Miranda William R, Oh Jae K
Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Cardiol Clin. 2017 Nov;35(4):551-558. doi: 10.1016/j.ccl.2017.07.008.
Effusive-constrictive pericarditis (ECP) corresponds to the coexistence of a hemodynamically significant pericardial effusion and decreased pericardial compliance. The hallmark of ECP is the persistence of elevated right atrial pressure postpericardiocentesis. The prevalence of ECP seems higher in tuberculous pericarditis and lower in idiopathic cases. The diagnosis of ECP is traditionally based on invasive hemodynamics but the presence of echocardiographic features of constrictive pericarditis post-pericardiocentesisis can also identify ECP. Data on the prognosis and optimal treatment of ECP are still limited. Anti-inflammatory agents should be the first line of treatment. Pericardiectomy should be reserved for refractory cases.
渗出-缩窄性心包炎（ECP）是指血流动力学上具有显著意义的心包积液与心包顺应性降低并存。ECP的标志是心包穿刺术后右心房压力持续升高。ECP在结核性心包炎中的患病率似乎较高，而在特发性病例中较低。传统上，ECP的诊断基于有创血流动力学检查，但心包穿刺术后出现缩窄性心包炎的超声心动图特征也可诊断ECP。关于ECP的预后和最佳治疗的数据仍然有限。抗炎药物应作为一线治疗。心包切除术应保留用于难治性病例。
