高血压英文ppt精品课件congestive heart

Congestive heart failure Ivan Ceroveki Mentor: A. mega Horvat Elementary notions Cardiac output Peripheral circulation Preload Afterload Definition of CHF Complex syndrome Impaired function of the heart Compromised peripheral perfusion Epidemiology Prevalence in Europe: 2 % Prevalence 65 yrs: 10 % 1st year mortality: 30 40 % 5 year mortality: 60 70 % Clinical characteristics Acute heart failure Chronic heart failure Clinical characteristics Left heart failure Right heart failure Biventricular (congestive) heart failure Aetiology Cardiac pathology Ischaemic heart disease Hypertensive heart disease Cardiomyopathy Valvular heart disease Congenital heart disease Pericardial disease Aetiology Extracardiac pathology Pulmonary disease: pulmonary embolism Endocrine and metabolic disease Infective disease Toxic substances: alcohol Pathophysiology Sympathetic activation Increased heart rate Increased myocardial contractility Venous vasoconstriction Arteriolar vasoconstriction Pathophysiology RAAS system Arteriolar vasoconstriction Fluid retention Pathophysiology Natriuretic peptides Diuretic effect Natriuretic effect Hypotensive effect Pathophysiology Ventricular dilatation Increase in metabolic requirements Clinical features Common symptoms Fatigue Dyspnoea Palpitations Weight gain Clinical features Left heart failure Paroxysmal nocturnal dyspnoea Orthopnoea Basal lung crackles Presence of the third heart sound Clinical features Right heart failure Jugular venous distension Hepatomegaly Peripheral oedema Diagnostics Chest X-ray ECG Blood tests Echocardiography Natriuretic peptide Treatment Vasodilator therapy ACE inhibitors Angiotensin II receptor antagonists Nitrates Hydralazine Treatment blockers Metoprolol Bisoprolol Carvedilol Treatment Diuretics Loop diuretics Thiazide diuretics Potassiumsparing diuretics Treatment Digoxin Dopamine Dobutamine Antiarrhythmic drugs Treatment Revascularization Biventricular pacemaker Cardiac transplantation References Vrhovac B et al: Interna medicina, Naklada Ljevak, 2008 Ballinger A, Patchett S: Pocket Essentials of Clinical Medicine, Else