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PostSubject: may discourage treatment   Fri Apr 06, 2007 9:36 pm

The detailed clinical diagnosis consider : 1) the disease; 2) chronic heart disease (as well as its stage of the Strazhesko, NYHA); 3) complications HSN. Treatment Assign range of activities aimed at creating a home environment that is conducive to reducing the burden on serdecnososudioften system, as well as drugs designed to affect miocard and various links pathogenesis HSN. The activities the stage HSN. Patients are holding therapeutic exercise, a healthy lifestyle; Important it is the right job. Common activities include : limitation of physical activity and diet that : * When I HSN the normal physical activity is not contraindicated, allowed netagelaya physical work, sports without significant voltage. When HSN investigated the excluded sports and heavy physical work. Recommended shorter working hours and the introduction of an extra day of rest. Patients diagnosed with HSN III stage to the house, and when symptoms progressirovanii - polupostelny regime. Very important enough sleep (at least 8 hours per day). * On the occasion HSN stage should be limited to the admission of table salt with food (daily intake should not exceed 2 g). Upon IIB stage in the third of the salt per day shall not exceed 2 grams. Bessolevaya diet (no more than 0.2 grams of salt per day), with a stage III. In developing HSN excluded alcohol, strong tea and coffee of inciting the heart directly and through activation SAS Drug therapy is focused on : 1. unloading hearts by influencing the neirogormonale mechanisms of pathogenesis HSN and peripheral vessels; 2. sokratimosti the heart (inotroponaya stimulation); 3. normal water balance; 4. impact on the deterioration in the metabolism miocarde. Unloading hearts by influencing the neirogormonale mechanisms of pathogenesis HSN featured prominently in the treatment. To this end shall inhibitors angiotenzinprevrashchau general enzyme (IAPF), which impede the transition angiotenzina I angiotenzin II with a powerful vazopressorian by pushing education concentration. In addition, the IAPF violates excess synthesis norarenalina and identity. IAPF feature is the impact they have not only on the circulating, but also at the local organ (tissue) RAAS. This combination of the effects of a wide range of clinical effects IAPF : lower prednagruzki (through increased venous pressure) and postnagruzki (at the expense of peripheral vascular resistance); Decline curves and AD; Remodelirovania blocking the left heart; Reducing atrophy and dilatation of the left heart; Dioreticescoe effect; Normalization and prevention elektrolitnykh violations; Antiaritmicescie effects. ИАПФ short action-каптоприл (капотен) appointed dose 12,5-37,5 mg / day, divided into 2-4 reception. IAPF prolonged action (within 12-24 hours), enalapril (enap, enam, renitek) appointed dose of 5-10 mg / day in 2 admission, another stretch-IAPF ramipril (tritaze) Designate smaller doses - 1,25-2,5 mg / day in the reception 1-2; perindopril (prestarium) appointed dose of 4-6 mg / day (the drug benefit different from the absence of the so-called economies of the first dose, to the fall of AD after the first administered, which may discourage treatment IAPF). To achieve therapeutic effect ИАПФ should take at least 2-4 weeks. In appointing ИАПФ may be adverse reactions in the form of dry cough caused by the excess education брадикинина (in the appointment of ИАПФ брадикинина not). In such cases, and sometimes, from the very beginning of treatment shall receptor blockers to angiotenzino II-lozartan (kozaar) in the dose of 100 mg / sut. Another way discharge, reduced peripheral vascular tone through vazodilatatorov affecting various sections vascular bed. Has vazodilatatora having a predominant influence on the mainstream ORIONE (nitroglycerin, izosorbitdinitrat, izosorbitmononitrat, molsidomin), the arterial track (hydralazine, apressin), and have a combination of (sodium nitroprusside, prazosin, doksazosin).

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