6.Chapter2-20100927黑白版.pdf

Heart Failure (心力衰竭) Brief account： In certain pathological circumstances, if cardiac output is below the level of adaptation to the needs of human body, heart cannot maintain effective circulation. Therefore, a series of symptoms and signs develop. 1 Brief account： Classified according to Acute HF 急性心力衰竭 Clinical course Chronic HF 慢性心力衰竭 Clinical Left HF 左心衰 manifestations Right HF 右心衰 Bilateral HF 全心衰 2 Left heart failure (左心衰) Brief account The main pathological change is pulmonary congestion (肺淤血) , pulmonary edema develops in severe cases. 3 Symptoms  Dyspnea :  Exertional dyspnea (端坐呼吸)  Paroxysmal nocturnal dyspnea (夜间阵发性呼吸困难)  Orthopnea (端坐呼吸)  Cough with pink frothy sputum (粉红色泡沫痰) in pulmonary edema  Cough with sputum /cough with blood stained sputum (痰中带血) 4 Signs Inspection  Tachypnea (呼吸急促)  Cyanosis (紫绀)  Orthopnea (端坐呼吸) Percussion Findings of respective organic heart diseases 5 Signs Auscultation  Findings of primary organic heart diseases  Fast heart rate (心动过速)  Diastolic gallop rhythm (舒张期奔马律，心肌严重损害的体征)  Moist crackles (湿罗音) at the lung bases (肺底部) .  Crackles and wheezing rales over both lungs