医学交流课件：心包疾病.pptVIP

Causes 病因 Idiopathic pericardial effusion自发性心包积液 ? reactive blood vessels 血管反应？ ? immune mediated 免疫介导？ Neoplasia 肿瘤 Right atrial haemangiosarcoma 右心房血管肉瘤 Chemodectoma 化学感受器瘤 Lymphoma 淋巴瘤 Left atrial rupture 左心房破裂 Idiopathic Pericardial Haemorrhage 自发性心包出血 Younger dogs 幼小的犬 Golden retrievers 金毛巡回猎犬 50% chance will recur 50％的可能性再发 If recurs can drain 2nd time 如再发可再次排液 Risk of developing constrictive pericarditis 有发生缩窄性心包炎的可能 Neoplasia 肿瘤 RA haemangiosarcoma hopeless Chemodectoma allow fluid to drain into pleural cavity thoracotomy balloon dilation of window Left Atrial Rupture 左心房破裂 Advanced DMVD ？？ Very poor prognosis 预后不良 Try draining small volumes to keep out of tamponade but not enough to encourage bleed 试着排出少量液体，以解除心包填塞，但不要排出太多，以免继续流血 Don’t buy any large bags of dog food 不要买大包狗粮 Others 其它 Transudates 漏出液 Secondary to right heart failure 继发于右心衰竭 FIP in cats – high SG and protein 猫传染性腹膜炎－比重和蛋白质均高 renal failure – small volumes 肾衰－少量 Purulent pericardial effusion 化脓性心包积液 Cattle, cats rarely 牛，猫少见 drain and antibiotics 排出并用抗生素 surgery for FB 手术取出异物 Peritoneopericardial Diaphragmatic Hernia 腹膜心包膈疝 Congenital 先天性 Incidental finding 偶然发现 Vague discomfort, rapid breathing GI signs 隐约感觉不舒服，呼吸快，有胃肠道症状 Long haired cats and Weimaraners 长毛猫和德国魏犬 Muffled displaced heart sounds 心音低沉，不在其原来的位置 Large cardiac silhouette 心脏轮廓大 Surgery? 手术？ PPDH Radiographs 腹膜心包膈疝的X光片 Pericardial cyst 心包囊肿 Large cyst in pericardium 心包内有大的囊 Remnant of omentum from PPDH PPDH后遗留的网膜 Can give signs of RHS failure 可表现为右心衰竭 Surgery 手术 Usually straight forward 通常直接进行 Sally Martin Constrictive pericardial disease缩窄性心包疾病 Rare 很少见 Difficult to differentiate from restrictive cardiomyopathy 很难与限制性心肌病进行鉴别 Based on variations of mitral inflow velocities on echocardiography 要以超声心动上二尖瓣流进时的流速为基础 Surgery can be difficult! 手术很困难 Any Questions? 提问 Pericardial Disease 心包疾病 Pericardial effusions 心包积液 Haemorrhagic 血性的 Transudates 漏出液 Exuda