WordNet

flow under pressure
an unrestrained expression of emotion (同)gush, outburst, blowup, ebullition
located around the heart or relating to or affecting the pericardium; "pericardial space" (同)pericardiac

PrepTutorEJDIC

〈U〉流出,噴出;〈C〉流出物(量) / 〈C〉(感情・言葉などの,通例過剰な)吐露,ほとばしり

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/23 11:57:53」(JST)

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Pericardial effusion ("fluid around the heart") is an abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation leads to an increased intrapericardial pressure which can negatively affect heart function. A pericardial effusion with enough pressure to adversely affect heart function is called cardiac tamponade. Pericardial effusion usually results from a disturbed equilibrium between the production and re-absorption of pericardial fluid, or from a structural abnormality that allows fluid to enter the pericardial cavity.

Normal levels of pericardial fluid are from 15 to 50 mL.

Signs and symptoms

Chest pain or pressure are common symptoms. A small effusion may be asymptomatic. Larger effusions may cause cardiac tamponade, a life-threatening complication; signs of impending tamponade include dyspnea, low blood pressure, and distant heart sounds.

The so-called "water-bottle heart" is a radiographic sign of pericardial effusion, in which the cardiopericardial silhouette is enlarged and assumes the shape of a flask or water bottle.

It can be associated with dullness to percussion over the left subscapular area due to compression of the left lung base. This phenomenon is known as Ewart's sign.^[1]

Causes

Pericarditis
Long term usage of cabergoline ingredient (dopamine agonists)
Between January 2004 and October 2012, 11 individuals taking benzodiazepines reported pericardial effusion to the FDA.
Viral infection (coxsackie virus)
Infection
Drug Eluting Stents
Inflammatory disorders, such as lupus, rheumatoid arthritis^[2] and post myocardial infarction pericarditis (Dressler's syndrome)
Cancer that has spread to the pericardium
Trichinosis
Kidney failure with excessive blood levels of urea nitrogen
Minoxidil
Hypothyroidism
Heart surgery^[3] (postpericardotomy syndrome)
Clogged Chest tube after heart surgery, leading to retained blood complications

Diagnosis

Water bottle-shaped heart

Sinus tachycardia with low QRS voltage and QRS alternans

It may be:

transudative (congestive heart failure, myxoedema, nephrotic syndrome),
exsudative (tuberculosis, spread from empyema)
hemorrhagic (trauma, rupture of aneurysms, malignant effusion).
malignant (due to fluid accumulation caused by metastasis)

A CT scan image showing a pericaridal effusion
A very large hemorrhagic pericardial effusion due to malignancy as seen on ultrasound. closed arrow: the heart, open arrow: the effusion
Pericardial effusion due to malignancy. Note bulbous heart and primary lung cancer in right upper lobe.
An ECG showing electrical alternans in a person with a pericardial effusion.
A pericardial effusion due to pericarditis

Treatment

Treatment depends on the underlying cause and the severity of the heart impairment. Pericardial effusion due to a viral infection usually goes away within a few weeks without treatment. Some pericardial effusions remain small and never need treatment. If the pericardial effusion is due to a condition such as lupus, treatment with anti-inflammatory medications may help. If the effusion is compromising heart function and causing cardiac tamponade, it will need to be drained, most commonly by a needle inserted through the chest wall and into the pericardial space called pericardiocentesis. A drainage tube is often left in place for several days. In some cases, surgical drainage may be required by cutting through the pericardium creating a pericardial window.

References

^ "Pericardial Disease".
^ [1]
^ Pericardial effusion:What are the symptoms?, Dr. Martha Grogan M.D.

External links

Pericardial Disease Cleveland Clinic Online Medical Reference

UpToDate Contents

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1. 心嚢液貯留の診断および治療 diagnosis and treatment of pericardial effusion
2. 心膜疾患の病因 etiology of pericardial disease
3. 悪性腫瘍関連心膜疾患 pericardial disease associated with malignancy
4. 心タンポナーデ cardiac tamponade
5. 心膜の心エコー評価 echocardiographic evaluation of the pericardium

English Journal

CT findings in 11 patients with TAFRO syndrome: a variant of multicentric Castleman's disease.

