Centre de Recherche et Centre Cardiovasculaire du Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada.
Can J Cardiol. 2013 Apr;29(4):519.e5-6. doi: 10.1016/j.cjca.2012.08.010. Epub 2012 Nov 10.
Herein, we present the case of a 49-year-old woman who presented to a peripheral hospital with a 4-day history of progressive shortness of breath. Following a clinical diagnosis of heart failure and slightly elevated cardiac troponins on initial blood work, the patient was referred for same-day diagnostic coronary angiography, which revealed normal coronary arteries but the surprising finding of a fluoroscopic swinging heart due to a massive pericardial effusion. The patient promptly improved after emergent pericardiocentesis. Fluoroscopic clues to the diagnosis of pericardial effusion are reviewed, with accompanying illustrative video and hemodynamic tracings.
在此，我们报告一例 49 岁女性病例，她因进行性呼吸困难 4 天到一家外周医院就诊。根据最初血液检查结果提示心力衰竭和心肌肌钙蛋白轻度升高，临床诊断为心力衰竭，患者当天被转至行诊断性冠状动脉造影，结果显示冠状动脉正常，但令人惊讶的是发现大量心包积液导致透视下心脏摆动。紧急心包穿刺引流后患者迅速好转。本文回顾了心包积液的透视诊断线索，并附有说明性视频和血流动力学图。
