慢性肺心病教学稿件.pptVIP

Chronic Pulmonary Heart Disease OUTLINE Definition ： Chronic lung,chest or pulmonary vascular diseases→Pulmonary vascular resistance ↑ → Pulmonary artery pressure↑ → Hypertrophy and dilatation of the right ventricle →Right Heart Failure Prevalence：0.44%～0.46% Onset ages：＞40 years old Incidence season：Winter and Spring Predisposing factors ：Acute respiratory infections Clinical Manifestations Compensation stage of cardiac and lung function Symptoms: cough, sputum, short of breath; dyspnea and palpitation on exertion; fatigue and decrease of exercise tolerance;exacerbated by acute infection. Signs: cyanosis, signs of emphysema, moist rales and/or rhonchi; P2A2 , systolic murmur of tricuspid area, subxiphoid visible/palpable cardiac impulse, distended jugular venous. Clinical Manifestations Decompensation stage of cardiac and lung function Respiratory failure Symtoms: severe dyspnea,especially at night, headache, insomnia,inappetence, somnolence, dizziness,confusion, even delirium. Signs: conjunctiva congestion and edema, retinal vasodilatation, optic papillary edema; weakness or disappear of deep reflexes, pathological reflexes. Clinical Manifestations Decompensation stage of cardiac and lung function Right heart failure Symtoms: dyspnea aggravated, palpitation, inappetence, abdominal distention,nausea. Signs: cyanosis, arrhythmia, tachycardia,subxiphoid systolic murmur or even diastolic murmur. Tender hepatomegaly, Hepatojugular reflux, lower extremity edema, ascites. Chest radiography： Enlarged right descending pulmonary artery diameter ≥15mm ; The ratio of diameter of right descending pulmonary artery to trachea≥1.07 ; Right descending pulmonary artery broadens＞2mm during dynamic observation Bulge of the middle segment of pulmonary artery or with the height≥3mm Enlargement of the pulmonary arteries and the major branches, with marked tapering of peripheral arteries Pulmonary cone protrudes or with the height≥7mm Righ