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PostSubject: diseases differs   Fri Apr 06, 2007 5:03 pm

Therefore, the final diagnosis of cardiomyopathy is possible only if mandatory exclusion following diseases : stenosis mouth primitive (method), the lack of mitral valve disease, hypertensive disease. Treatment. More often than not, for the treatment of cardiomyopathy gipertroficskih beta-adrenoblokatora used, which reduces the sensitivity of the attack kateholaminam need it and oxygen pressure gradient (or arising in the growing physical strength), lengthened the diastolic filling and improved filling chamber. These drugs can be found to be patogeneticakimi because origin gipertroficescoy cardiomyopathy may act as a pathological response adrenergicakih receptors in the heart kateholamin. Assign anaprilin (propranolol, inderal, obzidan) in the dose of 200 mg / day or atenolol 100 mg / sut. Answers as calcium antagonists, verapamil (izoptin, fenoptin) in the dose of 120-480 mg / day, to a lesser extent, nifedipin. Their application is the detection of high-receptors to calcium antagonistam miocarde in patients with gipertroficescoy cardiomiopatiei that perhaps reflects an increased concentration of calcium channels through which calcium ions enter miocard. Beta-adrenoblokatora and calcium antagonists, in addition to action on vnutriserdecnuu hemodinamics have also antianginalny effect. If violations ventricular rhythm appoint cordaron dose of 600-800 mg / day in the 3rd week and then on 200-400 mg / sut. In developing heart failure appoint mochegonne drugs (saluretiki - furosemide, uregit) and aldosterone antagonists (verospiron, aldakton) in the dose. Forecast. The annual rate of 3-8%, with a sudden death occurs in 50% of these cases. Older patients die from progressive heart failure, and young suddenly as a result of paroxizmov ventricular tachycardia, full atrioventrikuliarna blockade asistoliei with acute myocardial infarction (which may arise in a maloizmenennah coronary arteries). Increased output obstruction tract left heart or decrease the stuffing during physical activity may be the cause of sudden death. Restrigus cardiomyopathy Restrigus cardiomyopathy known in two versions (previously discussed as two distinct pathological process), endocardialny fibrosis and endomiocardialny fibroelastos Leffler. Patomorfological picture with the two diseases differs little and is characterized by sudden swelling endocarda combined with overdetermination ventricular myocardium, cavities which can be extended or reduced. Normally, in a morbid process involves both turned in isolation or right or left. The most typical change right heart chamber involving sosochkovykh muscles and sukhojilnykh chords progressive obliteratiei cavity chamber. As syndrome restrigus cardiomyopathy may occur with the diseases, leading to a breach of diastolic relaxation (the so-called "diseases of the accumulation-amiloidoz, hemochromatosis, glikogenoz). In these diseases in miocarde accumulate pathological substance behind the relaxation tool.

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