Draw back the clinical manifestation of the narrow pericarditis and _'s symptom of the diagnosis

Draw back the clinical manifestation of the narrow pericarditis and _'s symptom of the diagnosis
First, clinical manifestation
Pericardium contract narrow time that form different in size, develop into pericardium contract take place, acute pericarditis getting narrow to claim acute to contract usually, more than one year person is called chronically contracting narrowly. There are 3 kinds of forms in the course of developing: Person who sustain, acute pericarditis their react all over within several days after treating and symptom, such as generating heat, can getting slower gradually when aching at chest,etc., solve even disappear totally, liver is old and reducing to aggravate instead at neck anger piece,etc. extravasated blood physical signs intravenous intravenous, so it is very difficult to confirm acute one and draw back the narrow demarcation line of one in this kind of patient, this, with oozing the liquid while absorbing, the pericardium is increased thick and contracting narrowly and taking shape and nearly existing at the same time and having something to do, so it is difficult to distinguish the demarcation lines of two issues; The intermittence type, pericarditis acute symptom and physical sign of one can totally disappear in certain time, the patient thought pathological change healed, but the pericardium appears again to draw back narrow symptom and physical sign several months later, this and response of the pericardium is relatively slow, take shape to contract narrowly relevantly within relatively long time; The getting up type slowly, the clinical manifestation of this kind of patient's acute pericarditis is too more lightly to even have medical history, but there is gradual advancement symptoms such as tired and unable, abdominal distension, lower extremities edema,etc., draw back narrowly the pericardium within 1- 2 years.
1.Symptom
The main symptom of the narrow pericarditis is abdominal distension, lower extremities edema to contract, this relates to the fact that venous pressure increase, although have, have difficulty in breathing or sit up straight, breathe, it function the whole by heart, but caused by accumulating liquid oppression in ascites or thorax. In addition patient tell tired, lose the appetite often and upper abdomen glutted, etc.
2.Physical sign
Blood pressure low, pulse quickly, appear by pulse strange, be if you can't last atrium, quiver for 30% timesed 1/3. Venous pressure is obviously raised, even if venous pressure still keeps higher level after diuresis. The intravenous anger one of neck, more obvious while inhaling (Kussmaul solicits) ,The intravenous relaxation of neck expanded is early to collapse (Freidreich was solicited) suddenly . Kussmaul solicit with Freidreich soliciting, belonging to non- specific physical sign, heart pigeonhole fill in and serious right heart of reason any depleted, can all see. The heart looks at and examines and sees the retraction of apex of the heart of systolic phase, the relaxation early apex of the heart beats. There is relaxation one to beat and strike the sense in palpation. The heart voiced sound circle of percussion is normal or expands. Hear the pericardium knock and hit the sound among the rib of left reason 3- 4 of the brestbone, there is no noise. Other physical sign: Such as the jaundice, wet sound, liver of lung bottom are big, the ascites is more obvious than the lower extremities edema, similar to liver cirrhosis.
Second, diagnose
The intersection of pericardium and the intersection of disease and medical history, intravenous to combine neck the intersection of anger and bloated, the intersection of liver and old, ascites, the intersection of heart and circle quite and heart sound remote to knock, hit transliteration with the pericardium, can set up the pericardium tentatively and draw back narrow diagnosis. And then find the pericardium calcification by the X-ray examination of chest, the electric chart of heart changes and can be fixed and diagnosed for low-voltage and T wave now. Check to the competent heart conduit of the not typical case, can obtain in the heart curve Israel of pressure assists diagnosis.
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