肺心病英文-内科学课件.pptxVIP

8肺心病英文中山大学内科学1

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Mechanismand Pathology（一）Pulmonaryhypertension：Definition：meanpulmonaryarterypressure（mPAP）≥25mmHg atrest or ≥30mmHg duringexercise.FunctionalchangesinpulmonaryvascularHypoxia,Hypercapnia,Respiratoryacidosis,vasoconstrictionsubstances→Pulmonary vasoconstriction→PulmonaryhypertensionHypoxiaisthemostimportantfactorleadstopulmonaryhypertensionAnatomicchangesinpulmonary vascularRemodelingofpulmonaryvesselsIncreased bloodviscosityandbloodvolume4

5Mechanismand Pathology（二）DysfunctionofrightheartPulmonaryhypertension→ Afterloadofrightventricular↑,Oxygensupplyofmyocardium↓→Hypertrophyanddilatationoftherightventricle→Rightheartfailure(三）Damagestoothervitalorgans：Multipleorgandysfunction

6ClinicalManifestationsCompensationstageofcardiacandlungfunctionSymptoms:cough,sputum,shortofbreath;dyspneaandpalpitationonexertion;fatigueanddecreaseofexercisetolerance;exacerbatedbyacuteinfection.Signs:cyanosis,signsofemphysema,moistralesand/orrhonchi;P2A2,systolicmurmuroftricuspidarea,subxiphoidvisible/palpablecardiacimpulse,distendedjugularvenous.

7ClinicalManifestationsDecompensationstageofcardiacandlungfunctionRespiratoryfailure Symtoms:severedyspnea,especiallyatnight,headache,insomnia,inappetence,somnolence,dizziness,confusion,evendelirium. Signs:conjunctiva congestionandedema,retinalvasodilatation,opticpapillaryedema;weaknessordisappearofdeepreflexes,pathologicalreflexes.

8ClinicalManifestationsDecompensationstageofcardiacandlungfunctionRightheartfailure Symtoms:dyspneaaggravated,palpitation,inappetence,abdominaldistention,nausea. Signs:cyanosis,arrhythmia,tachycardia,subxiphoidsystolicmurmurorevendiastolicmurmur.Tenderhepatomegaly,Hepatojugularreflux,lowerextremityedema,ascites.

9Chestradiography：Enlargedrightdescendingpulmonaryarterydiameter≥15mm;Theratioofdiameter