Download - Cardio-Vascular an Vi

7/26/2019 Cardio-Vascular an Vi

1/19

BOLILE

APARATULUI

CARDIO-VASCULAR


2/19

A.Obstrucia fuxuluisangvin cerebral

Ateroscleroz; embolii; neoplzii; tromboz;tr!mtisme

B.CardiopulmonareB"#Aritmii cr$iceB#%#Ostr!c&ii

Br$iritmii' bloc!ri cr$ice;Sin$rom br$icr$ie-tr(icr$ie;

Sincop )sopresore;*ipersensibilitte sin!s!l!i croti$in;

T(iritmii' t(icr$ie s!pr)entric!lr;Sin$rom t(icr$ie-br(icr$ie;

T(icr$ie )entric!lr;Stenoz ortic s! p!lmonr;

*ipertro+e simetric;Tmpon$ cr$ic, nomlii conenitle $ecor$ c! .!nt $rept-st/n

C.Presiunea sangvinC#"#Sc$ere $ebit!l!icr$icC#%#Sc$ererezisten&ei peri0erice

C#"#"#Sc$ere 0rec)en&ei cr$iceC#"#%#Sc$ere )ol!m!l!i btie 1sc$ere contrctilit&ii b1sc$ere )ol!m!l!i circ!lnt'

(ipo)olemie;(emorie; .oc; sincop t!sien;(ipotensi!ne post!rl;me$icmente )so$iltoreC#%#"#Vsc!lr' (iper)entil&ie

C#%#%#Sc$ere stim!lrii simptice' en&ibtblocn&i $renerici; *ipotensi!ne

post!rl; Sincop )so$epresore etc#D.Metabolice D#"#Sc$ere presi!nii C!ze cr$iop!lmonre

Etiologia sincopei2$!p Ettiner, "334 cit# $e BR5SLA6U, %77"1


3/19

emiologie Elemente de diagnostic

Examen general Obosel

Curba respiratorie Dispnee, t(ipnee, cinoz, ortopnee!oc precordial Cre.tere 0rec)en&ei

Ascultaie cardiac Diro+lrioz' s!8! $!bl!, $i+cil $e $esci0rt 20ono1Stenoz' s!8! sistolic $e stenoz p!lmonr 2proiec&interior s!b triceps .i intrre /n piept1

Ascultaie pulmonar 9omote s!pr$!te, comple:e .i )rite pe prc!rs!le)ol!&iei

"adiogra#e lateral Diro+lrioz' $imin!re importnt l!minii bron.ice,bron(opne!monie obstr!cti)Stenoz' (iperclritte p!lmonr

Electrocardiogram T(icr$ie, P cresc!t .i sci&it, c!rb RS s! RS, ST /nlt

s! s!b$ecltEc$ilibru acido%ba&ic Aci$oz, poi lcloz respirtorie mortl

'epatomegalie -l


4/19

emiologie uspiciune de ,CD uspiciune de ,cD asociatcu ,cs

Examen general r elemente speci+ce OboselCurba respiratorie orml Pert!rbt $e- l!n!l !nei Ics

!oc precordial


5/19

emiologie uspiciune mic uspiciune mare Diagnostic decertitudine

/ 4 7 8Examen general Obosel proresi) l

e0ortT!se c(intos,emetiznt noct!rn +


8/19

:ipul e(u&iunii Etiologia Elemente caracteristice

S/ne "#T!morile bzei cor$!l!i%#Alte neoplzii2metsttice1G#R!pt!r tri!l!i st/nF#Tr!mtisme4#Tr!me itroene

De obicei l rse brc(ice0le,peste )/rst $e H ni, s/neneco!ltDe obicei l msc!li $in rsemici, peste H niP!nc&ie s! cteterism cr$ic

Trnss!$t "#Ins!+cien& cr$icconesti)%#*ipoproteinemieG#Sec!n$r, (erni$i0rmticperitoneopericr$ice

