Naggar C Z, Dillon W D, Butterly J R, Malacoff R F
J Am Coll Cardiol. 1985 Aug;6(2):467-70. doi: 10.1016/s0735-1097(85)80187-x.
Echocardiography has emerged as a sensitive study in the evaluation of pericardial effusion. The specificity of echocardiographic signs in cardiac tamponade remains undefined, however. Two such signs, early diastolic collapse of the right ventricular free wall and late diastolic collapse of the right atrial wall, were observed in two patients without clinical evidence of cardiac tamponade. Increased intrapericardial pressure was documented in each patient. Accumulation of pericardial fluid under high pressure results in a reversal of the instantaneous transmural pressure gradients in early and late diastole, causing collapse of the right ventricular and the right atrial wall, respectively; however, such a tense pericardial effusion may not cause hemodynamic embarrassment severe enough to yield clinical signs of cardiac tamponade.
超声心动图已成为评估心包积液的一项敏感检查。然而，心脏压塞时超声心动图征象的特异性仍不明确。在两名无心脏压塞临床证据的患者中观察到了两个这样的征象，即右心室游离壁舒张早期塌陷和右心房壁舒张晚期塌陷。记录显示每名患者的心包内压力均升高。高压下心包积液的积聚导致舒张早期和晚期瞬间跨壁压力梯度逆转，分别导致右心室壁和右心房壁塌陷；然而，这种紧张性心包积液可能不会引起严重到足以产生心脏压塞临床体征的血流动力学障碍。