Kiguchi T1, Sato C2, Takai K3, Nakai Y4, Kaneko Y5, Matsuki M6.
Clinical radiology.Clin Radiol.2017 Oct;72(10):905.e1-905.e5. doi: 10.1016/j.crad.2017.05.007. Epub 2017 Jun 16.
PMID 28629605

Team-based approach to identify cardiac toxicity in critically ill hematopoietic stem cell transplant recipients.

Dandoy CE1, Jodele S1, Paff Z2, Hirsch R3, Ryan TD3, Jefferies JL3, Cash M3, Rotz S1, Pate A1, Taylor MD3, El-Bietar J1, Myers KC1, Wallace G1, Nelson A1, Grimley M1, Pfeiffer T1, Lane A1, Davies SM1, Chima RS2.
Pediatric blood & cancer.Pediatr Blood Cancer.2017 Oct;64(10). doi: 10.1002/pbc.26513. Epub 2017 Mar 8.
PMID 28271596

Anticancer drug-loaded quantum dots engineered polymeric nanoparticles: Diagnosis/therapy combined approach.

Belletti D1, Riva G2, Luppi M2, Tosi G1, Forni F1, Vandelli MA1, Ruozi B3, Pederzoli F1.
European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.Eur J Pharm Sci.2017 Sep 30;107:230-239. doi: 10.1016/j.ejps.2017.07.020. Epub 2017 Jul 18.
PMID 28728978

Japanese Journal

症例大量血性心膜液においてアデノシンデアミナーゼ高値が認められた特発性心膜炎の1例

井出雄一郎,伊藤一貴,長尾強志 [他]
呼吸と循環 60(12), 1266-1272, 2012-12
NAID 40019497598

縦隔リンパ節腫脹から気管内浸潤と心嚢水貯留をきたした肺クリプトコッカス症の1例

沼田岳士,児玉孝秀,山田英恵,佐藤信也,小川良子,本間晋介,栗島浩一,坂本透,酒井光昭,佐藤幸夫,南優子,檜澤伸之
気管支学 : 日本気管支研究会雑誌 34(5), 456-461, 2012-09-25
背景.免疫不全宿主に生じる肺クリプトコッカス症では,肺野結節影に加え浸潤影や胸水貯留など様々な臨床所見を呈することがある.症例. 71歳女性.肺腺癌の手術歴があり,重症筋無力症のため胸腺摘出術後に免疫抑制剤の投与を受けていた.慢性咳嗽のため近医受診し,胸部CTにて左肺上葉結節影,縦隔リンパ節腫脹,心嚢水,両側胸水が認められたため,肺癌の再発を疑われ紹介受診となった.気管支鏡検査では気管前壁にポリー …
NAID 110009518310

Related Pictures

$Pericardial Effusion X Ray Umedic : \x3cb$

★リンクテーブル★

リンク元	「心嚢液貯留」「PE」「心膜水腫」「心膜液貯留」「心嚢液」
拡張検索	「malignant pericardial effusion」
関連記事	「effusion」「pericardial」

「心嚢液貯留」

Pericardial effusion
	A 2D transthoracic Echocardiogram of pericaridal effusion. The Swinging Heart
Classification and external resources
Specialty	Cardiac surgery
ICD-10	I30, I31.3
ICD-9-CM	423.9
DiseasesDB	2128
eMedicine	med/1786
Patient UK	Pericardial effusion
MeSH	D010490

　　[★]

英: pericardial effusion
関: 心膜液貯留、心嚢血腫、乳糜心膜症

原因

大動脈解離(Stanford A型)、急性心膜炎、結核性心膜炎
川崎病
全身性エリテマトーデス
急性膵炎
心外膜への腫瘍浸潤

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