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PostSubject: as a result of paradox   Fri Apr 06, 2007 5:08 pm

Digoxin to appoint mertzatelna dichotomy conventional doses (it must be borne in mind that when dilatation cardiomyopathy can quickly develop digitalisnaya intoxication, and the reception drug must be strict). Therapy beta-adrenoblokator and can be successfully carried out with dilatation cardiomyopathy and congestive heart failure. It transferred beta-adrenoblokatora selective, and the initial dose of drugs to be very low (for example, atenolol appointed dose 12,5-25 mg / day, metoprolol - 12,5-50 mg / day). The beneficial effects of the drug is due to its bradicarditiceski act, and possibly reducing the rest miocard. In dilatation cardiomyopathy can be transplantation of the heart. The statement-long heavy heart failure and the absence of the effect of therapy. Gipertrofica cardiomyopathy Gipertrofica cardiomyopathy is characterized by massive overdetermination ventricular (mainly left), with vpachivaniem cavity in the right heart chamber mejjeludockova walls, which can be significantly strengthened. In some cases, there were only isolated hypertrophy mejjeludockova walls (the so-called isolated gipertroficski subaortalny stenoses), or apical portion of testing. The cavity of the left heart chamber reduced, while the left auricle extended. Gipertrofica cardiomyopathy more frequently in younger age; The average age of patients at the time of diagnosis is about 30 years. However, the disease can be detected and much later, at the age of 50-60 years, in a few cases gipertrofica cardiomyopathy diagnosed in those over 70 years of age, which is casuistry. The identification of the disease linked to the manifestation nerezka thyroid diseases and the lack of significant changes vnutriserdecna hemodynamics. Coronary atherosclerosis occurs in 15-25% of patients. In gipertroficescoy cardiomyopathy have a high frequency of sudden deaths (up to 50%) as a result of developing ventricular heart rhythm (paroxizmalnaya ventricular tachycardia). The 5-9% of patients gipertrofica cardiomyopathy complicated infectious endocarditis, which increasingly affects mitralny than aortalny valve, and the characteristic symptoms within endocardita infection. The role of heredity in a гипертрофической cardiomyopathy confirmed in the survey relatives (determined in their 17-20% of cases). The relationship between the frequency detection gipertroficescoy cardiomyopathy and identify certain HLA antigen HLA system (more V27 and DR4). AA. In cardiomyopathy gipertroficescoy the two main pathological mechanism is a violation of diastolicescoy the hearts and on the part of patients obstruction output tract left chamber. Between diastola enters jeludocki lack of blood due to poor rastajimosti them, which leads to a rapid recovery of end-diastolic pressure. Under these circumstances, developing compensatorno school, Denmark, and then the WM left atrium, and in case of his decompensation-pulmonary hypertension ( "passive" type). Obstructing termination of the left heart chamber, a developing during Systolic testing is the result of two factors : the swelling mejjeludockova wall (miocardialny) and the violation of the front door mitral valve. Sosoczkowaya muscle Сβ, slide valve strengthened and covers the outflow of blood from the left chamber as a result of paradox : between Systolic it nears mejjeludockova partition and connected with it. The obstruction turned left in the period Systolic ventricular the pressure gradient between the cavity left chamber and the primary predator. Pressure gradient from the same patient can vary widely, and the impact of blood from the left chamber enters the apparatus in the first half of Systolic. Heart failure is due expressed violations diastolicescoy ,0 managers left heart chamber and lower uterine the left atrium, which for some time has compensatornuu role.

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