内科学概论心脏血管内科PPT课件.ppt

;血壓的形成;高血壓分類;遺傳基因的影響 鈉鹽的過度攝取 Renin-Angiotensin system 交感神經系統 細胞膜的異常 血管的增生肥厚 內皮細胞功能異常 胰島素抗性;續發性高血壓;高血壓的分類JNC7;Initial Measurements;血壓的測定;Clinical pressure Ambulatory pressure Home pressure;Blood Pressure Measurement;Ambulatory Measurement;Advantages of Self-Measurement;高血壓臨床表現;高血壓自然病程;正確測量血壓 外觀: 脂肪分布 皮膚 肌肉 及神智狀況 眼底檢查 頸部—頚動脈及甲狀腺觸診聽診 心臟—大小節律及心音異常 ???—有無囉音 腹部—腫瘤? 動脈雜音 股動脈搏動 四肢—動脈博動 水腫 神經檢查 ;Laboratory tests;Optimal Tests;What is the target of BP with therapy?; Cardiovascular Risk In Patients with Hypertension;Clinical Risk factors for Stratification;高血壓的治療;Treatment;Treatment;Antihypertensive drugs;Treatment;Treatment;Treatment;Treatment;Treatment;Lifestyle Modifications;Treatment;Treatment;Follow Up;動脈粥狀硬化的故事;冠狀動脈;冠狀動脈;冠狀動脈的故事;血管內腔變小;;AtherothrombosisThrombus and Plaque;Unstable and Stable Plaque;;Plaque Rupture誘發因素;心臟血管阻塞;Hemostatic clot Formation;Thrombus formation;冠狀動脈疾病;内科学概论心脏血管内科PPT课件;Plaque/atheroma obstruction of the coronary artery lumen;休息時胸痛通常持續超過20分鐘 近二星期內新出現的胸痛 加重型胸痛 較頻繁 發作時間延長 較容易發生;Ischemic Heart Disease胸痛;猝心絞痛 心肌梗塞Sudden death ;冠狀動脈疾病; New Definition of MI-biochemist;New Definition of MI-ECG;急性心肌梗塞 Acute MYOCARDIAL INFARCTION;New Definition of MI-established MI;New Definition of MI-image;Use of cardiac markers in ACS;Chest pain Troponin I/T, CK-MB ECG changes Echocardiography Nuclear cardiology Cardiac catheterization;急性心肌梗塞 Acute MYOCARDIAL INFARCTION;急性心肌梗塞 Acute MYOCARDIAL INFARCTION;急性心肌梗塞-心導管;Myocardial infarction;LCC;;Reperfusion;Optimal Strategy UA/NSTEMI;急性心肌梗塞 Primary PTCA;氣球擴張術;Stenting;Interventional Cardiology;Sites of Anti-thrombotic Drug Action;;THROMBUS;Streptokinase Urokinase;急性心肌梗塞 Thrombolysis;急性心肌梗塞 Thrombolysis;ThrombolysistPA;適用於發作時間較久 受損範圍較小患者 價錢較便宜 腦溢血機會較低 易過敏 2年內最好不要再使用第二次 不必併用Heparin 100萬單位1小時內 滴注完畢 ;Initiate fibrinolysis if indicated Goals: 30 min from entry to ER;FIBRINOLYSISABSOLUTE CONTRAINDICATION; FIBRINOLYSIS RELATIVE CONTRAINDICATION;;内科学概论心脏血管内科PPT课件;THROMBUS;Adhesion;GP IIb/II