渗出性缩窄性心包炎的诊断与治疗：一例报告
Diagnosis and treatment of effusive-constrictive pericarditis: a case report.
作者信息
Al-Saiegh Yousif, Spears Jenna, Barry Tim, Lee Christopher, Haber Howard, Goldberg Sheldon
机构信息
Department of Internal Medicine, Pennsylvania Hospital-University of Pennsylvania Health System, 800 Spruce Street, Philadelphia, PA, USA.
Department of Cardiology, Pennsylvania Hospital-University of Pennsylvania Health System, 800 Spruce Street, Philadelphia, PA, USA.
出版信息
Eur Heart J Case Rep. 2021 May 8;5(5):ytab174. doi: 10.1093/ehjcr/ytab174. eCollection 2021 May.
BACKGROUND
Effusive-constrictive pericarditis (ECP) is a rare syndrome involving pericardial effusion and concomitant constrictive pericarditis. The hallmark is a persistently elevated right atrial pressure of >10 mmHg or reduction of less than 50% from baseline despite pericardiocentesis. Aetiologies include radiation, infection, malignancy, and autoimmune disease.
CASE SUMMARY
A 71-year-old man with a history of atrial fibrillation, obesity, hypertension, obstructive sleep apnoea, managed with continuous positive airway pressure presented with acute pericarditis complicated by pericardial effusion leading to cardiac tamponade. He was diagnosed with ECP after pericardiocentesis and was managed surgically with a pericardial window.
DISCUSSION
Early detected cases of ECP can be managed by medical therapy. Therapeutic interventions include pericardiocentesis, balloon pericardiostomy, and pericardiectomy. This report describes a case of new-onset congestive heart failure secondary to ECP.
背景
渗出性缩窄性心包炎（ECP）是一种罕见的综合征，涉及心包积液和伴随的缩窄性心包炎。其特征是尽管进行了心包穿刺术，但右心房压力持续升高>10 mmHg或较基线降低不到50%。病因包括放疗、感染、恶性肿瘤和自身免疫性疾病。
病例摘要
一名71岁男性，有房颤、肥胖、高血压、阻塞性睡眠呼吸暂停病史，采用持续气道正压通气治疗，因急性心包炎并发心包积液导致心脏压塞就诊。心包穿刺术后被诊断为ECP，并接受了心包开窗手术治疗。
讨论
早期发现的ECP病例可采用药物治疗。治疗干预措施包括心包穿刺术、球囊心包造口术和心包切除术。本报告描述了一例继发于ECP的新发充血性心力衰竭病例。
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