05:01,23,May,2009 | (428/0/0) | Original

hypertrophic cardiomyopathy support


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hypertrophic cardiomyopathy support

Hypertension
Category: Internal Medicine
Overview:
Hypertension (cardiovascular medicine), clinical manifestations continued to increase circulation and arterial blood pressure associated with heart, brain, kidney and vascular wall structure and function of the damage, after a slow onset and the final cause of death was heart failure , renal failure and cerebral vascular accident. The disease is most common cardiovascular diseases, WHO published the prevalence of adult hypertension in up to 15%. The national rate of about 7-10% of patients with disease. With age, the incidence has significantly increased. Blacks, obesity, smoking, mental and other groups have a higher prevalence. Long-term, systematic, regular antihypertensive treatment can help slow down the progression of the disease and prevent target organ damage and improve quality of life.
Symptoms:
1. Continuous arterial blood pressure is increased the performance of the major disease-oriented. Systolic blood pressure more than 140mmHg or diastolic blood pressure more than 90mmHg;
2. Dizziness, headache, tinnitus and other symptoms more common;
3. The disease in combination with advanced multi-heart, brain, kidney, retina, and vessel wall damage, there may be the appropriate target symptoms and signs of organ damage. Such as hypertension and heart disease, hypertensive renal disease, cerebrovascular accidents and so on.
Diagnosis based on:
1. Systolic blood pressure ≥ 140mmHg or DBP ≥ 90mmHg, and persistence, can be diagnosed with high blood pressure; systolic blood pressure 140-160mmHg and / or diastolic blood pressure 90-95mmHg, is the critical nature of hypertension.
2. A simple blood pressure, do not merge the heart, brain, kidney and other target organs were any structural damage as a high blood pressure; the same time any combination of the structure of the organ damage by the two hypertension; any of the above organs The failure or decompensation are the three blood pressure.
3. Except for all kinds of secondary hypertension.
Treatment:
Treatment principles
1. Light without target organ damage, should first 3-6 months of non-drug treatment, drug treatment is ineffective.
2. Antihypertensive drug treatment should follow the long-term, system, the principle of individual to stability, security, control of blood pressure. At the same time should attach great importance to the target organ protection and improved quality of life.
3. In addition to serving antihypertensive drugs, but should pay attention not nervous, then smoke, limit salt in food.

