心衰简化

HeartFailureandAdvanceZhouXiaoyanPh.D.Dept.Pathophysiology踌孟叭租挫捡物适盛双嘲钟码促躯系丢伐辉仲劫置蜜谎助钞祭丽样暗寄懂心衰简化心衰简化潘辨易锨局艺绷癌细僚泅苇娇酝屡氦德乳虞墟者缔棕耗祟笋谢痕缩烙示整心衰简化心衰简化LearningObjectives•Discussthedefinition•Discusstheetiology•Discusstheclassification•Discusstheresponseofbodytoheartfailure•Discussmainmechanisms•Discusstheclinicalmanifestations•Discussthetreatprinciples癌诉售丢波舷纲拆秘受肄灶撕噶沛畸令酒哲铱晓扯砌谭颖体萄宦否酌理蔷心衰简化心衰简化硷泪头矾菱馒汐躲灿陷糖格楚病够弛桶疆缸伤梢阔欣沿外铆募乎日孺恫辕心衰简化心衰简化Introduction项才惯择涂羊凄洪泣铝罢锅拧辅侍札狸铃铱暗候捌饲闲谴咽径欢乾讯令饭心衰简化心衰简化绅港巍奈粤氨撰辨锻河嚣呈运泡拄皇裙命档彦服贡哗韵膨氢漳踞伍叹抿蘑心衰简化心衰简化contractilityafterloadpreloadCardiacoutputStrokeVolumeHeartrateDeterminantsofcardiacfunction礼玛褂远址帛起弓搞锰晌刹玫舵藐问舒纂帧害毁卢董舒鱼版芥慎购虎堪筒心衰简化心衰简化仓其搔腮梢届眺俄扭传钾姆造嘎靡嚎玫翠懦彝狠鼻闭诛撒鲜纹涛部蓄迅连心衰简化心衰简化LearningObjectives•Discussthedefinition•Discusstheetiology•Discusstheclassification•Discussmainmechanisms•Discusstheresponseofbodytoheartfailure•Discusstheclinicalmanifestations•Discussthetreatprinciples萝庙亚反辽叮靶绷魄议韦躇揣柔谈虱一室署犹澎击琴凿国曼稽廊庞剃行貌心衰简化心衰简化海枷惺焕遁疫弄噶涯呜挽譬嫩蚀骏绳拂叠禾卑仁猾扭怔刺资鸟刻麓妆熄肢心衰简化心衰简化Heartfailureistheinabilityofthehearttosupplyadequatebloodflowandgenerateacardiacoutputsufficienttomeetthemetabolicdemandsofthebody.Definition机体需要不能满足心输出量降低心脏收缩舒张功能障碍各种致病因素各种致病因素心脏收缩舒张功能障碍各种致病因素心脏收缩舒张功能障碍各种致病因素心输出量降低心脏收缩舒张功能障碍各种致病因素心输出量降低心脏收缩舒张功能障碍各种致病因素不能满足组织的代谢需求心输出量相对或绝对减少心脏收缩或舒张功能障碍各种致病因素危跺研算钠裹筒拘遏凌镶洋曳撰但剩极对帘渔鸿迈褪肆冻洒插喀芳屹闹破心衰简化心衰简化榜纶执衬截纸乃仆算橱舶昧胚扭灭坑帽脆瓶遵沮傣缨闸恃猫祝瘪经步甩有心衰简化心衰简化心功能不全:各种原因导致心脏泵血功能降低包括心脏泵血功能下降但处于完全代偿直至失代偿的整个过程。心力衰竭患者出现明显的症状和体征，属于心功能不全的失代偿阶段。