内科学教学课件：心肌病，心包炎.pptVIP

Constrictive pericarditis Clinical manifestation 1. Symptoms: acute fatigue, weakness, weigh loss, exertional dyspnea, abdominal swelling, ankle edema 2.signs: jugular vein distention, hepatomegaly, ascites, heart sound↓ or disappear, the cardiac dullness normal, apical impluse↓↓,pericardial knock 50%(+), HR irregular accompanied by Af, SBp↓ ,kussmaul sign (jugular venous distension↑ ↑ when breathing) lab exam: 1. X-ray: cardiac shape normal pericardial calcification 2. ECG: low voltage T wave inverse 3. echo-CG: non-peculiarity treat 1. symptom therapy 2. operation– pericardiectomy Cardiomyopathy Definition The cardiomyopathies are disease that involve the myocardium primarily and are not the result of hypertension or congenital, valvular, coronary, arterial or pericardial abnormalities Etiology classification of CM WHO/ISFC1995 1. The definition of cardiomyopathy : a primary type, consisting of myocardial disease of unknown cause Etiology classification 2. Classification of cardiomyopathy: (1) DCM–dilated CM (2) HCM– hypertrophic CM (3) RCM– restrictive CM (4) ARVD/C – arrhythmogenic right ventricular CM Dilated cardiomyopathy character: left and/or right ventricular systolic pump function is impaired, leading to cardiac enlargement and often producing symptoms of congestive heart failure. Clinical manifestation 1. symptoms (1) early: asymptom (2) late: symptoms of left and right-sided congestive failure, manifested by dyspnea, peripheral edema and palpitation, hepatomegaly, thromboembolism, sudden death. Clinical manifestation 2. Signs: (1) heart enlarge (2) diastolic 3rd sound gallop (3) all kinds of arrhythmia Examanation 1. X-ray: heart/chest 50%, ventricular enlargement, pulmonary effusion 2. ECG: Arrhythmia such as atrial fibrillation, block. ST-segment and T-