Restrictive heart disease

Introduction to restricted heart disease Restricted heart disease includes endocardial fibrosis, which occurs mostly in the tropics, and eosinophilic cardiomyopathy, which occurs mostly in the temperate zone. This disease is very rare in China. Young adults are common and there is no obvious gender difference. The lesions can be confined to the left ventricle, and the right ventricle or biventricular is involved at the same time. Due to different lesions, there are different clinical manifestations. The onset of the disease is relatively slow. It occurs mostly in tropical and temperate zones, and the tropics are slightly more temperate. All age groups can be sick, the male prevalence rate is higher than that of women, and the ratio of male to female is about 3:1. basic knowledge The proportion of illness: 0.008% Susceptible people: no specific population Mode of infection: non-infectious Complications: pericardial effusion, acute renal failure, proteinuria, hematuria, uremia

Restrictive heart disease

The cause of this disease is unknown. Some people think that it is an autoimmune disease caused by eosinophilia and degeneration, but it has not been further confirmed. Eosinophilia is a phenomenon in which eosinophils in peripheral blood exceed 300 cells/mm3. It is a non-independent disease caused by various causes (the eosinophils in the blood of normal adults account for 0 to 6% of the total number of white blood cells, and the direct count is 50 to 300/mm3).

Restrictive heart disease prevention

There is no effective preventive measure for this disease. The main clinical problem is active treatment to avoid complications. The patient should not be tired. Some people observe that the mental state of the person is generally 8:00 am, 2 pm and 8 pm. The best state lasted for about 2 hours and each time it fell back. If you can take advantage of this change, it is the best way to establish a regular rhythm of life, and you can maximize your wisdom and potential to keep your brain in good working condition and improve your health. Prevent concurrent infections.

Restricted heart disease complications Complications, acute renal failure, proteinuria, urinary uremia

This disease can often be complicated by pericardial effusion and visceral embolism:

1, pericardial effusion

Pericardial effusion refers to the symptoms of liquid substance in the pericardial cavity due to pericardial lesions. It is a relatively common clinical English disease. The normal pericardial cavity contains 25-30 ml of liquid (up to 50 ml), for any reason. The amount of fluid in the pericardial cavity increases, more than 50 ml, that is, pericardial effusion, the clinical manifestations of Zhejiang are mainly related to the three factors of the amount of fluid in the pericardial cavity, the growth rate of fluid accumulation and the characteristics of pericardium.

2, visceral embolism

Visceral embolism is most common in the lungs and kidneys. When there are extensive thrombus in the glomerular circulation, acute renal failure can occur, manifested as low back pain, oliguria, proteinuria, hematuria, tubular urine, and even no urine and uremia.

Restrictive heart disease symptoms Common symptoms Abdominal distension Abdominal pain Pericardial effusion Hepatomegaly Paroxysmal nocturnal dyspnea Abdominal jugular vein engorgement Shortness of breath

The onset is slower. In the early stage, there may be fever, and there will be fatigue, dizziness and shortness of breath. The left ventricle is mainly characterized by left heart failure and pulmonary hypertension such as shortness of breath, cough, hemoptysis, basal rales of the lung, second tone of the pulmonary valve, etc.; the left ventricle is blocked by the right ventricle. The performance of the jugular vein engorgement, liver enlargement, lower extremity edema, ascites and so on. The heart beat is often weakened, the voiced voice is slightly enlarged, the heart sound is light, the heart rate is fast, and there may be diastolic gallop and arrhythmia. Pericardial effusion may also be present. Visceral embolism is not uncommon.

First, symptoms and signs caused by right ventricular disease:

Slow onset, abdominal distension, ascites, abdominal pain due to hepatic congestive hepatomegaly or abdominal wall due to ascites, labor dyspnea and paroxysmal nocturnal dyspnea, can be relieved by the use of ascites, indicating that dyspnea is mainly caused by ascites , the pre-cardiac discomfort, the loss of blood output is weak, the labor force declines, half of the patients have mild cough, sputum, main signs: apical beats weakened, the heart is light or moderately enlarged, the first heart sounds weakened, The lower left rim of the sternum has a systolic murmur, which can smell the third heart sound. The lower extremity edema is not commensurate with the ascites. The amount of ascites is large and the lower extremity edema is light. After diuretics, the lower extremity edema is reduced or disappeared, and the ascites often persists. The anger is obvious.

Second, the symptoms and signs caused by left ventricular disease:

Painfulness, shortness of breath, systolic murmur in the apex of the apex, and a small tremor in the apex of the apex. When the pulmonary vascular resistance increases, the pulmonary hypertension appears.

Third, bilateral ventricular lesions caused by symptoms and signs:

It is characterized by a syndrome of right ventricular and left ventricular endocardial myocardial fibrosis, but mainly characterized by signs and symptoms of right ventricular disease. A few patients have a prominent arrhythmia, mostly atrial arrhythmia, which can lead to extreme enlargement of the right atrium. Even the collapse, death, and some patients with chronic recurrent large amount of pericardial effusion as the main performance, often mistaken for simple pericardial disease.

The main manifestations of this disease, increased venous pressure, jugular vein engorgement, hepatomegaly, ascites, lower extremity edema, light and massive ascites, heart enlargement is spherical, weak beats, often with signs of atrioventricular valve insufficiency.

Restricted heart disease check

(1) X-ray inspection:

The heart is enlarged, and the right atrium or left atrium is enlarged. When the pericardial effusion is accompanied, the heart shadow is obviously enlarged, and endocardial calcification is seen.

(2) Electrocardiogram:

Due to increased cardiac load, mitral P-wave, atrial fibrillation, atrioventricular block and bundle branch block can be seen.

(C) cardiac catheterization:

Right ventricular endocardial myocardial fibrosis, due to decreased right ventricular compliance, increased right ventricular end-diastolic pressure, early diastolic sag, diastolic plateau wave, right atrial and vena cava pressure increased, left ventricular endocardial fibrosis The pulmonary circulation pressure is increased, and ventricular angiography shows that the ventricular cavity is reduced and the blood flow is slow.

Restrictive heart disease diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Clinically, it must be differentiated from constrictive pericarditis, especially restrictive cardiomyopathy with right ventricular disease. The clinical manifestations are similar. In the history of acute pericarditis, X-ray shows pericardial calcification, chest CT or magnetic resonance examination shows pericardium. Thickening, support pericarditis; electrocardiogram on the atrial or ventricular hypertrophy, bundle branch block, abnormal contraction time to support cardiomyopathy, echocardiography to help the identification of the two, apical heart occlusion and heart Intimal thickening establishes the diagnosis of cardiomyopathy, and ventricular angiography and endomyocardial biopsy can be performed in difficult cases.

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