图辅助心包穿刺术期间死亡。
血流动力学显著的PE的症状和体征往往是非特异性的。经胸超声心动图是快速确诊PE和心脏压塞的金标准。PE最常见病因是恶性肿瘤，其次是结核病。超声心动图引导下的心包穿刺术是治疗大量PE的一种安全有效的方法。
