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PostSubject: detection of characteristic   Fri Apr 06, 2007 5:06 pm

The nonspecific signs include an increase in the size of the left atrium, Denmark rear wall of the left heart chamber, reducing the average speed diastolic cover the front door mitral valve. The ECG can not be found in any specific changes. When sufficiently developed thyroid left turned on ECG may show its signs. Isolated hypertrophy mejjeludockova wall creates a zubza Q large amplitude in the left chest otwedeniah that complicated differential diagnosis of lesions as a result of the changes carried myocardial infarction. But prong Q neshiroki that avoids over myocardial infarction. In the evolution of cardiomyopathy and development gemodinamicescoy overload the left atrium at the ECG may show signs of atrophy syndrome left atrium : stopping R zubza more than 0.10 with increasing amplitude zubza E, a two-zubza R V1 playing with the large amplitude and the duration of the second phase. For all forms of cardiomyopathy gipertroficescoy common symptom is the frequent development jeludockovh arrhythmias (arrythmia and paroxizmalnaya tachycardia). The daily monitorirovania (holterovske grid) ECG these violations heart rhythm well documented paroxizmalnosti as they emerge. When Ray survey in the advanced stages of the disease can be identified in the left chamber and the left atrium, the ascending part predator. The left-heart correlates with the high pressure in the left jeludocke. At fonocardiogramme amplitude I and II saved shade (and even increased), which distinguishes SCOP stenosis of the mouth of rivers caused sreatmenem shutter valve (acquired defect), as well as evidence sistoliceski noise varying degrees of symptoms. Curve каротидного pulse unlike двухвершинная rules for the additional wave on the rise. The typical pattern, only with the pressure gradient "left-encyclopedia aorta, equal to 30 mm Hg With more stenosis as a result of the sharp narrowing of the outflow karotidna sfigmogramme only one flat tip. Invasive methods of the study (sensing divisions left heart contrast angiography) is not mandatory, as echocardiography is not reliable to determine the diagnosis information. However, in some cases with the help of these methods identify the characteristics of gipertroficescoy cardiomyopathy : a pressure gradient between the left heart and aorta from 50 to 150 mm Hg, increased end-diastolic pressure in the cavity of the left chamber to 18 mm Hg Pressure gradient decreases after beta-adrenoblokatoro . In contrast angiography reveals plot to reduce the outflow of the left heart, coronary artery not changed. Scanning hearts (with radioizotopom thallium) helps detect thickening mejjeludockova walls and free wall left chamber. Since 15-25% of patients have coronary arteriosclerosis, the old persons with epileptic typical anginozhnykh pain should koronarografiu, as these symptoms in gipertroficescoy cardiomyopathy usually due to the disease. Diagnostics. Diagnosis is based on the detection of characteristic combination of symptoms in the absence of evidence of sindromno similar pathology. The most characteristic of cardiomyopathy gipertroficescoy consistently found the following symptoms : 1) sistoliceski noise from the epicentre on the left side of the sternum, combined with the stored II tone; 2) the I and II to allow testing in combination with mezosistoliceski noise; 3) karotidna sfigmogramma; 4) an increase in the left chamber of the ECG and x-ray; 5), a typical symptom found in ejocardiograficescom study. In diagnostically difficult cases are sounding leftist divisions hearts and angiocardiografia. Diagnostic difficulties stem from the fact that individual symptoms gipertroficescoy cardiomyopathy may meet with a wide variety of diseases.

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