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 is 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, fluttering or beating too hard or too fast, may occur 和 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 is a rare disease that takes time to develop. 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 doctor diagnoses pericarditis based on your medical history, a physical exam 和 test results.

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

你的医生可能会问你是否患有:

• 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), your doctor will ask you 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 doctor will look for signs of excess fluid in your chest. 常见的症状是心包摩擦. This is the sound of the pericardium rubbing against the outer layer of your heart. Your doctor will listen for this using a stethoscope.

Your doctor 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

Your doctor may recommend tests to diagnose your condition 和 its severity. 最常见的测试是:

• 心电图(心电图): This detects 和 records your heart's electrical activity, with certain EKG results suggesting pericarditis.
• 胸部x光片: A chest X-ray takes pictures of the inside of the chest, 包括你的心脏, 肺和血管. The pictures can show whether you have an enlarged heart, which can be a sign of excess fluid in your pericardium.
• 超声心动图(回声): This test uses sound waves to create pictures of your heart, showing its size 和 shape 和 how well it's working. It can show fluid build-up in the pericardium.
• 心脏CT(计算机断层扫描)这张x光片很清楚, detailed picture of your heart 和 pericardium 和 helps to rule out other causes of 胸部疼痛.
• 心脏MRI(磁共振成像): A cardiac MRI uses magnets 和 radio waves to form detailed pictures of your organs 和 tissues. 它可以显示心包的变化.
  
  Your doctor also may recommend blood tests to find out if you've had a 心脏病, the cause of your pericarditis 和 the extent of inflammation in your pericardium.

了解更多:

• 查看心绞痛的动画