Schiller N B, Botvinick E H
Circulation. 1977 Nov;56(5):774-9. doi: 10.1161/01.cir.56.5.774.
We have identified pericardial effusion by echocardiography in 174 patients. Seventeen had cardiac tamponade which was not always clinically obvious. Right ventricular narrowing or compression, occurring in the minor axis at end diastole and end expiration, to 7 +/- 2 mm or less, was strongly associated with tamponade in patients with effusion. Right ventricular compression and signs of tamponade abated with pericardiocentesis. One patient was in tamponade without obvious right ventricular narrowing. Nonetheless, he demonstrated serial increases in right ventricular dimensions which paralleled hemodynamic improvement. Diminished left ventricular end-diastolic dimension, "swinging heart," electrical alternans, reciprocal respiratory variations in right and left ventricular end-diastolic dimensions and variation in amplitude of the mitral D-E slope were nonspecific for tamponade. Evaluation of right ventricular dimensions may be clinically useful to diagnose and monitor cardiac tamponade.
我们通过超声心动图在174例患者中发现了心包积液。17例存在心脏压塞，其临床表现并不总是很明显。舒张末期和呼气末短轴方向上右心室狭窄或受压，内径至7±2mm或更小，在有积液的患者中与心脏压塞密切相关。心包穿刺术后，右心室受压及心脏压塞征象减轻。1例患者存在心脏压塞，但无明显右心室狭窄。尽管如此，他的右心室尺寸呈系列增加，这与血流动力学改善情况平行。左心室舒张末期内径减小、“心脏摆动”、电交替、左右心室舒张末期内径的呼吸性反向变化以及二尖瓣D-E斜率幅度变化对心脏压塞而言均不具有特异性。评估右心室尺寸对于诊断和监测心脏压塞可能具有临床意义。
