Pérez-Casares Alejandro, Cesar Sergi, Brunet-Garcia Laia, Sanchez-de-Toledo Joan
Department of Pediatric Cardiology, Hospital Sant Joan de Déu Barcelona, University of Barcelona, Barcelona, Spain.
Division of Cardiac Intensive Care, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA.
Front Pediatr. 2017 Apr 24;5:79. doi: 10.3389/fped.2017.00079. eCollection 2017.
Pericardial effusion (PEff) is defined by an increase in the physiological amount of fluid within the pericardial space. It can appear following different medical conditions, mainly related to inflammation and cardiac surgery. Cardiac tamponade is a critical condition that occurs after sudden and/or excessive accumulation of fluid in the pericardial space that restricts appropriate filling of the cardiac chambers disturbing normal hemodynamics and ultimately causing hypotension and cardiac arrest. It is, therefore, a life-threatening condition that must be diagnosed as soon as possible for correct treatment and management. Echocardiographic evaluation of PEff is paramount for timely and appropriate diagnosis and management. A structured echocardiographic approach including two-dimensional, M-mode, and Doppler echocardiographic evaluation assessing (i) quantity and quality of pericardial fluid, (ii) collapse of cardiac chambers, (iii) respiratory variation of the ventricular diameters, (iv) inferior vena cava collapsibility, and (v) flow patterns in atrioventricular valves should give the bedside clinician the necessary information to appropriately manage PEff. Here, we review these key echocardiographic signs that will ensure an appropriate assessment of a patient with PEff and/or cardiac tamponade.
心包积液(PEff)定义为心包腔内生理性液体量增加。它可出现在不同的医学状况之后,主要与炎症和心脏手术有关。心脏压塞是一种危急状况,发生于心包腔内突然和/或过量积液,限制心脏腔室的适当充盈,扰乱正常血流动力学,最终导致低血压和心脏骤停。因此,这是一种危及生命的状况,必须尽快诊断以便进行正确的治疗和管理。超声心动图评估心包积液对于及时和恰当的诊断及管理至关重要。一种结构化的超声心动图方法,包括二维、M型和多普勒超声心动图评估,评估(i)心包积液的量和性质,(ii)心脏腔室的塌陷,(iii)心室直径的呼吸变化,(iv)下腔静脉的可塌陷性,以及(v)房室瓣的血流模式,应能为床边临床医生提供适当管理心包积液所需的信息。在此,我们回顾这些关键的超声心动图征象,这些征象将确保对心包积液和/或心脏压塞患者进行适当评估。