!

"#$
%$%!"&' ($)%!"&'
S2
vl88A1C uL8CLL SuCÞÞlA1C
SuCÞÞlAMLn1C
llSlCLCClCC
SuCÞÞlAMLn1C
llSSC
SuCÞÞlAMLn1C
ÞA8AuCSSC
SCPlCCCC
AÞL81u8A M
(CS)
S3
Þk
S4
S1
vl88A1C
Slnu8CMl
lÞL8ClnL1lCPL
SCPlCCCC ul
CPluSu8A M-1
uL8CLL
8Av
SuCÞÞlA1C
SuCÞÞlAMLn1C
vL8C
CLlCk Þ8C1CSlS1CLlCC
u'LlLZlCnL (Schlocco
aperLura A-Þ)
CLlCk
MLSCSlS1CLlCC
sLenosl valvole
aLrlo-venLrlcolarl
88, vÞC
(exLraslsLole
venLrlcolare
premaLura)
AC81lCC:
- sovraccarlco pressorlo: "#$%&"'!
(&)*+(, '-$)#$%"'&%$ ()#$)'&"(
- sovraccarlco dl volume:
'%"./+'$%0(!(&)*+(, -$)1'$#2!
3&4&!3' 5&#(66&
ÞCLMCnA8L:
- sovraccarlco pressorlo: "#$%&"'!
-&67&%()$, '-$)#$%"'&%$
-&67&%()$
- sovraccarlco dl volume: 3'8$4&!
'%#$)(#)'(6$
prolasso lembl mlLrallcl - lperuroldlsmo
- aorLosclerosl
- anemla arave
- ñsLola arLerovenosa
- lnsuñ. valvolare aoruca
- berl berl
lperLenslone
slsLemlca o
polmonare
lembl
valvolarl
calclñcl
lnsplrazlone: A2 -> Þ2
slncrone ln esp.
(lnsplrazlone: ^8v)
allunaaLo ln 88u,
sLenosl polmonare,
lperLenslone
polmonare
A2 -> Þ2 sla ln lnsplraz.
che ln esplraz.
(dlfeuo seuo
lnLeraLrlale ulA)
lnsplraz.: A2=Þ2
esplraz.: Þ2 -> A2
(88S, sLenosl aoruca,
lperLenslone slsLemlca)
sLenosl mlLrallca
rlemplmenLo venLrlcolare
rapldo proLodlasLollco
CALCÞÞC: paLoloalco
- sovraccarlco venLrlcolare
da aumenLaLo ßusso
()'9.)9'#&!1(61&6()$, ":.%#,
"'%3)&7' '-$)+'%$*+:$;
lnsumclenza mlocardlca
(+()3'&-(*$ '"+:$7'+(,
'-$)#$%"'1(, 7'&+()3'&-(*$;
perlcardlLe cosLrlmva
rlemplmenLo venLrlcolare
LeledlasLollco
sLaLo dl alLeraLa compllance (^LuÞ) ->
maaalore forza dl conLrazlone aLrlale
CALCÞÞC
Sn: '-$)#$%"'&%$ "'"#$'+(, "#$%&"'!
(&)*+(, +()3'&7'&-(*( '-$)#)&<+(!
&"#).=1(,!+()3'&-(*( '"+:$7'+(,
)'9.)9'#& 7'#)(6'+&!)$+$%#$,
7'&+()3'&-(*$
ux: "#$%&"' -&67&%()$, '-$)#$%"'&%$
-&67&%()$, +.&)$ -&67&%()$
%"**$
%$%!"&'
MLSCSlS1CLlCl CLCSlS1CLlCl
+"#!$#,$ ($)%!"&'
Þ8C1CulAS1CLlCl 1LLLulAS1CLlCl
LlLZlCnL
8lCu8Cl1C
LlLZlCnL 8lCu8Cl1C
a dlamanLe
"#$%&"'!(&)*+(>-&67&%()$
conunuo
'%"./+'$%0(!7'#)(6'+(>#)'+."-'3(6$
seano dl 8lvL8A CA8vALLC
aumenLo rumorl cuore dx
con lnsplrazlone
crescendo
"#$%&"'!7'#)(6'+(>#)'+."-'3(6$
aravlLa lnversa a lnLervallo 2-CS
decrescendo
'%"./+'$%0(!(&)*+(>-&67&%()$
3&4&!()#$)'&"&!
-$)1'&,!<"#&6(!()#$)&?
1$%&"(,!"8)$9(7$%#&!
-$)'+()3'+&
seano dl 8lvL8A CA8vALLC
aumenLo rumorl cuore dx
con lnsplrazlone
lnSulllClLnZA Ml18ALlCA:
sl lrradla ln ascella
lnSulllClLnZA 18lCuSÞluALL:
con sdopplamenLo paradosso S2,
con S3
8lvL8A-CA8vALLC +
lnSulllClLnZA AC81lCA:
focolalo dl Lrb
sl accompaana a ßusso "'"#&6'+&
sdopplamenLo S1
@ABCDE?FGDEC all'aplce (osclllazlone
lembo mlLrallco anL ln mesodlasLole)
S1 debole, S3 e S4
lnSulllClLnZA ÞCLMCnA8L:
lnlzla da componenLe Þ2
S1LnCSl AC81lCA:
lrradlazlonl ln alLo verso vasl del
collo, ln basso verso l'aplce
sdopplamenLo S1
sdopplamenLo paradosso S2
H@GG@I@JKDE!lrradlazlone verso
l'aplce mlma lnsuñ. mlLrallca, ma
non sl lrradla ln ascella
S1LnCSl Ml18ALlCA
S1 vlbraLo (schlocco chlusura M)
S2 aumenLaLo ln focolalo polm
(lperLens. polm.)
CS mlLrale all'aplce
HJ@L@M?BCNNG (lnsuñ. polm.
relauva)
-
.
/
0
1
-
1
1
1
.
S1LnCSl ÞCLMCnA8L
sdopplamenLo S1
maaalore amplezza sdopplamenLo S2
.
S1LnCSl 18lCuSÞluALL
8lvL8A-CA8vALLC +
0
234
-
.
/
0
1
AC
ÞCL
L88
18lC
AÞ/Ml18

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