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Pericarditis/Tamponade: Difference between revisions
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{| class="wikitable" cellpadding="0" cellspacing="0" border="0" | {| class="wikitable" cellpadding="0" cellspacing="0" border="0" | ||
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|Echocardiographic findings at a major inflow obstruction | !colspan="2"|Echocardiographic findings at a major inflow obstruction | ||
Doppler | |- | ||
Increased respiratory variation in peak speed of mitral E (> 25 %) and the tricuspid valve (> 40%) | |Doppler | ||
2 - D images | | | ||
Dilated inferior vena cava without respiratory variation in diameter | *Increased respiratory variation in peak speed of mitral E (>25%) and the tricuspid valve (>40%) | ||
Late diastolic to systolic early collapse of right and left atrium | |- | ||
Early diastolic RV collapse | |2 - D images | ||
However, early after cardiac surgery, there may be geloketteerd pericardial. This may cause local compression | | | ||
*Dilated inferior vena cava without respiratory variation in diameter | |||
*Late diastolic to systolic early collapse of right and left atrium | |||
*Early diastolic RV collapse | |||
|- | |||
|colspan="2"|However, early after cardiac surgery, there may be geloketteerd pericardial. This may cause local compression to occur, and the evidence of inflow obstruction more difficult to interpret. | |||
|} | |} | ||
Doppler measurements | Doppler measurements | ||
Evidence of an inflow impediment to the LV and RV expressing itself in elevated filling pressures. The mitral and tricuspid inflow pattern will play an E / A ratio > 1 exhibit generally. Also, the deceleration time will be of the mitral E- top shortened (<180 msec.) In the pulmonary vein flow, the S- wave will be smaller than the D- wave. | Evidence of an inflow impediment to the LV and RV expressing itself in elevated filling pressures. The mitral and tricuspid inflow pattern will play an E / A ratio >1 exhibit generally. Also, the deceleration time will be of the mitral E- top shortened (<180 msec.) In the pulmonary vein flow, the S- wave will be smaller than the D- wave. | ||
In a constrictive the right and left ventricular filling influence each other. The following indications point to this: | In a constrictive the right and left ventricular filling influence each other. The following indications point to this: | ||
Respiratory variation in MV inflow (at start of inspiration decline MV inflow E -top > 25 %) and TV inflow (at start of inspiration increase of E -top > 40 %). | Respiratory variation in MV inflow (at start of inspiration decline MV inflow E -top >25%) and TV inflow (at start of inspiration increase of E -top >40%). | ||
Respiratory variation in pulmonary vein flow wherein at the beginning of expiration the diastolic forward flow > 10 % increase. | Respiratory variation in pulmonary vein flow wherein at the beginning of expiration the diastolic forward flow >10% increase. | ||
Also, atrial fibrillation, this respiratory variation can be observed. In severe obstructive pulmonary same pattern can be seen. Reinforced by the change in intrathoracic pressure However, this will also increase sharply to the right ventricle during inspiration caval flow. In a constrictive flow will hardly increase. | Also, atrial fibrillation, this respiratory variation can be observed. In severe obstructive pulmonary same pattern can be seen. Reinforced by the change in intrathoracic pressure However, this will also increase sharply to the right ventricle during inspiration caval flow. In a constrictive flow will hardly increase. | ||
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Vs. constrictive pericarditis. restrictive cardiomyopathy | Vs. constrictive pericarditis. restrictive cardiomyopathy | ||
The image of a pericarditis resembles the image of a restrictive cardiomyopathy : good systolic LV function with diastolic dysfunction. However, there are differences that distinguish with echocardiography. In restrictive cardiomyopathy, there is a myocardial disease. Primarily, it is the function disorder of the myocardium. Therefore frequently hereby myocardial abnormalities seen bv speckled aspect, thickened valves, thickened atrial septal amyloidosis is also an impaired systolic function can often be observed. It can also often important klepdysfuncties observed while this is not part of constrictive pericarditis. At a restrictive cardiomyopathy The atria are often greatly enlarged with a restrictive cardiomyopathy. In a constrictive, there is also often some atria dilatation but this is not conspicuous. The mitral inflow patterns in a restrictive cardiomyopathy often show a more pronounced restrictive filling pattern emerges, E / A ratio of 2 or higher with deceleration times shorter than 140msec. In a restrictive cardiomyopathy, pulmonary hypertension can sometimes be a significant action (> 50 mmHg). In a constrictive is rarely a pulmonary pressure above 50 mmHg found. | The image of a pericarditis resembles the image of a restrictive cardiomyopathy : good systolic LV function with diastolic dysfunction. However, there are differences that distinguish with echocardiography. In restrictive cardiomyopathy, there is a myocardial disease. Primarily, it is the function disorder of the myocardium. Therefore frequently hereby myocardial abnormalities seen bv speckled aspect, thickened valves, thickened atrial septal amyloidosis is also an impaired systolic function can often be observed. It can also often important klepdysfuncties observed while this is not part of constrictive pericarditis. At a restrictive cardiomyopathy The atria are often greatly enlarged with a restrictive cardiomyopathy. In a constrictive, there is also often some atria dilatation but this is not conspicuous. The mitral inflow patterns in a restrictive cardiomyopathy often show a more pronounced restrictive filling pattern emerges, E / A ratio of 2 or higher with deceleration times shorter than 140msec. In a restrictive cardiomyopathy, pulmonary hypertension can sometimes be a significant action (>50 mmHg). In a constrictive is rarely a pulmonary pressure above 50 mmHg found. | ||
More specific effects are shown in the table below : | More specific effects are shown in the table below : | ||
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|Mitral lateral É | |Mitral lateral É | ||
|< septal É | |< septal É | ||
|> É septal | |>É septal | ||
|- | |- | ||
|Ventricular septal strain | |Ventricular septal strain | ||
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|Video | |Video | ||
|- | |- | ||
! | !Video source <cite>1</cite> | ||
|} | |} | ||