normalpericardialphysiologyandtonadephysiology-nt正常心包填塞生理學(xué)和生理學(xué)n-資料下載頁(yè)
2025-01-12 07:35本頁(yè)面
【正文】 xtent of inversion NO Duration of inversion YES RA inversion lasting 1/3 of the cycle has a specificity of 100% and Sensitivity of 94% for clinical tampnade 2D Features of Tamponade The longer the duration of RA inversion the higher the probability of tampodane Inversion 1/3 of systole 94% Sensitive 100% Specific RA free wall is a thin flexible structure ? brief inversion can occur without Tamponade. RV Compression No controversy as to the exact timing of RV free wall inversion Early diastole May be transient OR May persist throughout diastole. RV diastolic collapse Occurs when: Intrapericardial pressure RV pressure RV Diastolic Collapse (RVDC) Also affected by: Intravascular volume Low pressure tamponade RV Pressure RVH and PHTN = RVDC at higher pressures Chamber pliance RV: Ischemia, Trauma, Post CABG adhesions LV : Ditto ? LV less pliant = shape alteration is minimal pared to Atria or RV despite pressure equalization RV Inversion RV inversion preceeds the onset of clinical tamponade Significant Drop in MAP Onset of Pulsus Continued increase in intrapericardial pressure ? Increasing prominence of RV inversion In severe tamponade RV inversion persists throughout diastole Rate of PE Accumulation also affects Tamponade Physiology Volume of the fluid Rate of accumulation Slowly accumulating 1Li Rapid accumulation of 50100 cc Doppler Findings Percent change in Doppler Flow Velocity with Inspiration
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