Restriktivna kardiomiopatiia - Restriktivna kardiomiopatiia...

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Restriktivna kardiomiopatiia To je primarno oboljenje srčanog mišića koje se karakteriše poremećajem dijastolne funkcije leve komore, njenom smanjenom rastegljivošću i rigiditetom zidova, što onemogućava normalno punjenje ove šupljine. Etiologiia: idiopatski oblik; sekundarni oblik (amiloidoza, sarkoidoza, hemohromatoza, endokarditis, endomiokardna fibroza). Patofiziologiia: smanjena je rastegljivost zidova srčanih komora, zbog čega je poremećeno njihovo punjenje, pa se pritisak u venskom sistemu i pretkomorama povećava. Venska kongestija se ogleda stazom na plućima i ostalim organima. Sinusna tahikardija je kompenzatorni mehanizam u održavanju minutnog volumena. Klinička slika: znaci pulmonalnog i sistemskog venskog zastoja, povišenje venskog pritiska i insuficijencija levog i desnog srca. Dispneja, ortopneja, malaksalost, pretibijalni edemi, edem pluća. Fizički znaci: srčani tonovi su tihi, tahikardija, poremećaji ritma, presistolni protodijastolni galop, sistolni regurgitacioni šum (ponekad). EKG: poremećaji sprovođenja impulsa, nespecifične promene ST segmenta. Rentgen, EHO, kateterizacija. Terapiia: neuspešna. Zasniva se na principima terapije hipertrofične kardiomiopatije. Reumatska groznica Akutna reumatska groznica je sindrom koji nastaje 2-3 nedelje nakon preležane infekcije gornjih respiratornih puteva izazvane (3-hemolitičkim streptokokom grupe A. Karakteriše je prolaznost svih promena, osim promena na srcu, koje dovode do definitivnih oštećenja i sklonosti ka recidiviranju.
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