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LES PERICARDITES EN MEDECINE INTERNE Lo c Guillevin H pital Cochin, Universit de Paris 55 me Congr s de la SNFMI, B

Le p?ricarde prot?ge le c?ur des pathologies m?diastinales Il positionne le c?ur dans le m?diastin Il r?duit les frottements avec les structures adjacentes Il pr?vient une trop grande dilatation des structures cardiaques Il optimise les rapports volume/pression intra et intercavitaires. . LE PE

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LES PERICARDITES EN MEDECINE INTERNE Lo c Guillevin H pital Cochin, Universit de Paris 55 me Congr s de la SNFMI, B

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    18. Table 1. Tests and Treatments for Various Causes of Acute Pericarditis.Table 1. Tests and Treatments for Various Causes of Acute Pericarditis.

    31. Figure 1. Cardiac Tamponade. Pericardial pressure-volume (or strain-stress) curves are shown in which the volume increases slowly or rapidly over time. In the left-hand panel, rapidly increasing pericardial fluid first reaches the limit of the pericardial reserve volume (the initial flat segment) and then quickly exceeds the limit of parietal pericardial stretch, causing a steep rise in pressure, which becomes even steeper as smaller increments in fluid cause a disproportionate increase in the pericardial pressure. In the right-hand panel, a slower rate of pericardial filling takes longer to exceed the limit of pericardial stretch, because there is more time for the pericardium to stretch and for compensatory mechanisms to become activated.Figure 1. Cardiac Tamponade. Pericardial pressure-volume (or strain-stress) curves are shown in which the volume increases slowly or rapidly over time. In the left-hand panel, rapidly increasing pericardial fluid first reaches the limit of the pericardial reserve volume (the initial flat segment) and then quickly exceeds the limit of parietal pericardial stretch, causing a steep rise in pressure, which becomes even steeper as smaller increments in fluid cause a disproportionate increase in the pericardial pressure. In the right-hand panel, a slower rate of pericardial filling takes longer to exceed the limit of pericardial stretch, because there is more time for the pericardium to stretch and for compensatory mechanisms to become activated.

    46. Figure 3. Most Common Sites of Blind and Image-Guided Insertion of the Needle for Pericardiocentesis. In the paraxiphoid approach, the needle should be aimed toward the left shoulder. In the apical approach, the needle is aimed internally.Figure 3. Most Common Sites of Blind and Image-Guided Insertion of the Needle for Pericardiocentesis. In the paraxiphoid approach, the needle should be aimed toward the left shoulder. In the apical approach, the needle is aimed internally.

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