资源描述：
《慢性心力衰竭最新指南解读课件幻灯》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、慢性心力衰竭最新指南解读田野教授哈尔滨医科大学附属二院心内科第五届北方介入心脏病学暨心血管疾病诊疗新进展国际研讨会2009.01.11哈尔滨ESC-51COUNTRIESContentDefinitionanddiagnosisDiagnostictechniquesNon-pharmacologicalmanagementPharmacologicaltherapyDevicesandsurgeryCo-morbiditiesandspecialpopulationsDefinitionanddiagnosis“Theve
2、ryessenceofcardiovacularmedicineistherecognitionofearlyheartfailure”SirThomasLewis,1933DefinitionofHFImportantly,itwasemphasisedthatthediagnosisisnotdependentonacertainejectionfraction(EF),althoughithasimplicationsforprognosis.CommonclinicalmanifestationsClinicalma
3、nifestationsFatigueCoughBreathlessnessSwollenanklesDepressionWeightgainLossofappetiteNeedtourinateatnightPalpitationSwollenabdomenClassificationofHFCommoncausesofHFCoronaryheartdiseaseManymanifestationsHypertensionOftenassociatedwithleftventricularhypertrophyandeje
4、ctionfractionCardiomyopathiesFamilial/geneticornon-familial/non-genetic(includingacquired,e.g.myocarditis)Hypertrophic(HCM),dilated(DCM),restrictive(RCM),arrhythmogenicrightventricular(ARVC),unclassifiedDrugsβ-Blockers,calciumantagonists,antiarrhythmics,cytotoxicag
5、entsToxinsAlcohol,medication,cocaine,traceelements(mercury,cobalt,arsenic)EndocrineDiabetesmellitus,hypo/hyperthyroidism,Cushingsyndrome,adrenalinsufficiency,excessivegrowthhormone,phaeochromocytomaNutritionalDeficiencyofthiamine,selenium,carnitine.Obesity,cachexia
6、InfiltrativeSarcoidosis,amyloidosis,haemochromatosis,connectivetissuediseaseOthersChagas'disease,HIVinfection,peripartumcardiomyopathy,end-stagerenalfailureClassificationofHF•NewonsetFirstpresentationAcuteorslowonset•TransientRecurrentorepisodic•ChronicPersistentSt
7、able,worsening,ordecompensatedTimeisimportantforvarioustypesofheartfailure.DiagnostictechniquesClinicalexaminationDiagnosisofHFwithnatriureticpeptidesAsregardsdiagnostictools,theimportanceofBNP/NT-proBNPwasstressed,anditisnowrecommendednotonlyforexcludingheartfailu
8、re,butalsoforconfirmationofthediagnosis.DiagnosticassessmentssupportingthepresenceofHF(BNP)inDifferentiatingbetweenDyspneaAlanS.Maisel,NEnglJMed2
