[Phonomechanocardiography of constrictive pericarditis]

There were studied 19 constrictive pericarditis cases demonstrated by anatomist study. It was evident, at all of them, systemic veiny hypertension's syndrome. "Extinguished" cardiac noises and "quiet" heart only appeared at the 42% of the cases. 73% of patients were found with important incapacity. Lyan's pericardic protodiastolic crack was registered at the 75% of the cases and only at 2 cases (10.9%) it was found reinforcement of pulmonary noise II. It is agree with the haemodynamic discovery of pulmonary pression's light elevation. Characteristically, precordiogrammes showed great "A" wave, and it was agree with telediastolic pression's elevation of the two ventricles obtained by catheterism. Phlebogramme was characteristic of systemic veiny hypertension by impediment of ventricular filled at all the studied cases. Measurement of cardiac cycle's phases showed diminution at PE, Blumberger's intrasystolic quotient, left expulsion fraction (Carrard's method) and ventricular pression's elevation middle velocity (VPEMV). By the contrary Weissler's index was found elevated. Eventhough found ciphers could be considered like bordering normal values, there is a difference statistically significance in relation with the values that were found in sane subjects. These discoveries were interpreted in the base that the patient's heart with constrictive pericarditis acts at the curve's ascendent part of the ventricular function because it has incapacity to utilize Starling's mechanism. Process' chronicity produces myocardic atrophy by "discuss" and, by this, ventricular function's improvement can be no immediate to pericardiectomy. Apexcardiogramme shows the impedement to ventricular filled with its diastolic morphology which is very similar to intracavitary pression's curve ("square root's image"). It is postuled the hypothesis that these sicks do not develop important pulmonary hypertension, because right ventricle's poor diastolic distension impides generation of major expense and systolic pression and, by other side, the impedement to ventricular filled has repercussion over right auricle and systemic veiny territory much more distensible, with the known clinical consequences.