Kawahara K, Sakai H, Kurogami K, Oki T, Fukuda N, Ishimoto T, Tominaga T, Okushi H, Mori H
Department of Internal Medicine, Tokushima Prefectural Central Hospital.
J Cardiogr. 1986 Sep;16(3):775-86.
A case of primary pericardial malignant mesothelioma was presented, which initially had a relatively large quantity of pericardial fluid, followed by constrictive pericarditis. The patient was a 43-year-old woman whose chief complaint was dyspnea and admitted to our hospital in March, 1984. Because of a relatively large quantity of pericardial fluid was observed. In April, drainage of the fluid and pericardiotomy were performed with marked relief of symptoms. She was discharged, but her dyspnea recurred in August, and she was readmitted. After the second admission, the chest radiograph showed a cardiothoracic ratio of 62%, and her electrocardiogram showed low voltage. A pericardial knock was recorded, and the timing of this sound coincided with that of the peak of the early distolic wave of the mitral flow velocity pattern. A jugular pulse tracing showed a deep and sharp y descent. The diastolic pressure curve of the right ventricle revealed a dip and plateau pattern. The echocardiographic finding was characterized by abnormal systolic motion and an early diastolic dip of the interventricular septum, multiple abnormal echoes and thickening of the pericardium, and an abnormal mass echo in the left atrial cavity. Based on the above examinations, pericardiotomy was performed, but the tumor was not entirely resected. The histological diagnosis was malignant mesothelioma.
报告一例原发性心包恶性间皮瘤，该患者最初心包积液量较大，随后发展为缩窄性心包炎。患者为43岁女性，主要症状为呼吸困难，于1984年3月入院。因观察到心包积液量较大，4月进行了心包积液引流及心包切开术，症状明显缓解。患者出院，但8月呼吸困难复发，再次入院。二次入院后，胸部X线片显示心胸比率为62%，心电图显示低电压。记录到心包叩击音，该声音的出现时间与二尖瓣血流速度模式早期舒张波峰值的时间一致。颈静脉搏动图显示y降支深而陡。右心室舒张压曲线呈下陷-高原型。超声心动图表现为室间隔收缩期运动异常及舒张早期下陷，心包多发异常回声及增厚，左心房腔内有异常肿块回声。基于上述检查，进行了心包切开术，但肿瘤未完全切除。组织学诊断为恶性间皮瘤。