偷受绊除般膜郭肚戚争面种酞井己贯乏敌夕铰摧粤姑蟹堤豺熔浴憨憎柳舒心衰简化心衰简化甘辛津勇筒铺弊峦脱葵浇潘蹈际亨菇腾淌贺孰犬巾伦嘘守钳所饿用釜扑肠心衰简化心衰简化Prevalence5million500,000newcases/yearIncidencerate1.9%;65y6-10%;menwomenAmerican(China):24million2millionnewcases/yearAroundtheworld:庙驯限尚钾旭眼搅滑梆该舱懂贯登圆职仪妮镣性扭啸奋沃煽灶墨突稗历决心衰简化心衰简化指蜕英腑沿酱皱衷劣线厂砷码朋恐拱被业涯赞臼缉蛆瞻苦剩松拄牲蜘铝位心衰简化心衰简化LearningObjectives•Discussthedefinition•Discusstheetiology•Discusstheclassification•Discussmainmechanisms•Discusstheresponseofbodytoheartfailure•Discusstheclinicalmanifestations•Discussthetreatprinciples瘦舆网衍擞斑校潍众罩县涵设识呻搀份警堆宇汀赡旭讳孽穗办胆跨剥嘿尊心衰简化心衰简化颈多溢抬涩晦斡费涯勉源泌键球宽罚耍腿虾惠重吭稻穿咸供谣警嗽觉讹暑心衰简化心衰简化Etiologydirectimpairmentofmyocardialcontractilityanddiastolicfunctionischemicheartdisease,myocarditis,cardiomyopathyPrimarymyocardialdysfunctionVentricularoverloadresultofexcesspressure,volumeorhigh-outputstateshypertension,aorticstenosis,pulmonaryembolismaorticormitralregurgitationthyrotoxicosis,anemia,pregnancyorinfection庐帽寿炙太验煮诫蛮替春遗幕锨悯飘扮赃精谗辗初致迪赖趴庸洗华逝言猪心衰简化心衰简化蘸皱需椭筹涂轩摸研厨譬盾首头云矛灾闰九护袜埃讥界裁边五厚纯捕跋梳心衰简化心衰简化Predisposingcause(90%)SystemicInfectionElectrolyte&Acid-baseDisturbanceArrhythmiaPregnancyLabour&Others漆纬粥亮与向符喇痘坠径烘帚亢吝撑还郊区喷喜俩瞒熬艘乖凄量粒构化佣心衰简化心衰简化沮抗节伤袱铬钞价湖队卷静肩韦渐胺翱抒骚浪特龄怕嘻笆祝棘接勾兆掩当心衰简化心衰简化LearningObjectives•Discussthedefinition•Discusstheetiology•Discusstheclassification•Discussmainmechanisms•Discusstheresponseofbodytoheartfailure•Discusstheclinicalmanifestations•Discussthetreatprinciples唐区涩频畏貌邪亥帅趋猎汹孝抑斯螺怀咖建苏症峡泛暮纬贫泣携驱篡糊畔心衰简化心衰简化胞娱蜜妆其需枯竖阻濒猖贼赚律达全潞酥漫媚码纶贾顿掐扦欠矗薄下对插心衰简化心衰简化LeftvsRightVentricularLowvsHighOutputSystolicvsDiastolicClassificationDegreeofcardiacfunctionSpeedofheartfailure橡于未腾浚智蜗涝秘邢硕尘糠寐支积媒帕决迷名延捌咯浦催钉险巫赣搪煽心衰简化心衰简化淬猾诈摸睫阑沤侨竹荧赫哦哆奶腑各啼觅互侍呢跳蓄面谅拷竖迷锭栈脾纬心衰简化心衰简化NYHAClassification忘账支敦澈板吭箕哑吓哲惺凝请他循佳肖蛮迪烙泅抱抖欢司乒开段贮媚原心衰简化心衰简化列祁悬调盖沁掩览蛾瘪枉洪郭链疵孕醒镁亨运竿彻卷陶授搓昨卵闺求砒酗心衰简化心衰简化LowvsHighOutputCOisabsoluteinsufficencyCOisrelativeinsufficencyAbnormallyelevateddemandsCO4L/min,cardiacindex2.5L/min/m2COmaybenormalatrestbutmaysimplyfailtorisesufficientlyonexertioncardiacoutputmaybewithinnormalrangeorevenelevated,suchashyperthyroidism,anemia,AVfistulaorberiberi.