normalpericardialphysiologyandtonadephysiology-nt正常心包填塞生理學(xué)和生理學(xué)n-在線瀏覽
2025-03-01 07:35本頁面
【正文】 Normally Transmural pressure 0 at all times Transmural pressure across any cardiac chamber: (Intracavitary pressure) (Intrapericardial pressure) Tamponade Physiology With increasing intrapericardial pressure, ., negative ? positive (Intracavitary pressure) (Intrapericardial pressure) cavity collapse occurs when local transmural gradient bees negative local transmuralgradient bec s negative Tamponade Physiology Filling pressure elevation is a pensatory mechanism to maintain cardiac output In fully developed tamponade Diastolic pressure in all four chambers is elevated, and Equalized Tamponade Physiology Lower Pressure chambers (ATRIA) Affected Before Higher pressure chambers (VENTRICLES) Tamponade Physiology The pressive effects of the pericardial pressure is most prominent during the phase of the cardiac cycle when the pressure of the chamber in question is the lowest. Ventricles ? Early Diastole Atria ? Systole ? RA Compression Weyman () RA Inversion Begins in late diastole Continues into ventricular systole for variable period before normalizing RA Compression Feigenbaum “The most mon finding [of tamponade] is diastolic invagination of the Rt. Ventricular and/or Rt. Atrial wall during diastole.” RA Compression RA inversion Extremely sensitive sign of clinical tamponade Specificity only 50% Correlation with likelihood of tamponade: E
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