Marta Liliana, Alves Miguel, Peres Marisa, Ferreira Ricardo, Ferreira Hugo, Leal Margarida, Nobre Ângelo
Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal.
Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal.
Rev Port Cardiol. 2015 Jan;34(1):69.e1-6. doi: 10.1016/j.repc.2014.08.013. Epub 2014 Dec 17.
Constrictive pericarditis is a clinical condition characterized by the appearance of signs and symptoms of right heart failure due to loss of pericardial compliance. Cardiac surgery is now one of the most frequent causes in developed countries, while tuberculosis remains the most prevalent cause in developing countries. Malignancy is a rare cause but usually has a poor prognosis. The diagnosis of constrictive pericarditis remains a clinical challenge and requires a combination of noninvasive diagnostic methods (echocardiography, cardiac magnetic resonance and computed tomography); in some cases, cardiac catheterization is needed to confirm the diagnosis. The authors present the case of a 51-year-old man, hospitalized due to cardiac tamponade. Diagnostic investigation was suggestive of tuberculous etiology. Despite directed medical therapy, the patient developed effusive-constrictive physiology. He underwent pericardiectomy and anatomopathologic study suggested a neoplastic etiology. The patient died in the postoperative period from biventricular failure.
缩窄性心包炎是一种临床病症，其特征是由于心包顺应性丧失而出现右心衰竭的体征和症状。在发达国家，心脏手术是目前最常见的病因之一，而在发展中国家，结核病仍然是最普遍的病因。恶性肿瘤是一种罕见病因，但通常预后较差。缩窄性心包炎的诊断仍然是一项临床挑战，需要结合非侵入性诊断方法（超声心动图、心脏磁共振成像和计算机断层扫描）；在某些情况下，需要进行心导管检查以确诊。作者介绍了一名51岁男性因心脏压塞住院的病例。诊断性检查提示为结核病因。尽管进行了针对性的药物治疗，但患者仍发展为渗出性缩窄性生理状态。他接受了心包切除术，解剖病理学研究提示为肿瘤病因。患者术后死于双心室衰竭。