E0!zi!ne rreori $etectbil le:men +zic s! r$ioloic

E:s!$t "#En0!zi!ne pericr$ic

i$ioptic benin%#Pericr$it septic

Lic(i$ sero-sn)inolent, c!lore

)i.nie, neco!lbilE:s!$t seros /n bol Crre .ileptospiroz; sn)inolent /nt!berc!loz s! socit c!ple!rit .i cocci$ioi$omicoz

Diagnosticul di(erenial -n e(u&iunile pericradice la c-ine2$!p Ettiner .i S!tter, "3>7 cit# De M*ERMARIU, "3341

i i di( i l i i - $i # i dil i di l i i


9/19

peci#care Cardiomiopatia'ipertro#e Dilataie

imptome-$ispnee;-tromboembolie;

-ptie;-0rec)en& cr$ic cresc!t;-zomote cr$ice intense;-e$em p!lmonr 2lic(i$ /nc)itte ple!rl1;

-$ispnee;-tromboembolie;

-ptie r);-0rec)en& cr$ic cresc!t;-zomote cr$ice $imin!te-lic(i$ /n c)itte ple!rl;

E;< -t!lb!rri $e con$!cere;-ritmii;

-ritmii

Ecocardiogra#e

-cre.tere )ol!m!l!i peretel!icr$ic;-perete inter)entric!lr cresc!t;-sept cresc!t;-c)itte )entric!l!l!i st/neste mrit

-$ilt&ie;-perete inter)entric!lr s!b⁢

Modi#cri

mor(opatologice

-(ipertro+ m!.c(ilor

)entric!l!l!i st/n;-)ol!m!l tri!l!i st/n cresc!t;-tromboembolie rteril;

-$ilt&i triilor .i )entric!lilor;

-tromboembolie rteril;

:"A:AME=: -Propnol ' 7,4-",7 m=N m#c#,per os;-!rosemi$ ' 7,4-%,% m=Nm#c#, i#)#;-C to ril ' 7 4-" m N m#c#

-Propnolol ' 7,4-",7 m=N m#c#, per os-!rosemi$ ' 7,4-%,% m=N m#c#,per os, i#)#;-Cptopril ' 7,4-" m=N m#c#, per os;-Dio:in ' $oz ini&il ' 7,77F m=N m#c#, peros2$i)izt /n $o! pr&i1-$oz $e /ntre&inere ' 7,77Gm N m#c# er os $i)izt /n $o! r i

Diagnostic di(erenial >i terapie -n $ipertro#a >i dilataia cardiac la pisic2$!p ?$!s ?elin$ .i col#, "33G, prel!crt $e ?O@, %771


10/19

ufuri cardiace emnevascular

e

emnepulmon

are

Diagnostic

topogra#c

Diagnosticde boal

:imp deapariie

,ntensitate

:imbru oc depercepi

e

Propagare

/ 4 7 8 ? 6 2 1 0

Sufuldiastolic

?e$ie

?e$ie

D!lce

D!lce

ocr!lortic

ocr!lp!lmonr

Pecroti$

-

P!ls

rterilsltre&

-

-

D

Ins!+cien& orticIns!+cien

&p!lmonr

S!8!ri

en$ocr$iceornice '

en$ocr$ite2cronice1 .i

)icii)l)!lre $elt nt!r

Suful

presistolo

c

Slb

Slb

D!r

D!r

ocr!ltric!spi$

ocr!lmitrl

Spre )/r0

Spre )/r0

lebectzie;P#)#

neti)e:ert

P##nemo$i+

-

D

Stenoztric!spi$i

n

Stenozmitrl

S!8!rien$ocr$ice0!nc&ionle '

$ilt&iecr$ic,

r!pt!ri s!(ipotonie cor$elor

ne e cr er e agnos c n va vu opa e cron ce2$!p BR95 .i col#, "3H"1


11/19

/ 4 7 8 ? 6 2 1 0

Sulul

sistolic

?e$ie

?e$ie

?re

?e$ie

D!lce

D!lce

D!r

D!r

ocr!ltric!spi$ocr!lmitrl

ocr!lortic

ocr!lp!lmonrei

Spre )/r0

Spre )/r0

Pe croti$

-

P#)# poziti) '

