膜心脏病:大动脉吐
Raffi Bekeredjian1, Paul A Grayburn
1Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
Circulation
|July 7, 2005
概括
大动脉反 (AR) 管理包括监测无症状患者和及时手术治疗有症状的个体. 心声图是诊断和评估左心室 (LV) 影响的关键.
科学领域:
- 心脏病学 心脏病学
- 心血管医学 心血管医学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 大动脉反 (AR) 涉及从大动脉到左心室 (LV) 的透静血流.
- 急性AR是一种造成肺和低血压的外科紧急情况.
- 慢性严重的AR导致LV体积/压力过载,缩性高血压和宽脉压.
研究的目的:
- 概述大动脉反的诊断和管理策略.
- 定义慢性严重AR手术干预的标准.
- 讨论医疗治疗在治疗AR中的作用.
主要方法:
- 心声图是AR的主要诊断工具.
- 评估包括确定AR的原因,严重程度和LV大小,功能和血液动力学.
- 临床监测症状, LV 扩张或功能障碍至关重要.
主要成果:
- 许多慢性严重的AR患者仍然补偿正常的LV功能和没有症状.
- 在LV喷射分数下降到55%以下或LV末缩维度达到55毫米之前,需要进行手术.
- 具有症状的患者需要手术,除非伴随性疾病对其有禁忌.
结论:
- 心声谱对于诊断AR和指导管理决策至关重要.
- 仔细监测允许在无症状患者中推迟手术.
- 血管扩张疗法旨在通过降低静脉压来延迟手术或管理不可手术的病例.
相关概念视频
Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aortic Regurgitation IV: Nursing Management
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...


