心臓タンポネード 心臓タンポネード 臨床的診断かエコーカルディオグラフィの診断か?
1Division of Cardiology, University of Cincinnati College of Medicine, Ohio 45267-0542.
Circulation
|May 1, 1993
まとめ
心臓タンポネドの診断は,静脈圧の上昇や呼吸不全などの臨床症状に依存し,エコーカルディオグラフィによって確認されます. 大量の心周内流出を有する一部の患者は,軽度または薬剤で治療可能な場合,排水を必要としない場合があります.
科学分野:
- 心臓病学 心臓病学
- 内科内科は,内科の内科である.
背景:
- 心臓タンポネード (Cardiac tamponade) は,循環器袋に液体の蓄積が特徴となる重大な状態である.
- 臨床的な表情は変動し,時には古典的な徴候が欠けることもあります.
研究 の 目的:
- 心臓タンポネードに対する診断基準の概要を述べる.
- 診断の確認におけるエコーカルディオグラフィの役割について議論する.
- 軽度の症例と重度の症例を区別し,管理決定を導くために.
主な方法:
- 静脈の全身圧,心拍動脈,呼吸不全,パラドックスな脈拍を中心とした臨床検査.
- エコーカルディオグラフィは,心周流出の大きさ,心室圧縮,および流れの変動を評価するために使用されます.
- 古典的な徴候が欠けているかもしれない特定の臨床シナリオの評価.
主要な成果:
- 診断は主に臨床的であり, perikardial effusionと心臓圧縮のエコーカルディオグラフィの発見によってサポートされています.
- パルサスパラドックスと高静脈圧は,左心房機能不全や局所性タンポネードなどの特定の状態では欠けることがあります.
- 右心房圧縮のエコーカルディオグラフィの証拠は,静脈圧上昇の明らかな臨床的徴候なしに発生することがあります.
結論:
- 心臓タンポネード診断は,臨床データとエコーカルディオグラフィのデータを統合します.
- 循環器切開を含む管理は,重症度および病因学に基づいて個別化されるべきです.
- 軽度の症例や,ドレスラー症候群のような治療可能な原因のある症例では,観察または医療管理が十分である場合があります.
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