Department of Internal Medicine, Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI, USA.
Cardiol Rev. 2011 Sep-Oct;19(5):233-8. doi: 10.1097/CRD.0b013e31821e202c.
Pericardial disease leading to pericardial effusion (PEF) is a common condition encountered by the clinician in day-to-day practice. If the PEF becomes large enough, it can cause hemodynamic compromise, resulting in a cardiogenic shock state known as cardiac tamponade. There are many clinical and echocardiographic signs that a clinician can use to assess whether a large PEF is hemodynamically significant. However, these signs can be either conflicting or even absent. The purpose of this review is to first, describe the physiology of the pericardium in health and how it changes with disease; second, outline the pathophysiology of pericardial tamponade and discuss how it is responsible for the physical and echocardiographic findings of cardiac tamponade; and third, suggest an approach to applying these findings in a systematic order to ensure a correct diagnosis.
心包疾病导致的心包积液（PEF）是临床医生日常实践中常见的病症。如果 PEF 足够大，它可能导致血流动力学障碍，导致一种称为心脏压塞的心源性休克状态。有许多临床和超声心动图征象，临床医生可以用来评估大量的 PEF 是否具有血流动力学意义。然而，这些征象可能相互矛盾，甚至不存在。本综述的目的首先是描述健康状态下心包的生理学以及疾病如何改变心包；其次是概述心脏压塞的病理生理学，并讨论其如何导致心脏压塞的物理和超声心动图表现；最后，建议以系统的方式应用这些发现的方法，以确保正确的诊断。
