高血压英文课件Congestiveheart

Congestive heart failureIvan CerovekiMentor:A.mega Horvat.Congestive heart failureIvan C1Elementary notionsCardiac outputPeripheral circulationPreloadAfterload.Elementary notionsCardiac outp2Definition of CHFComplex syndromeImpaired function of the heartCompromised peripheral perfusion.Definition of CHFComplex syndr3EpidemiologyPrevalence in Europe:2%Prevalence 65 yrs:10%1st year mortality:30 40%5 year mortality:60 70%.EpidemiologyPrevalence in Euro4Clinical characteristicsAcute heart failureChronic heart failure.Clinical characteristicsAcute 5Clinical characteristicsLeft heart failureRight heart failureBiventricular(congestive)heart failure.Clinical characteristicsLeft h6AetiologyCardiac pathologyIschaemic heart diseaseHypertensive heart diseaseCardiomyopathyValvular heart diseaseCongenital heart diseasePericardial disease.AetiologyCardiac pathology.7AetiologyExtracardiac pathologyPulmonary disease:pulmonary embolismEndocrine and metabolic diseaseInfective diseaseToxic substances:alcohol.AetiologyExtracardiac patholog8PathophysiologySympathetic activationIncreased heart rateIncreased myocardial contractilityVenous vasoconstrictionArteriolar vasoconstriction.PathophysiologySympathetic act9PathophysiologyRAAS systemArteriolar vasoconstrictionFluid retention.PathophysiologyRAAS system.10PathophysiologyNatriuretic peptidesDiuretic effectNatriuretic effectHypotensive effect.PathophysiologyNatriuretic pep11PathophysiologyVentricular dilatationIncrease in metabolic requirements.PathophysiologyVentricular dil12Clinical featuresCommon symptomsFatigueDyspnoeaPalpitationsWeight gain.Clinical featuresCommon sympto13Clinical featuresLeft heart failureParoxysmal nocturnal dyspnoeaOrthopnoeaBasal lung cracklesPresence of the third heart sound.Clinical featuresLeft heart fa14Clinical featuresRight heart failureJugular venous distensionHepatomegalyPeripheral oedema.Clinical featuresRight heart f15DiagnosticsChest X-rayECGBlood testsEchocardiographyNatriuretic peptide.DiagnosticsChest X-ray.16TreatmentVasodilator therapyACE inhibitorsAngiotensin II receptor antagonistsNitratesHydralazine.TreatmentVasodilator therapy.17Treatment blockersMetoprololBisoprololCarvedilol.Treatment blockers.18TreatmentDiureticsLoop diureticsThiazide diureticsPotassiumsparing diuretics.TreatmentDiuretics.19TreatmentDigoxinDopamineDobutamineAntiarrhythmic drugs.TreatmentDigoxin.20TreatmentRevascularizationBiventricular pacemakerCardiac transplantation.TreatmentRevascularization.21ReferencesVrhovac B et al:Interna medicina,Naklada Ljevak,2008Ballinger A,Patchett S:Pocket Essentials of Clinical Medicine,Elsevier Saunders,2007United States National Library of Medicine(nlm.nih.gov)Wikipedia(wikipedia.org).ReferencesVrhovac B et al:Int22The end.The end.23