Pericarditis/Tamponade: Difference between revisions

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Pericarditis is an inflammation of the pericardium (heart sac) usually caused by a virus. Echocardiographic is often seen in the pericardium (pericardial effusion). A fatal complication of pericarditis is that an inflammation in the heart causes the pericardial fluid or blood to fill up when relaxed, this is called tamponade.
Pericarditis is an inflammation of the pericardium (heart sac) usually caused by a virus. Echocardiographic is often seen in the pericardium (pericardial effusion). A fatal complication of pericarditis is that an inflammation in the heart causes the pericardial fluid or blood to fill up when relaxed, this is called tamponade.
 
 
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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.


After a pericardectomie often still an abnormal filling pattern is observed. On the one hand it is thought that this is due to incomplete pericardectomie. On the other hand this is possible because the myocardium is sometimes involved in the disease process. The measured with TDI early diastolic velocity of the mitral valve annulus septal (E ') often takes postoperatively decreases, which would fit in a relaxation disorder of the myocardium. When may explain in autopsies the increased myocardial fibrosis that is found. The disease process which gave constriction, can also cause myocardial fibrosis. (radiotherapy, auto- immune processes). The emergence of a more restrictive image after pericardectomie is associated with a worse prognosis.
After a pericardiectomy often still an abnormal filling pattern is observed. On the one hand it is thought that this is due to incomplete pericardiectomy. On the other hand this is possible because the myocardium is sometimes involved in the disease process. The measured with TDI early diastolic velocity of the mitral valve annulus septal (E ') often taken postoperatively decreases, which would fit in a relaxation disorder of the myocardium. This may explain in autopsies the increased myocardial fibrosis that is found. The disease process which gave constriction, can also cause myocardial fibrosis (radiotherapy, auto- immune processes). The emergence of a more restrictive image after pericardiectomy is associated with a worse prognosis.


==Constrictive pericarditis==
==Constrictive pericarditis==


Constrictive pericarditis is a form of pericarditis in which the pericardverdikt and if it were a hard shell forms around the heart. This is also called " armored heart " called. Thus, the heart can not fill normally (diastolic dysfunction). Inhalation reduces the pressure in the chest. Due to the lower pressure more blood can flow to the right ventricle. This bends the ventricular septum to the LV far. The LV can therefore be less filled.
Constrictive pericarditis is a form of pericarditis in which the pericardium is thickened and it were a hard shell that forms around the heart. This is also called "armored heart". Thus, the heart can not fill normally (diastolic dysfunction). Inhalation reduces the pressure in the chest. Due to the lower pressure more blood can flow to the right ventricle. This bends the ventricular septum to the LV far. The LV thus therefore becomes less filled.


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It is good to realize that none of the exceptions that can be seen specifically in a constrictive pericarditis for this syndrome. Also in other syndromes such deviations can be observed. It is the combination of abnormalities may be a strong indication of a constrictive pericarditis.
It is necessary to realize that specific deviations do not suggest a constrictive pericarditis. Such deviations are observed in other syndromes also. It is the combination of different deviations that gives a strong indication of a constrictive pericarditis.
 
==Constrictive pericarditis vs 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 can be distinguished with echocardiography. In restrictive cardiomyopathy, there is a myocardial disease. Primarily, it is the function disorder of the myocardium. Therefore, often deviations with regards to myocardial are observed, for example like the speckled aspect, thickened valves, thickened atrial septal amyloidosis and also a reduced systolic function. Dysfunctions can also be detected even if it is not part of the 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.


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.
More specific effects are shown in the table below :
More specific effects are shown in the table below :


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