Any changes in the pericardium - filmy bag that surrounds the heart, pericardium classified as disease. One of the most common - an inflammatory disease called pericarditis.
Constrictive pericarditis or compressing occurs usually as a result of acute exudative pericarditis, but can sometimes develop as an independent disease.
In constrictive pericarditis both leafletsheart bag (pericardium) are closely soldered together. The pericardium is thickened, thickens and loses its ability to properly stretch during contraction of the heart muscle.
As a result of these changes pericardium loses itselasticity and could not be stretched first in diastole, thereby limiting, the phase of the cardiac muscle relaxation. Consequently, complicated filling of the heart chambers in diastolic period. First blood overflowing the large veins, then there is stagnation of blood in the systemic circulation.
The cause of constrictivepericarditis may be rheumatism, tuberculosis and other infections of the heart and chest trauma, blood diseases, kidney disease with accumulation of urea in the blood of metabolic products.
Constrictive pericarditis can bethe final stage of the flow of exudative pericarditis. If he develops independently, it usually takes a long time without complaints. The patient goes to a doctor only when he already occur congestion in the systemic circulation.
Noteworthy veins in the neckalmost all patients. There are complaints of swelling in the lower extremities, heaviness in the right upper quadrant, the increase in volume of the abdomen. The pulse is usually frequent. Blood pressure low. Heart sounds when listening to muffled. On the electrocardiographic low ventricular complexes, a variety of cardiac arrhythmias in the late stage.
Drug treatment of constrictivepericarditis futile. Therefore, when the first signs of compression of the heart (the stagnation in the systemic circulation, complaints of pain in the heart, edema, increased central venous pressure), surgery is performed.
Produce perikardektomiyu - surgical removalpericardium. Removal of part of the heart bags inefficient, so removed almost all of the pericardium. Thorax opened and separated from the pericardium of the heart from the left ventricle, and almost all of the pericardium is removed, leaving only the portions where the nerve passes.
The results of operations are good. Mortality was lowest. Nearly all patients recover completely.