Mann T, Brodie B R, Grossman W, McLaurin L
Am J Cardiol. 1978 Apr;41(4):781-6. doi: 10.1016/0002-9149(78)90832-9.
Eight patients with metastatic malignancy of the pericardium who demonstrated the hemodynamics of subacute effusive-constrictive pericarditis were studied. All patients had clinical evidence of cardiac tamponade due to malignant pericardial effusion and were referred for therapeutic pericardiocentesis. In six in whom pericardiocentesis was successfully performed, right atrial pressure remained elevated after pericardiocentesis and return of the intrapericardial pressure to zero; in these patients, hemodynamic data were initially compatible with tamponade but suggested constriction after removal of the pericardial fluid. In the remaining two patients, echocardiography revealed pericardial fluid, but attempted pericardiocentesis was unsuccessful. In these two patients, the hemodynamic data suggested pericardial constriction; subsequent pathologic examination revealed neoplastic involvement of the visceral pericardium. Thus, subacute effusive-constrictive pericarditis, previously recognized as a complication of tuberculosis or mediastinal radiation, may also be due to metastatic malignancy. The syndrome can readily be demonstrated when right heart catheterization is performed in conjunction with pericardiocentesis.
对8例表现为亚急性渗出性缩窄性心包炎血流动力学特征的转移性心包恶性肿瘤患者进行了研究。所有患者均有因恶性心包积液导致心脏压塞的临床证据，并因治疗目的接受心包穿刺术。在成功进行心包穿刺术的6例患者中，心包穿刺术后右心房压力仍升高，心包内压力恢复至零；在这些患者中，血流动力学数据最初与心脏压塞相符，但在抽出心包积液后提示存在缩窄。其余2例患者，超声心动图显示有心包积液，但心包穿刺术尝试未成功。在这2例患者中，血流动力学数据提示心包缩窄；随后的病理检查显示脏层心包有肿瘤浸润。因此，亚急性渗出性缩窄性心包炎，以前被认为是结核病或纵隔放疗的并发症，也可能由转移性恶性肿瘤引起。当结合心包穿刺术进行右心导管检查时，该综合征很容易被证实。