8ebectzie

P## mo$i+cts! mic

P## $!r, mic,lent

-

-

D

-

D

Ins!+cien&tric!psi$

Ins!+cien&mitrlStenozortic

Stenozp!lmonr

S!8!rien$ocr$ice0!nc&ionle '

$ilt&iecr$ic,

r!pt!ri s!(ipotonie

cor$elor s!m!.c(ilor

ppilri cre+:ez )l)ele

Sulul

sistolic

orteslb

D!lce

n 0r0ocrelormobile,

intermitente

- - - -

S!8!ri/n.eltore '

nemie,c.e:ie, stri0ebrile, $!pe0ort!ri mri

etc#

Sulul

sistolic

Di0erit D!lcen 0r

0ocrelor,mi

0rec)entspre bz

cor$!l!i

- - - -

S!8!ri $in

nomliicr$iceconenitle 'persisten&cnl!l!irteril,

!rii Botllo, ori+ci!l!i

inter)entric!lretc#


12/19

e&iunea "A " A Aort MPA Circ. P C Alte caracteristici/ 4 7 8 ? 6 2 1 0 /5 //

,nsu#cie

namitralei

Pote + sec!n$r

cr$ioptiei, en$ocr$itelors! .!nt!l!i $rept-st/n

teno&aaortic

?e$istin lrit-0rec)ent/nt/lnit

,nsu#cienaortic

C!zt $e en$ocr$it s!bol conenitl

,nsu#cientricuspidian

Pote + sec!n$rcr$iomioptiei, in0#Przitre c! se$i! cr$ic,stenozei p!lmonre

teno&apulmonar

De)iere pe:!l!i, similrc! LV*

:etralogia allot

Pozi&i ortei este crnil.i pote lri me$istin!l

De(ectseptalatrial

Menerlizrecr$iomeliei $c esteprezent VSD

Diro#lario&

Artere p!lmonre lri,in+ltrte p!lmonre

Aspecte radiogra#ce tipice -n bolile cardiace)$!p QirN .i col#, "337; elson .i Co!to, "333 cit# $e ?O@, %77+


13/19

/ 4 7 8 ? 6 2 1 0 /5 //Persistenacanaluluiarterial

E$em!l p!lmonr este0rec)ent /nt/lnit

De(ectseptalventricular)D+

Aspectele)riz#Pote +consecin& $e0ect!l!ien$ocr$il 2l pisic1

Cardiomiopatie$ipertro#c

Ape: $e)it, e$emp!lmonr, colec&ieple!rl

Cardiomiopatiecongestiv)dilataie+

Colec&ie ple!rl,e$em p!lmonr0rec)ent /nt/lnit

E


14/19

ubstaa =ume despecialitate

,ndicaii Posologie

/ 4 7 8Amiodaron Cr$rone ibril&ie !ric!lr "-",4 m=N=zi, $e F ori, per

osAprindin iborn T!lb!rri $e ritm )entric!lr G-4 m=N=zi, /n % prize, per

osAtenolol Tenomine T!lb!rri $e ritm

s!pr)entric!lrCr$iomioptie (ipertro+c*ipertiroi$ie

7,4 m=N=zi

Benzilthiouracil Bs$ene *ipertiroi$ie2pisic1 "47 m=zi 2" spt#1, poi,"77 m=zi, /n G prize, per os

Bepridil Cor$i!m estbilite estbilitCaptopril Lopril Ins!+cien& cr$ic "-4 m=N=zi, /n G prize, per

osCarbimazol eomerczole *ipertiroi$ie2pisic1 "4 m=zi 2" spt#1, poi "7

m=zi, /n G prize, per os

Cibenzolin Ciprln T!lb!rri $e ritm rezistente llte me$icmente

4 m=N=zi, /n G prize, per os

Digitalin Diitline nti)elle Ins!+cien& cr$iccomptibil c!(ipocontrctilitte

7,74-7," m=N, /n % prize,per os

Digoxin Dio:ine coro:ine Ins!+cien& cr$icT!lb!rri $e ritm

s!pr)entric!lrCr$iomioptie

7,7"-7," m=N=zi, /n % prize2pisic1

7,7"> m=N=zi, /n % prize,per os 2c/ine1

,ndex terapeutic -n cardiopatiile carnivorelor)$!p M(erri!, "334 cit# $e ?O@, %77+


