Zusammenfassung
Der Rückgang bakterieller Infektionskrankheiten, insbesondere der Tuberkulose, hatte in den 40er und 50er Jahren die Häufigkeit von Perikarderkrankungen deutlich vermindert. In den letzten 20 Jahren wurde aber ein Anstieg von Herzbeutelerkrankungen registriert, der z. T. mit der Entwicklung diagnostischer und therapeutischer Verfahren in der Medizin in Zusammenhang steht, zu einem anderen Teil aber auch durch eine Änderung des Krankheitspanoramas bedingt ist. So hat die ansteigende Zahl von Herzinfarkten auch die Begleit- und Folgeerkrankungen wie Infarktperikarditis und Postmyokardinfarktsyndrom prozentual ansteigen lassen. Ebenso bedeutsam ist die Zunahme postoperativer Herzbeutelreaktionen als Folge einer Eröffnung des Perikards bei herzchirurgischen Eingriffen. Das gilt für operative Korrekturen angeborener wie erworbener Herzfehler, in besonderem Umfang aber auch für koronarchirurgische Eingriffe, die an Zahl die übrigen Herzoperationen weit übertreffen. Echokardiographische Kontrollen haben in 20–25% aller Fälle einen meist passageren Herzbeutelergruß sowohl nach Infarkt als auch nach operativen Eingriffen am Herzen erkennen lassen. Die Zunahme vorwiegend stumpfer Thoraxtraumen, insbesondere bei Autounfällen, hat gleichfalls zu einer Zunahme sog. traumatischer Perikarditiden geführt. Schließlich vermochten neue therapeutische Verfahren wie die Immunsuppres-sion oder die Anwendung wirksamerer Zytostatika einen protrahierteren Krankheitsverlauf bei immunologischen oder tumorösen Erkrankungen zu bewirken, so daß im Langzeitverlauf der Erkrankungen perikardiale Reaktionen häufiger beobachtet wurden.
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Schölmerich, P. (1989). Erkrankungen des Perikards. In: Just, H., et al. Myokarderkrankungen Perikarderkrankungen Herztumoren. Handbuch der inneren Medizin, vol 9 / 5. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-95517-4_19
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