临床见习前理论课件：心功能不全.ppt

Laboratory findings Chest x-ray Size and shape of the cardiac silhouette Kerler lines (i.e., sharp, linear densities of interlobular interstitial edema) “Butterfly” pattern (a cloud-like appearance and concentration of the fluid around the hili) Treatment Goals of Drugs in the Treatment of Heart Failure Treatment of chronic stable HF Enhance survival Minimize symptoms and disability Improve functional capacity Delay disease progression Classes of Drugs Used to treat Heart Failure Drugs Class Diuretics “Loop” diuretics Thiazides Vasodilators Nitrovasodilators Natriuretic peptides (nesiritide) Classes of Drugs Used to treat Heart Failure Drugs Class Positive Inotropic Agents Digitalis derivatives Beta-adrenergic receptor agonists Phosphodiesterase inhibitors Classes of Drugs Used to treat Heart Failure Neurohormonal Inhibitors Angiotensin-converting enzyme inhibitors (ACEIs) Angiotensin receptor blockers (ARBs) Beta-adrenergic receptor blocking compounds Class I Benefit >>> Risk Procedure/ Treatment SHOULD be performed/ administered Class IIa Benefit >> RiskAdditional studies with focused objectives needed IT IS REASONABLE to perform procedure/administer treatment Class IIb Benefit ≥ RiskAdditional studies with broad objectives needed; Additional registry data would be helpful Procedure/Treatment MAY BE CONSIDERED Class III Risk ≥ BenefitNo additional studies needed Procedure/Treatment should NOT be performed/administered SINCE IT IS NOT HELPFUL AND MAY BE HARMFUL should is recommended is indicated is useful/effective/ beneficial is reasonable can be useful/effective/ beneficial is probably recommended or indicated may/might be considered may/might be reasonable usefulness/effectiveness is unknown /unclear/uncertain or not well established is not recommended is not indicate