心包炎的症状和诊断

心包炎的症状和体征

A common symptom of acute pericarditis is a sharp, stabbing 胸部疼痛，通常来得很快. It's often in the middle or left side of the chest, 和 there may be pain in one or both shoulders.

Sitting up 和 leaning forward tends to ease the pain, while lying down 和 breathing deep worsens it. Some people describe the pain as a dull ache or pressure in their chest.

胸痛可能感觉像 心脏病. If you experience 胸部疼痛, call 911 right away because you may be having a 心脏病.

Fever is another common symptom of acute pericarditis. Other symptoms are weakness, trouble breathing 和 coughing. 心慌, which are feelings that your heart is skipping a beat, 拍打的拍打得太用力或太快的, 可能发生. This can be a sign of deeper heart tissue involvement.

Chronic pericarditis often causes tiredness, coughing 和 shortness of breath. Chest pain is sometimes absent with this type of pericarditis. Severe cases of chronic pericarditis can lead to swelling in the stomach, feet, ankles 和 legs 和 低血压 (低血压).

心包炎的并发症

Two serious complications of pericarditis are 心脏压塞 和 慢性缩窄性心包炎.

• 心脏压塞 happens if too much fluid collects in the sac, putting pressure on the heart. This prevents the heart from properly filling with blood, 这样流出心脏的血液就少了, 导致血压急剧下降的. 未经治疗的心脏填塞可能是致命的.
• 慢性缩窄性心包炎 是一种需要线上电子游戏飞禽走兽发展的罕见疾病吗. It leads to scar-like tissue forming throughout the sac around the heart. As the sac becomes stiff 和 unable to move properly, the scarred tissue starts to compress the heart 和 prevent it from functioning well.

诊断心包炎

A health care professional diagnoses pericarditis based on your medical history, 体检和检查结果.

专家参与

初级保健医生, 比如家庭医生, 内科医生或儿科医生, 经常诊断和治疗心包炎. 心脏病, pediatric cardiologist or infectious disease specialist may be involved, depending on the patient’s age 和 medical conditions.

病史

Your health care professional may ask whether you have had:

• A recent respiratory infection or flu-like illness
• A recent 心脏病 or injury to your chest
• 其他医疗条件

如果你有 胸部疼痛 (心绞痛), you will also be asked to describe how it feels, where it's located 和 whether it's worse when you lie down, 呼吸或咳嗽.

物理考试

When the pericardium is inflamed, the fluid between the sac's two layers of tissue increases. So, your health care professional will look for signs of excess fluid in your chest. 常见的症状是心包摩擦. This is detected more often in patients with acute pericarditis than in those with chronic pericarditis. It’s thought that the rub might be the result of inflammation. Your health care professional will listen for this using a stethoscope.

Your health care professional may hear other chest sounds that are signs of fluid in the pericardium (pericardial effusion) or the lungs (pleural effusion). Both are more severe problems related to pericarditis.

诊断测试

The most common tests used to diagnose pericarditis 和 its severity are:

• Blood tests: May be recommended to find out if you've had a 心脏病, the cause of your pericarditis 和 the amount of inflammation in your pericardium.
• 心电图(心电图): Measures your heart's electrical activity 和 certain results may suggest pericarditis.
• 胸部x光片: Takes pictures of the inside of the chest, including your heart, lungs 和 blood vessels. An X-ray can show whether your heart is enlarged due to excess fluid in your pericardium. It may also reveal signs of infection, sarcoidosis or malignancies that may cause pericarditis.
• 超声心动图(回声): This test uses sound waves to create pictures of your heart, 显示它的大小, 形状和效果如何. 它可以显示心包积液.
• 心脏CT(计算机断层扫描): This type of X-ray takes a clear, detailed picture of your heart 和 pericardium. 这有助于排除其他原因引起的胸痛.
• 心脏MRI(磁共振成像):也叫CMR, this test uses magnets 和 radio waves to form detailed pictures of your organs 和 tissues. 它可以显示心包的变化.

了解更多:

• 查看心绞痛的动画