15/19

/ 4 7 8Dobutamin Dob!tre: 6oc cr$ioen

P!se! c!t $e ins!+cien&cr$ic conesti)

4-"4 !=N=min#, i#)#, $il!t /nsol# l!cozt, izotonic

Enalapril Renitine Ins!+cien& cr$ic 7,4 m=N=zi, per osFlecainid lecine T!lb!rri $e ritm rezistente l

lte me$icmente4 m=N=zi, /n % prize, per os

Flunarizin Sibeli!m Tromboembolie 2pisic1 " m=N=zi, /n % prize, per osFurosemid Lsili: Is!+cien& cr$ic 2$i!retic1 F m=N=zi, /n % prize, poi %

m=N=zi, /n % prize, tot l %zile, per os 2pisic1H m=N=zi, /n % prize, poi Fm=N=zi /n % prize 2c/ine1

Heparin r:iperine Tromboembolie 2pisic1 "77 UI=N=zi, s#c#, se re/noiexiletin ?e:itil T!lb!rri $e ritm )entric!lr " m=N=zi, /n G prize, per osilrinon Inocor 6oc cr$ioen 7,4 m=N=zi, i#)#, % inec&ii!icardipin Lo:en estbilite estbilit!iedipin A$lte Cr$iomioptie (ipertro+c "m=N=zi, /n % prize, per os"uabain !bine Diitlizre $e !ren& 7,7" m=N, i#)##rocainamid Pronestl T!lb!rri $e ritm )entric!lr H-%7 m=N=zi, /n G prize, per

os

#ropaenon Rt(mol T!lb!rri $e ritm rezistente llte me$icmente

4 m=N=zi, /n G prize, per os

#ropanolol A)locr$l Cr$iomioptie (ipertro+cT!lb!rri $e ritms!pr)entric!lr*ipertiroi$ie

7,-G m=N=zi, /n G prize, peros

$rinitine Lenitrl

perc!tne

Ins!+cien& cr$ic

2)so$ilttor1

G ori=zi, l bz !rec(ii

%erapamil Isoptine ibril&ie !ric!lr "-",%H m=N=zi, /n F prize, per


16/19

Medicamenteantiaritmice

Pre&entare Productor

/ 4 7

CAA , )blocanteale canalelor desodiu+Li$ocin

Uz )eterinr-%7 m=ml 2% 1, sol# in#Uz !mn-%7 m=ml 2% 1, sol# in# Di0erite 0ormeilocin 2Astr, estboro!(,?A1

Procinmi$ %47, G>4 .i 477 m, tblete .i cps!le"77 .i 477 m=ml, sol# in#

Pronestl 2Bristol ?res S!ibb,Princeton, W1

Procinmi$ 2retr$1 %47, 477, >47 .i "777 m, tblete Pronestl 2Bristol ?res S!ibb,

Princeton, W1S!l0t $e !ini$in2stn$rt1

%77 .i G77 m, tblete Di0erite 0orme

S!l0t $e !ini$in 2retr$1 G77 m, tblete !ini$e: E:tentbs 2A#*#Robins, Ricmon$, VA1

Ml!cont $e !ini$in2retr$1

G%F m, tbleteH7 m=ml, sol# in#

!inl!te D!r-Tbs 2Berle:Lbortories, ne, W1

!inlnLnnet, P(il$elp(i, PA 2EliLill, In$inopolis, I1

Polilct!ront $e!ini$in

%>4 m, tblete 2ec(i)lent %77 m$e s!l0t $e !ini$in1

Cr$io!in 2P!r$!e re$ericN,orXlN, CT1

Tocini$ F77 .i 77 m, tblete Tonocr$ 2?ercN, est Point, PA1?i:elitin "47, %77 .i %47 m, cps!le ?e:itil 2Boe(riner Iei(eim

