What Is the Pericardial Sac?

Traumatic blood pericardium refers to the blood in the pericardial cavity caused by trauma. It is often caused by heart trauma, pericardial damage to large blood vessels or pericardial injury. Most of them are caused by sharp or firearm injuries in the anterior region of the heart, and some may be caused by severe closed chest injury.

Traumatic blood pericardium

Traumatic blood pericardium refers to the blood in the pericardial cavity caused by trauma. Often heart trauma, large pericardium

After cardiac surgery or interventional cardiac examination and treatment, it also occasionally causes cardiac perforation and blood pericardium. The degree of harm of blood pericardium and

1. Symptoms of acute pericardial tamponade: chest tightness, irritability, pale complexion, wet and cold skin, difficulty breathing, and even loss of consciousness.

2. Signs: Shortness of breath, may have cyanosis. Jugular vein irritation, fast and weak pulses, decreased blood pressure, reduced pulse pressure difference, increased central venous pressure, wounds in the anterior heart area (blood overflow with breathing or heartbeat), weakened or disappeared apical pulse, and weak heart sounds. There may be strange pulses (pulse pulses weaken or disappear when inhaling, and become stronger at the end of expiration). KussmAuis may also appear (the jugular vein is flared when inhaled).

Diagnose based on

1. There is a chest trauma, especially a sharp injury history in the anterior cardiac area.

2. There are signs and symptoms of acute pericardial tamponade.

3. Chest X-ray showed weakened heart pulsation and chest radiograph showed normal or slightly larger heart shadow.

4. Electrocardiogram: no special changes or changes in low voltage and ST-T in each lead.

5. Echocardiography: to understand the situation of blood accumulation in the pericardial cavity.

6. Nuclear magnetic resonance (MR) examination. Patients with stable conditions can make this test to determine the situation of hemorrhage in the pericardial cavity.

7. Pericardial puncture: a clear diagnosis, immediate relief, pericardial tamponade symptoms.

8. Localized pericardial exploration: Clinically, pericardial tamponade is highly suspected, but pericardial puncture cannot be confirmed. Localized pericardial exploration is feasible.

Principles of traumatic blood pericardium

1. Pericardial puncture: it can immediately relieve the symptoms of pericardial tamponade and improve hemodynamics. The puncture site is usually taken under the xiphoid process or the fourth intercostal approach of the anterior heart region. This is a slow development of pericardial tamponade caused by blunt injuries, which can be observed temporarily under close supervision after pericardial puncture treatment. If tamping symptoms recur, surgical exploration should be considered.

2. Surgical treatment: Cut the pericardium, remove the pericardial hemostasis or blood clots, remove the pericardial stuffing, repair the major blood vessel damage, and clear the source of bleeding from the blood pericardium. At the same time as anti-shock therapy, the rapid development of pericardial tamponade caused by closed injury often has heart injury. As with penetrating heart injury, surgery should be performed immediately. In these cases, even if pericardial puncture is effective in reducing pericardial tamponade, surgery must be performed. Negative pericardial puncture does not rule out heart damage. Prompt surgical exploration should be performed based on signs.

3. For the treatment of acute pericardial tamponade, the timeliness of the treatment is particularly emphasized, and the treatment is timely and effective. In order to avoid the serious consequences of pericardial tamponade.

4. To maintain ventricular filling pressure, the use of vasodilators can increase the stroke volume. Isoproterenol increases heart rate and myocardial contractility, increases stroke volume, and reduces peripheral vascular resistance, so it can be used to improve cardiac output in patients with pericardial tamponade. Norepinephrine is an alpha-receptor stimulant, which increases vascular resistance. Digitalis is not suitable for those who have pericardial tamponade because it can increase the afterload and cannot increase the stroke volume of pericardial tamponade.

5. Appropriate application of antibiotics to prevent infection.

Traumatic blood pericardial medication principles

1. Early administration of blood transfusion, anti-shock therapy (isoproterenol increases heart rate and myocardial contractility, reduces peripheral vascular resistance, and improves cardiac output of patients with pericardial tamponade) and pericardial puncture, prepare for thoracotomy surgery, and apply appropriately Antibiotics prevent infection and surgical treatment as soon as possible.

2. Antibiotics are applied systemically after surgery, and those with open injuries routinely use tetanus antiviral serum.

3. Symptomatic treatment and supportive treatment (including new special drugs).