心力衰竭英文ppt课件.pptVIP

* * * * * * * * Summary of management of H. F. Treating the underlying cause and associated diseases General care — daily life adjustments Drug therapy: ACEI Diuretics in case presence of congestion Beta-blockers Digoxin if necessary Acute Left Heart Failure—Pulmonary edema Etiological causes: Acute myocardial infarction, Hypertension, Mitral stenosis, etc. Pathophysiology — marked increase of the pulmonary blood volume and capillary pressure resulting exudation in alveoli. Clinical features: Severe dyspnea Cough with frothy sputum,blood tinged Full of lung rales Restlessness to mental retardation Management of Acute Left Heart Failure Oxygen therapy. Positive pressure oxygenation if necessary Vasodilator therapy: Nitroglycerin,nitropruside I.V. Diuretics: Furosemide I.V. Positive inotropic therapy: Dobutamine, milrinone (N.B. cardiac glycoside is contraindicated in the first 24 hr. of AMI) Sedatives: Morphine in small dosage may help the restlessness state 进展 1.急性心衰治疗顺序：强心、利尿、扩管 2.慢性心衰治疗顺序：神经内分泌疗法、强心、利尿。 心功能 I：ACEI；II：ACEI+ β受体阻滞剂+洋地黄类；III： ACEI+ β受体阻滞剂+洋地黄类+利尿剂；Ⅳ： ACEI+ 洋地黄类+利尿剂。 基因治疗；心肺移植等 * * * * kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk * * * * * * * * * * * * * * * * * * * * * * * Definition of Heart Failure Heart failure is a pathophysiological state of heart in which, the heart cannot pump enough blood to meet the needs required by the metabolizing tissue, or to do so only from an elevated filling pressure. Classification Etiological Causes of Heart Failure Myocardial damage: myocardial ischemia, inflammation etc. Increased cardiac load Increased preload: congenital heart diseases with left to right shunt. Increased afterload: hypertension, stenosis of cardiac valves. Disturbance of the diastolic filling: constrictive pericarditis, hypertrophic cardiomyopathy, etc. Pathophysiology Compensatio