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Cv - Curs 6 - Cardiomiopatiile Hipertrofica Dilatativa Si Restrictiva)+Pericardite

Cv - Curs 6 - Cardiomiopatiile Hipertrofica Dilatativa Si Restrictiva)+Pericardite

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Published by synoida

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Categories:Types, School Work
Published by: synoida on Jul 05, 2010
Copyright:Attribution Non-commercial

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11/29/2014

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CARDIOMIOPATIILE (HIPERTROFICA, DILATATIVA SI RESTRICTIVA)CARDIOMIOPATIA HIPERTROFICADefinitie:
hipertrofie ventriculara ce intereseaza predominant septul si peretii, farahipertrofie ventriculara ce intereseaza predominant septul si peretii, faradilatatie ventriculara, care determina perturbarea functiei diastolice prin scadereadilatatie ventriculara, care determina perturbarea functiei diastolice prin scadereacompliantei ventriculare.compliantei ventriculare.
Fiziopatologie
relaxare diastolica anormala
o
 presiunii telediastolice in VS
o
 presiunii in AS siretrograd in venele pulmonare
dispnee
o
masa miocardica
o
consumul de oxigen
ischemie miocardica (angina si aritmii)umplere diastolica anormala
q
debitul cardiac la efort
sincopa
 
Simptomatologie
asimptomaticadispnee de efort, angor, sincopa / moarte subita
Examenul obiectiv
puls carotidian normal / saltaret, puls venos, dublu impuls apicalsuflu de ejectie mezosistolic (spatiul apicosternal)suflu pansistolic de IMsemne ale complicatiilor (fibrilatie atriala, ICC, tromboembolie arteriala, endocarditainfectioasa )
Explorarea paraclinica
ECG
: unde Q in precordialele stangi, unde T negative si HVS
Fonocardiograma
: suflu sistolic ejectional, maxim in protosistola
Carotidograma
: anacrota abrupta urmata de platou / incizura la mijlocul platoului
Apexcardiograma
: unde
A
ample (
o
 presiunii telediastolice in VS)
 
E
cocardiografia: metoda de electie
E
cocardiografia: metoda de electie
hipertrofia asimetrica a SIV, hipo-/ imobilitate septala
raportul grosime sept / grosime perete posterior 
>
1,3
iametrului ventricular 
sectiune parasternala axa lunga ce arata hipertrofia asimetrica septala

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