P(rmce!ticls, Ri$e+el$, CT1enitoin 47 m=ml, sol#in# Dilntin 2PrNe-D)is, ?orris

e ca e an ar m c)$!p ELSO .i COUTO, "333+


17/19

/ 4 7

CAA a ,,%a )blocantebeta%adrenergice+Proprnolol

"7, %7, F7, 7, H7, 37 m,tblete" m=ml, sol#in#F, H .i H7 m=ml, sol#orl,

cps!le

In$erl 2et(-AerstLbortoires, P(il$elp(i, PA12Ro:ne Lbortoires, Col!mb!s,O*1

In$erl LA 2et(-AerstLbortoires1Atenolol %4, 47 .i "77 m, tblete

4 m="7 ml, sol#in#Tenormin 29enec, ilminton,DE1

Esmolol "7 m=ml .i %47 m=ml, sol#in# Bre)ibloc 2D!Pont ?ercN,ilminton, DE1

CAA a ,,,%a )blocante

ale canalelor de potasiu+Bretli!m

47 m=ml, sol#in# Bretlol 2D!Pont Criticl Cre,

ilminton, DE1

Amio$rone %77 m, tblete47 m=ml, sol#in#

Cr$rone 2et(-AerstLbortoires, P(il$elp(i, PA1

Sotlol H7, "7 .i %F7 m, tblete Betpce 2Berle:, ne, W1

CAA a ,%a )blocante

ale canalelor de calciu+Verpmil

F7, H7 .i "%7 m, tblete

4m=% ml, sol#in#

Cln 2Serle, C(ico, IL1

Isoptin 2Qnoll P(rmce!ticl,(ippn, W1

Diltizem G7, 7, 37 .i "%7 m, tblete4m=ml, sol#in#

Cr$izem-CD 2?rion ?errelDoX, Qnss Cit, ?O1

Diltizem "%7, "H7, %F7 .i G77 m,cps!le"%7, "H7 .i %F7 m, cps!le

Cr$izem-CD 2?rion ?errelDoX1Dilcor R 2R(one-Po!lencRorer, Collee)ille, PA1


18/19

A=:,CO,=E"


19/19

=ume generic Denumire comercial Do&a )interval+

Benzopril Lotensin 7,%4 m>N, per os, %F ore 2c/ine1

Cptopril Cptopril 7,4-% m=N, per os, H-"% oreEnlpril Encr$ 7,%4-7,>4 m=N, per os, "%-%F ore

Lisinopril Prini)il 7,F-" m=N, per os, "%-%F ore 2c/ine1

Rmipril Altce 7,4 m=N, per os, "%-%F ore 2c/ine1

Atenolol Tenormin ,%4-"%,4 m, per os, "%#%F ore 2pisic1"-% m=N, per os, "%-%F ore 2c/ine1

Proprnolol In$erl 4-"7 m=N, per os, H-"% ore 2pisic14-H7 m=N, per os, H-"% ore 2c/ine1

Przosin 2blocrereceptor!l!il0$reneric1

?inipress 7,%4-" m=N, per os, H-"% ore 2pisic17,%4-" m=N, per os, H-"% ore 2c/ine1

Amlo$ipine or)sc 7,%4 m, per os, %F ore 2pisic1

Diltizem Cr$izem >,4-"4 m, per os, H-"% ore 2pisic17,%4-% m=N, per os, H-"% ore 2c/ine1

Verpmil Isoptin " m=N, per os, H-"% ore 2pisic1

Diltizem Cr$izem DC "7 m=N, per os, %F ore 2pisic1

*i$roclortrizi$ *$roD!ril %-F m=N, per os, "% ore

!rosemi$ Lsi: "-F m=N, per os, H-"% ore

Spironolcton Al$ctone %-F m=N, per os, %F ore

edicamente (olosite -n terapia anti$ipertensiv la c-ine >i pisic)$!p P*ILIP, "333+

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