JSC Astana Medical University Done by: Kazhimuratova M.E. Group: 413 GM Checked by:D.B Astana,2018 y. - презентация

1 JSC Astana Medical University Done by: Kazhimuratova M.E. Group: 413 GM Checked by:D.B Astana,2018 y.

2 Plan: I.Inroduction. Pulmonary heart disease II.Main body a)The main causes of them b)Clinical features c)Diagnosis and treatment III. Conclusion

3 Pulmonary heart disease or cor pulmonale is the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance (such as from pulmonic stenosis) or high blood pressure in the lungs.

4 Acute Acute pulmonary heart disease usually results in dilatation. Dilatation is a stretching (in length) of the ventricle in response to acute increased pressure Chronic Chronic pulmonary heart disease usually results in right ventricular hypertrophy (RVH) Hypertrophy is an adaptive response to a long-term increase in pressure.

5 Acute PHD massive thromboembolism in the pulmonary artery system; valve pneumothorax; severe prolonged attack of bronchial asthma; common acute pneumonia. Factors contributing to the development of pulmonary embolism should include Increase of coagulability atherosclerosis and vasculitis in the pulmonary artery system increase in blood pressure in the pulmonary circulation

6 Bronchopulmonary form, diseases affecting the airways and alveoli: chronic obstructive bronchitis, pulmonary emphysema, bronchial asthma, pneumoconiosis, bronchiectasis, polycystic lung disease, sarcoidosis, pneumosclerosis, etc. Thoracodiaphragmatic form, diseases of the thorax with limited mobility: kyphoscoliosis, ankylosing spondylitis, post-thoracoplasty, pleural fibrosis, neuromuscular diseases (poliomyelitis), diaphragm paresis, Pickwick syndrome in obesity, etc.; Vascular form; diseases affecting the pulmonary vessels: primary pulmonary hypertension, thromboembolism in the pulmonary artery system, vasculitis (allergic, obliterating, nodular, lupus, etc.), atherosclerosis of the pulmonary artery, compression of the pulmonary arteries, and pulsation of the pulmonary arteries

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11 CyanosisAscitesWheezing Shortness of breath

12 Enlargement of the liver Raised jugular venous pressure Jaundice Presence of abnormal heart sounds Intercostal recession Pain in chest

13 Investigations available to determine the cause of cor pulmonale include the following: Chest x-ray – right ventricular hypertrophy, right atrial dilatation, prominent pulmonary artery Pulmonary hypertension Instrumental diagnostics

14 ECG – right ventricular hypertrophy, dysrhythmia, P pulmonale (characteristic peaked P wave) Thrombophiliascreen - to detect chronic venous thromboembolism (proteins C and S, antithrombin III, homocysteine levels) P pulmonale

15 Contrast-enhanced computed tomography of the chest of a patient with pulmonary arterial hypertension. Massive dilatation of the pulmonary arterial trunk and branches (#). The ratio of the diameter of aorta (Ao) to the diameter of main pulmonary artery (PA) is >1.5. Computed tomography

16 Macro-preparation

17 In the clinical analysis of blood is determined by compensatory erythrocytosis, ESR slowdown. In the biochemical analysis of blood cholesterol and β lipoproteins are often lowered. Laboratory investigation

18 In the analysis of urine revealed signs of stagnation in the kidneys: microhematuria, small proteinuria, hyaline cylinders. Characterized by a decrease in glomerular filtration and nocturia.

19 Treatment antibiotics expectorants oxygen therapy diuretics digitalis Vasodilators and anticoagulants

20 bronchodilator require when wheezing is present, the majority of individuals Anticoagulants used when venous thromboembolis m is present Oxygen required to resolve the shortness of breath. to the lungs also helps relax the blood vessels and eases right heart failur requires diuretics to decrease strain on the heart

21 euphyllinum (intravenously, orally, rectally in the early stages - nifedipine, with decompensated course - nitrates (isosorbide dinitrate, nitroglycerin) under the control of blood gas composition due to the risk of hypoxemia. For the purpose of correction arterial hypertension potassium-sparing diuretics (triamteren, spironolactone, etc.) in case of left ventricular insufficiency, cardiac glycosides (intravenous Korglikon) are used. With symptoms of circulatory insufficiency right ventricula type

22 References 1. "Cor Pulmonale. Pulmonary heart disease information. Patient | Patient". Patient. Retrieved Shi, Liwei; Xie, Yanming; Liao, Xing; Chai, Yan; Luo, Yanhua ( ). "Shenmai injection as an adjuvant treatment for chronic cor pulmonale heart failure: a systematic review and meta-analysis of randomized controlled trials". 3.Voelkel, Norbert F.; Quaife, Robert A.; Leinwand, Leslie A.; Barst, Robyn J.; McGoon, Michael D.; Meldrum, Daniel R.; Dupuis, Jocelyn; Long, Carlin S.; Rubin, Lewis J. ( ). "Right Ventricular Function and Failure Report of a National Heart, Lung, and Blood Institute Working Group on Cellular and Molecular Mechanisms of Right Heart Failure". 4. Matthews, Jennifer Cowger; McLaughlin, Vallerie ( ). "Acute Right Ventricular Failure in the Setting of Acute Pulmonary Embolism or Chronic Pulmonary Hypertension: A Detailed Review of the Pathophysiology, Diagnosis, and Management". 5."Types of Cardiomyopathy - NHLBI, NIH". Retrieved George, Ronald B. ( ). Chest Medicine: Essentials of Pulmonary and Critical Care Medicine. Lippincott Williams & Wilkins. 7. "Blood clots: MedlinePlus Medical Encyclopedia". Retrieved

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