Cardiology Department, Maria Vittoria Hospital, Torino, Italy.
J Cardiovasc Med (Hagerstown). 2010 Oct;11(10):712-22. doi: 10.2459/JCM.0b013e3283340b97.
The treatment of pericardial diseases is largely empirical because of the relative lack of randomized trials compared with other cardiovascular diseases. The main forms of pericardial diseases that can be encountered in the clinical setting include acute and recurrent pericarditis, pericardial effusion with or without cardiac tamponade, and constrictive pericarditis. Medical treatment should be targeted at the cause of the disease as much as possible. However, the cause of pericardial diseases may be varied and depends on the prevalence of specific diseases (especially tuberculosis). The search for an etiology is often inconclusive, and most cases are classified as idiopathic in developed countries where tuberculosis is relatively rare, whereas a tuberculous etiology is often presumed in developing countries where tuberculosis is endemic. The aim of the present article is to review current medical therapy for pericardial diseases, highlighting recent significant advances in clinical research, ongoing challenges and unmet needs. Following a probabilistic approach, the most common causes are considered (idiopathic, viral, tuberculous, purulent, connective tissue diseases and neoplastic pericardial disease). In this article, the therapy of idiopathic and more common forms of infectious pericarditis (viral and bacterial) is reviewed.
由于与其他心血管疾病相比，随机试验相对较少，因此心包疾病的治疗在很大程度上是经验性的。在临床环境中可能遇到的主要心包疾病形式包括急性和复发性心包炎、有心包填塞和无心包填塞的心包积液以及缩窄性心包炎。医疗治疗应尽可能针对病因。然而，心包疾病的病因可能多种多样，具体取决于特定疾病的流行情况（特别是结核病）。病因的寻找往往没有定论，在结核病相对较少的发达国家，大多数病例被归类为特发性，而在结核病流行的发展中国家，常假定为结核性病因。本文的目的是回顾心包疾病的当前医学治疗方法，重点介绍临床研究的最新重要进展、正在面临的挑战和未满足的需求。根据概率方法，考虑最常见的病因（特发性、病毒性、结核性、化脓性、结缔组织疾病和肿瘤性心包疾病）。本文回顾了特发性和更常见的感染性心包炎（病毒性和细菌性）的治疗方法。
