弁性心疾患:大動脈の再発
Raffi Bekeredjian1, Paul A Grayburn
1Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
Circulation
|July 7, 2005
まとめ
大動脈再発症 (AR) の管理には,無症状の患者のモニタリングと,症状のある個人に適切な手術を行うことが含まれます. エコーカルディオグラフィは,診断と左心室 (LV) の影響を評価する鍵です.
科学分野:
- 心臓病学 心臓病学
- 心血管医学は,心臓血管医学である.
- 医療診断 医療診断
背景:
- 大動脈反発 (AR) は,大動脈から左心室 (LV) へのダイアストリック血流を伴う.
- 急性ARは,肺腫と低血圧を引き起こす外科的緊急事態です.
- 慢性的な重度のARは,LVの体積/圧力の過負荷,静脈性高血圧,および幅の広い脈圧につながる.
研究 の 目的:
- 大動脈反発の診断と管理戦略の概要を述べる.
- 慢性重症ARにおける外科介入の基準を定義する.
- ARの管理における医療療法の役割について議論する.
主な方法:
- エコーカルディオグラフィは,ARの主要な診断ツールです.
- 評価には,ARの原因,重症度,およびLVのサイズ,機能,および血液動力学の決定が含まれます.
- 症状,LVの拡張,または機能不全の臨床モニタリングは極めて重要です.
主要な成果:
- 多くの慢性重症AR患者は,正常なLV機能と症状のない状態で補償されています.
- 手術は,LVのエジェクション分子が55%以下になるか,またはLVのエンドシストリック寸法が55mmに達する前に示されています.
- 症状のある患者は,併発性疾患によって kontraindicated されていない限り,手術を必要とします.
結論:
- エコーカルディオグラフィは,ARの診断と管理決定の指針に不可欠です.
- 慎重にモニタリングすることで,無症状患者の手術を遅らせることができます.
- 血管拡張剤療法は,静脈圧を下げることで手術を遅らせたり,手術不能の症例を管理することを目的としています.
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