01-心衰临床基础推荐.pptVIP

* Under normal circumstances, the heart accepts blood at low filling pressures during diastole and then propels it forward at higher pressures during systole. A variety of disorders can impair the ability of the heart to meet the metabolic demands of the body. Heart failure (HF) can be defined as a complex clinical syndrome resulting from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with (diastolic HF) or eject blood (Systolic HF). It is a clinical diagnosis only since there is no diagnostic test for heart failure. The goal of HF therapy is to prevent ventricular remodeling or reverse ventricular remodeling. Today, substantial healthcare resources are used to treat heart failure patients, yet heart failure patients continue to have a poor quality of life and an unacceptably high mortality rate. * 气短；下肢水肿；活动乏力；夜间不能平卧；腹部水肿、食欲下降；干咳；夜尿增多；记忆减退 * Make sure all students understand the NYHA classes and that this classification is very subjective and can change easily on a daily basis. Make sure you make the point that the NYHA classes are based on a patient’s symptoms and NOT ejection fraction. Note that Class II is Moderate exercise and Class III is minimal exercise only slight differences. Our CRT patients fall into the Class III or Class IV range. A Class III patient has trouble walking just a few hundred meters or up a flight of stairs as opposed to the Class IV patient who could be shuffling weakly down the hall or intubated on the Cardiac ICU. A Class IV patient could be a “difficult” case to turn around with CRT. May show up to the EP lab table and require 2-3 extra pillows because they can’t lay flat due to the pulmonary congestion. Reference: The Criteria Committee of the NYHA. Diseases of the Heart and Blood Vessels: Nomenclature and Criteria for Diagnosis. 6th ed. Boston, Mass: Little Brown; 1964. * In late 2001, the American College of Cardiology (ACC) and the American Heart Association (AHA) releas