高血压英文ppt精品课件congestive heart

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1、CongestiveheartfailureIvanCerovečkiMentor:A.ŽmegačHorvatElementarynotionsCardiacoutputPeripheralcirculationPreloadAfterloadDefinitionofCHFComplexsyndromeImpairedfunctionoftheheartCompromisedperipheralperfusionEpidemiologyPrevalenceinEurope:2%Prevalence>65yrs:10%1styearmortality:30–40%

2、5yearmortality:60–70%ClinicalcharacteristicsAcuteheartfailureChronicheartfailureClinicalcharacteristicsLeftheartfailureRightheartfailureBiventricular(congestive)heartfailureAetiologyCardiacpathologyIschaemicheartdiseaseHypertensiveheartdiseaseCardiomyopathyValvularheartdiseaseCongenit

3、alheartdiseasePericardialdiseaseAetiologyExtracardiacpathologyPulmonarydisease:pulmonaryembolismEndocrineandmetabolicdiseaseInfectivediseaseToxicsubstances:alcoholPathophysiologySympatheticactivationIncreasedheartrateIncreasedmyocardialcontractilityVenousvasoconstrictionArteriolarvaso

4、constrictionPathophysiologyRAASsystemArteriolarvasoconstrictionFluidretentionPathophysiologyNatriureticpeptidesDiureticeffectNatriureticeffectHypotensiveeffectPathophysiologyVentriculardilatationIncreaseinmetabolicrequirementsClinicalfeaturesCommonsymptomsFatigueDyspnoeaPalpitationsWe

5、ightgainClinicalfeaturesLeftheartfailureParoxysmalnocturnaldyspnoeaOrthopnoeaBasallungcracklesPresenceofthethirdheartsoundClinicalfeaturesRightheartfailureJugularvenousdistensionHepatomegalyPeripheraloedemaDiagnosticsChestX-rayECGBloodtestsEchocardiographyNatriureticpeptideTreatmentVa

6、sodilatortherapyACEinhibitorsAngiotensinIIreceptorantagonistsNitratesHydralazineTreatmentβ–blockersMetoprololBisoprololCarvedilolTreatmentDiureticsLoopdiureticsThiazidediureticsPotassium–sparingdiureticsTreatmentDigoxinDopamineDobutamineAntiarrhythmicdrugsTreatmentRevascularizationBiv

7、entricularpacemakerCardiactransplantationReferencesVrhovacBetal:Internamedicina,NakladaLjevak,2008BallingerA,PatchettS:PocketEssentialsofClinicalMedicine,ElsevierSaunders,2007UnitedStatesNationalLibraryofMedicine(nlm.nih.gov)Wikipedia(wikipedia.org)Theend