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PostSubject: pathological process   Fri Apr 06, 2007 2:52 pm

There is evidence that the average dose of 180 mg / day for 3 admission, it has the same view as 240 mg verapamila, positive impact on diastolicescoe LV filling and the same symptomatic effect, but to a lesser extent, improved physical fitness patients. It should be noted that β-adrenoblokatora (except sotalol), and calcium antagonists are weak antiaritmicescoy activity, while the frequency of dangerous jeludockovh and supraventrikuliarnah arrhythmias in patients SCOP extremely high. Therefore, the case of this category of patients complications products in a number of the most popular and recommended specialists is dizopiramid. Дизопирамид about антиаритмикам IA class has expressed инотропным negative effect in patients Majnoon to reduce obstruction output tract LV positively affect the structure диастолы. The long-term care insurance dizopiramidom proved against SCOP patients with moderate outflow obstruction of LV. The benefit from the drug in patients with желудочковыми аритмиями. Initial dose is 400 mg per day, with a gradual increase to 800 mg. And, as in the case of appointment of sotalol, it is necessary to monitor the QT interval on the ECG. It is equally effective in the treatment and prevention of jeludockovh or supraventrikuliarnah arrhythmias in SCOP is amiodaron, who, along with antiaritmicescoy activity appeared to diminish gipercontraktilnost n and ishemiu attack. Moreover, proved its ability to prevent such patients sudden death. Hospital Treatment starts with nasashchath doses (600-1200 mg / day) for a period of 3-7 days, with a gradual, as the curves, the decline to support (to 200 mg / day or less). The depositions drug in the tissues of the possible breakdown of the thyroid gland, development pnevmofibrosa defeats cornea, skin and liver, and its long-term (more than 12 months) admission required regular monitoring of the status of these "vulnerable" with a view to early identification of possible drug complications. The Majnoon possible combinations of drugs that have a negative effect inotrope such β-blokatorov and calcium antagonists, and β-blokatorov dizopiramida. Signs of venous stagnation in the lungs, including night attacks cardiac asthma, and Majnoon are not rare, and in most cases are diastolicescoy LV dysfunction. The patients showed treatment β-блокаторами or calcium antagonists, coupled with a cautious салуретиков. Peripheral вазодилататоров including nitrate, and cardiac glycosides should be avoided because of the danger of worsening diastolic LV filling and the sharp decline in heart release until синкопе development and sudden death Various суправентрикулярные тахиаритмии, mainly car and fibrillation предсердий occur in 10-30% of patients Majnoon and make the risk of aggravating or кардиогемодинамики violations, tromboamboliy emergence, as well as increased risk of ventricular fibrillation at the frequent concomitant decrease atrioventrikulyarnogo connections, and the extra out routes between predserdiami and jeludockami. Consequently, in patients SCOP paroxizmale supraventrikuliarnae adults are classified as potentially fatal, and the speedy restoration of sinusovogo rhythm and the prevention of recurrent paroxizmov acquires special importance. For heavily paroxizmov mertzatelna adults except complications IA products group and evidence used β-blokatora, verapamil and digoxin, and the ineffectiveness of which resorted to elektroimpoulsnoy therapy. When a permanent form mertzatelna pre monitor testing reductions apply β-blokatora or verapamil, in conjunction with digoxinom. This is the only area where the sick obstructive SCOP may be nominated cordial cures without fear of vnutrijeludochkovogo pressure gradient. Since мерцательная Already in patients SCOP linked to a high risk of systemic тромбоэмболий, including stroke, as soon as it is development should begin therapy антикоагулянтами which, in the form of hard предсердий take indefinitely. Contrary to the widespread notion often far advanced stages of the pathological process in the predominantly neobstrugua form SCOP develops progressive sistolical dysfunction and severe heart failure (CH), associated with remodelirovaniem LV (metal wall and dilataciei cavity). This evolution of the disease affects 2-5% of patients Majnoon and characterizes the ultimate (дилатационную) special stage, and very quickly, the ongoing process is not dependent on the age of the patient and prescription demonstrations disease. Increased systolic LV size generally outpaced diastolicescoe expansion and prevails over it. Clinical characteristics of this stage are expressed, often refrakternaya CH long and extremely poor prognosis.

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