Bergman Michael, Vitrai Janos, Salman Hertzel
Department of Internal Medicine "C", Rabin Medical Center, Golda Campus (Hasharon), Petah-Tiqva, Israel; The Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
Eur J Intern Med. 2006 Nov;17(7):457-64. doi: 10.1016/j.ejim.2006.07.006.
Constrictive pericarditis is a rare condition characterized by clinical signs of right heart failure subsequent to loss of pericardial compliance. The etiology of constrictive pericarditis has changed during the last decades in developed countries. While, in the past, tuberculosis and idiopathic pericardial constriction were the prevalent causes of the disease, cardiac surgery has become one of the main reasons for its development in recent years. However, cases defined as idiopathic constrictive pericarditis are still observed. In addition to the classical chronic and subacute forms, new presentations, such as effusive-constrictive, localized, transient, occult, and constrictive pericarditis with normal pericardial thickness, have been described. Although conservative treatment may alleviate the patient's symptoms, pericardiectomy remains the only definitive treatment for the disease. It is worth noting that the sooner the diagnosis of pericardial constriction is established, the better the outcome is. The pathophysiological features, clinical findings, diagnostic tools, and therapeutic approach to constrictive pericarditis are detailed in this review.
缩窄性心包炎是一种罕见疾病，其特征为心包顺应性丧失后出现右心衰竭的临床体征。在过去几十年里，发达国家缩窄性心包炎的病因发生了变化。过去，结核病和特发性心包缩窄是该疾病的主要病因，而近年来心脏手术已成为其发病的主要原因之一。然而，仍有被定义为特发性缩窄性心包炎的病例被观察到。除了经典的慢性和亚急性形式外，还描述了一些新的表现形式，如渗出性缩窄性、局限性、短暂性、隐匿性以及心包厚度正常的缩窄性心包炎。尽管保守治疗可能会缓解患者症状，但心包切除术仍然是该疾病唯一的确定性治疗方法。值得注意的是，心包缩窄的诊断确立得越早，预后越好。本综述详细阐述了缩窄性心包炎的病理生理特征、临床表现、诊断工具及治疗方法。
