心力衰竭与充血性心力衰竭
心力衰竭是用于涵盖三个独特临床表现的术语。人心的心脏有四个腔室,可以放松并放松整个身体的血液。有两个心房和两个心室。在正常的心脏中,右心房和右心室之间有开放的连接,穿过三尖瓣,左心房和左心室之间通过二尖瓣。两个心房和两个心室之间没有开放的连接。因此,心脏的左侧和右半实际上充当了两个心。左半的失败导致一组不同的症状和迹象称为左心衰竭。右半失败导致一组独特的功能,共同称为正确的心力衰竭。两者的结合称为充血性心力衰竭。因此,重要的是要了解充血性心力衰竭是一种心力衰竭,而不是完全不同的状况。
原因可以许多心力衰竭。有three main pathologies that lead to heart failure; pump failure, increased pre-load, and increased after-load. Pump failure can occur due to myocardial infarction, cardiomyopathy, poor heart rate (negative chronotropic drugs), poor contractility (negative inotropic drugs) and poor filling (restrictive pericarditis). Preload may go up due to fluid overload, aortic and pulmonary regurgitation. Afterload may go up due to excessively high systemic blood pressure, aortic and pulmonary stenosis. Left heart failure causes poor output and increased pulmonary venous pressures. Therefore, the patient presents with dizziness, lethargy, poor exercise tolerance, syncope, fainting attacks, amaurosis fugax (due to poor output), dyspnea, orthopnea, paroxysmal nocturnal dyspnea and pink frothy sputum (due to increased pulmonary venous pressures). Right heart failure causes poor pulmonary circulation and increased systemic venous pressures. Therefore, the patient presents with dependent edema, enlarged liver, elevated jugular venous pressure (due to increased systemic venous pressure), reduced exercise tolerance and dyspnea (due to poor pulmonary circulation).
ECG,2D Echo,Troponin T,血清电解质和血清肌酐是所有类型的心力衰竭进行的重要研究。充血性心力衰竭伴有左右心力衰竭症状的结合。Acute heart failure是医疗紧急情况。病人应立即入院。应将患者放在床上,支撑,通过口罩给予氧气,附着在心脏监测仪上,插管,导管插入,血液应进行辅助研究。心电图应立即。静脉内源自注射应开始减少肺水肿。可以重复注射速尿,同时注意电解质水平和血压。吗啡很有帮助,但应该以很小的剂量给予,因为它会降低血压。如果血压崩溃,则应在给速尿中清除肺部时给予肌力支撑。病因因素的管理应齐头并进。一旦患者稳定,应开始口服速尿。 ACE inhibitors, selective beta blockers (with caution), calcium channel blockers (only nifedipine class drugs can be prescribed with a beta blocker), potassium sparing diuretics, nitrates, hydralazine and prazosin should be given as needed.
心力衰竭与充血性心力衰竭
•充血性心力衰竭是左右心力衰竭的结合。
• The management principles are the same for both conditions.
•充血性心力衰竭和其他类型之间的差异是充血性心力衰竭具有其他类型的特征,而孤立的左心衰竭或右心衰竭都具有特征性的症状和体征。
安·古特勒(Ann Gurtler)说
感谢您关于心力衰竭与充血性心力衰竭的清晰信息的著作。我最近被诊断出患有右心室
心脏衰竭。I also have been diagnosed with coronary arterial disease and idiopathic pulmonary artery hypertension. Do you have any thoughts on how this could be treated? I also have diabetes; I don’t smoke; am also trying to eat less fat, sugar and salt, and more fruits and
蔬菜。我今年75岁,想要比我的预后更长的寿命。你有什么建议吗?再次感谢。