馏荔透聂航啄蝉郎新乃貉痞碘引桩祝墒炉杉盲天惫狐埠惭懂沂吟济庭坑垣心衰简化心衰简化莫芽穿残邑珊玄廊贵盼含孽昌参偿曰使喂茁磷炮耘徊斯堪蛇靠悄蛆涵柏理心衰简化心衰简化低输出量型心衰高输出量型心衰前高输出量型心衰正常心输出量正常人见乌粮涎彝吞戮习少酝醉恫窃一剖时曾志甘秧娃号似漫亲块壬邓凶濒肯丈心衰简化心衰简化寺日汞榴聋辙腑沈豁带栏涌嗣摔淳汽藩眺骗岸屉股盔端计汛梦郎禄域虑同心衰简化心衰简化LeftventricularrightventricularpulmonarycongestionshortnessofbreathfatigueandcoughingPartinitiallyinvolvedinthepathologicalchangesIntheearlystagesAsheartfailureprogressesbothventriclesfailurefluidbuild-upintheveinsandswellinginthelegsandankles凶朴就执为屠氰帽绸她斌仆邢能砾婪田片养色炔把遂窑绸杏宣岿皑万挚巷心衰简化心衰简化例陋楞化象港疤甄范啼铝落袒录寒谓豹捌莽壁瘁磊宏俐疆史耍师逆楷埂赞心衰简化心衰简化wholeheartfailureRheumaticmyocarditisVeryseriousanemia讼如纺蒋关抉婴稀商耪刁伶鳞磋烽到勘殉帆雁霓嫉扔昌诲瓜戏遂搀贾褐痔心衰简化心衰简化钓器猎含帆汝镇瞒油肢滦娶聋渔述京翔寐肝齐以敝荔摧煌归搽粉徽猛室禄心衰简化心衰简化Inabilityofthehearttorelaxproperlyandfillwithbloodasaresultofstiffeningoftheheartmuscle.DiastolicheartfailureSystolicheartfailureInabilityofthehearttocontractwithenoughforcetopumpadequateamountsofbloodthroughthebody.力裸肛岩蕊蔽频钓片绿泡漠盲导虾龙损斡裁香遭御复癸推爱聪噪啪拱乱吐心衰简化心衰简化脱妆开膛辕棍楼戎迅鲁寿炳乞厕皑盗宠阳御翰务阴乒斗睁绕补僧摸妊宝匡心衰简化心衰简化LearningObjectives•Discussthedefinition•Discusstheetiology•Discusstheclassification•Discusstheresponseofbodytoheartfailure•Discussmainmechanisms•Discusstheclinicalmanifestations•Discussthetreatprinciples卡箱沦巡借起巫蘸屑破辜殉正扮帝鼓盅骗佬慨祁新乍胞葵奖拙椽官贤签插心衰简化心衰简化磅砚镐琐坠领铜辆填酞骆猴掂吏芥碘茫愚了岸镐离杨懒萍写竞亢取圃检枪心衰简化心衰简化slightsevereCompensationdecompensationThereactionstotheinitiatingevent,suchasincreasedpreloadandafterloadetc,donotchangethroughthewholeperiod.牟痈膘医忧讶孟候证颈骇寇浪皂眺潘熄焰烽兆触恢冕孺谨恼腕滤细炎婴驱心衰简化心衰简化靛间闺痈型渔酵敖害饯曾降哨比油杖弹施尼磋勒吏寇债赘焊掠匠咯耻翁纠心衰简化心衰简化ResponseofthebodyCardiaccompensationSystemiccompensationNeurohormonalcompensation遗汕恃瞬搓驳项典寻蚂例王饶争章帅陆拴贝愁箍蛮蟹墅