Fibrous thickening of the pericardium

Introduction Pericardial fiber thickening refers to inflammation caused by pericardial fibrosis, adhesion, and endocardial thickening.

Cause

It can be caused by infection, connective tissue abnormalities, metabolic abnormalities, injuries, myocardial infarction or certain drugs, which are common in pericarditis.

an examination

Related inspection

Electrocardiogram two-dimensional echocardiography dynamic electrocardiogram (Holter monitoring) Doppler echocardiography molybdenum target X-ray examination

Clinical manifestations of pericarditis

Patients may have fever, night sweats, cough, sore throat, or vomiting or diarrhea. Acute heart tamponade can occur when the pericardium quickly exudes a large amount of fluid. The patient has chest pain, difficulty breathing, cyanosis, pale complexion, and even shock. There may also be ascites, hepatomegaly and other symptoms.

Pericardial physicochemical examination

X-ray examination: When the amount of fluid exceeds 300 ml, the heart shadow increases to both sides, and the angle of the heart becomes an acute angle. At more than 1000 ml, the heart shadow is in the form of a flask and varies with body position. The heart beats weakened or disappeared.

Electrocardiogram

In the case of dry pericarditis, each lead (except avR), the ST segment is raised, and returns to the equipotential line after a few days, and the T wave is flat or inverted. When the pericardium has exudate, the QRS complex is low voltage.

Echocardiography: It shows an illuminating dark area in the pericardial cavity, which is an accurate, safe and simple diagnostic method.

At present, the treatment of this disease is still based on the treatment of primary disease. If necessary, symptomatic treatment measures can be taken. For example, chest pain can be given painkillers. If the amount of pericardial effusion is large, it can be used for pericardial puncture.

Chinese medicine believes that this disease is mostly caused by "heartache", "chest", "sipping", "edema" and other diseases. The incidence, especially the pericardial effusion and the spleen and stomach damage, water wet stop, block in the heart envelope. The water drink is stopped in the pericardium, but it can be forced into the heart and forced to the lungs, causing asthma and discomfort. Therefore, when treating, it is necessary to go to the water to drink the evil, and the water goes to its breath and self-leveling. The inflammation of the pericardium can be acute or chronic and can lead to exudation of the pericardium.

Differential diagnosis

The symptoms of pericardial fiber thickening need to be identified as follows:

Acute pericarditis

Symptoms can be caused by the primary disease, such as tuberculosis can have hot flashes in the afternoon, night sweats. Suppurative pericarditis can have chills, high fever, and sweat. Inflammation of the pericardium itself can show pain in the back of the chest, difficulty breathing, coughing, hoarseness, difficulty swallowing, etc. In the early stage of acute pericarditis and in the late stage of pericardial effusion absorption, pericardial friction sounds can be heard in the anterior region of the heart, which can last from several hours to several days. When the amount of pericardial effusion exceeds 300 ml, the apical beat can disappear. A significant reduction in cardiac output can cause shock. Diastolic relaxation is limited, so that increased venous pressure can produce jugular vein engorgement, hepatomegaly, ascites, lower extremity edema, and odd veins.

Constrictive pericarditis

The cause of this disease is mostly tuberculosis, followed by suppurative. After acute pericarditis, it usually takes 2-8 months to have obvious signs of pericardial constriction. Acute narrowing occurs within one year after acute pericarditis, and is chronically narrowed in one year. Mainly manifested as dyspnea, apical beat weakened or disappeared, jugular vein engorgement, hepatomegaly, massive ascites and lower extremity edema, odd pulse.

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