Medicine principles
1. At the beginning of regular antihypertensive drug treatment in all cases should be accepted from March to June in order to control sodium intake and exercise therapy as the main content of the non-drug treatment phase.
2. Drug treatment should be from a single species, the beginning and gradually adjust the dose to achieve sustained and stable control of blood pressure goal, combination therapy when necessary.
3. Treatment should take into account age, gender, occupation, and target organ damage and other factors, adhere to the principle of the individual. 4. The treatment process should be to prevent excessive lowering of blood pressure, so as not to affect organ perfusion.
Prevention of common sense:
In modern society, the prevention of hypertension, from youth, prime of life should be attention. Control of obesity, is a very important part. Because, hypertension, coronary heart disease and obesity are directly related. Do not obese individuals without hypertension, obesity can be ignored. Patients with mild hypertension, the symptoms are not heavy, you can not take antihypertensive drugs, pay attention to work and rest, maintaining adequate sleep, appropriate exercise can make blood pressure returned to normal. It seems from the existing treatment conditions, hypertension can be controlled basically, do not stress. Use of antihypertensive drugs, should be continuously taken, so that blood pressure remained in the normal state, with the use of stop-down when the rise time, prone to accidents. However, taking any antihypertensive drugs, should they pass from person to person, in accordance with the principle of the individual. Long-term risk of hypertension in people, to prevent emotional and mental excitement tension, so as to avoid cerebral vascular and cardiovascular accidents. Quit smoking, not heavy drinking, have a direct impact on hypertension. Owned a pair of blood pressure, himself or his family will be operating, on the rational use of drugs, good for blood pressure changes observed.
Hypertrophic cardiomyopathy
Category: Internal Medicine
Overview:
Hypertrophic cardiomyopathy (Cardiology), the main pathological changes are progressive asymmetric hypertrophy. According to the site and extent of myocardial hypertrophy of different, divided into two types: (1) mainly caused by ventricular septal hypertrophy in outflow obstruction known as hypertrophic obstructive cardiomyopathy; (2) cardiac hypertrophy without outflow tract obstruction is called non-obstructive hypertrophic cardiomyopathy. Main clinical manifestations of dyspnea, angina, syncope, palpitations, weakness, enlarged heart, apex and left sternal border 3 and 4 intercostal rough ejection systolic murmur. Global distribution of the disease was, the incidence can also be presented familial sporadic clinical cases more men than women, older women with more serious symptoms. Most patients can survive for several years, so the prognosis is still good. In fatal cases, 50% of sudden death.
Symptoms:
1. Dyspnea, angina, syncope, palpitations, weakness, dizziness, sudden death can occur;
2. Apex beat strong, the apex or along the left sternal border 3,4 tremor intercostal contraction, heart to the left under the expanded split second heart sound, heard the third and fourth heart sounds, apex and left sternal border 3, 4 intercostal News and rough ejection systolic murmur.
Diagnosis based on:
1. Less non-obstructive symptoms, breathing difficulties early in the main, late may have atrial fibrillation and heart failure. Obstruction after exertion may have palpitations, shortness of breath, fatigue, activities dizziness, syncope, angina and sudden death.
2. Expanding the left heart border, lifting of the apex beat. Non-obstructive general no noise, and obstruction often in the left sternal border 3,4 intercostal systolic ejection murmur, systolic fine tremor in some patients. In addition, a fourth heart sound, and can often reverse split second heart sound.
3. ECG: left ventricular hypertrophy in common disorders, many patients in the left chest leads and I, avL lead abnormal Q waves. Some patients with ventricular conduction block or WPW syndrome.
4. Echocardiography: ventricular septal thickness / left ventricular posterior wall thickness greater than 1.3, abnormal systolic anterior mitral leaflet moves forward, the left ventricular outflow tract stenosis.
5. Left heart catheterization: Obstruction of left ventricular cavity and left ventricular outflow tract systolic pressure gradient between the selective left ventricular angiography showed a small contraction of late left ventricular cavity was shoe-shaped.
Treatment:
Treatment principles
1. General treatment: rest, if necessary, use of sedatives, heart failure low-salt diet;
2. Reduced ventricular contractility, improving ventricular compliance;
3. Control arrhythmia;
4. Heart failure improved cardiac function;
5. Symptomatic and supportive treatment;
7. Surgical treatment;
8. Heart transplantation for end-stage patients.

Medicine principles
1.β-receptor blockers or calcium channel blocker; in the use of large doses of β blockers or calcium channel blockers, attention should occur atrioventricular block or heart failure ;
2. Digitalis drugs and vasodilators used only for patients with heart failure and no heart failure, not to use, digitalis doses should be small, and pay attention to toxicity.
3. Recently there has atrial fibrillation, choice of drugs or electrical cardioversion, electrical cardioversion should be a period of time prior to anticoagulation therapy;
4. Angina should not use nitrite or nitrate drugs, application of β-blockers;
5. Of chronic complete atrioventricular block, sick sinus syndrome, permanent artificial cardiac pacemaker can be installed.
Prevention of common sense:
Familial hypertrophic cardiomyopathy genetic predisposition, family history of the disease and therefore, should pay attention to the hospital regularly. Such as shortness of breath, fatigue, chest pain, syncope, should be as soon as possible to the hospital for treatment. Of diagnosed patients with hypertrophic cardiomyopathy should avoid fatigue, prevention of respiratory tract infection, abstain from alcohol, maintain a good state of mind to the hospital regularly review, to protect or improve heart function and improve quality of life. The majority of patients treated, the course can be maintained for several decades, the prognosis is still good. Should not participate in violent sports, in order to avoid accidents such as sudden death. Such as severe breathing difficulties, increased during supine, sweating, severe cardiac dysfunction may be taken to the patient sitting or semi-sitting or lying position, to call for help or medical aid center in the most safe, stable and fast traffic Tools taken to a nearby hospital.

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