Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Name
Age
Gender
Address
RM
: Nn. S
: 21 years
: Female
: Pare-Pare
: 38 63 31
DM (-)
HT (-)
History of Reumatic Heart Disease is
unknown
Present status:
Severe illness/ Under nutrition/Conscious
Vital signs:
BP : 100/70 cmHg
HR : 90 bpm regular
RR : 28 x/minute
T
: 37,8C
No mass, no pain
JVP R+4 cmH2O
Chest :
Inspection
: Asymmetrical, left chest is
convex than the right chest
Palpation
: No mass, no pain
Percussion
: Relative Dullness is heard from
ICS
III and below for both
side of the
chest
Auscultation : Vesicular, Rh +/+ (diffuse)
Heart:
Abdominal :
Complete blood
count
WBC: 5.800/l
RBC: 3,69x106/l
HGB: 8,7 gr/dl
HCT: 31,0%
PLT: 307x103/l
Electrolyte
Sodium: 130
Potassium: 3.3
Chloride: 101
Blood chemistry:
GDS : 97 mg/dl
Ureum : 17 mg/dl
Creatinine : 0.6 mg/dl
SGOT/SGPT: 17/8 u/dl
Total Prot : 7.0 mg/dl
Albumin : 3.1 mg/dl
Globulin : 3.9 mg/dl
Ck : 27
Ck-MB : 17 u/dl
Interpretation:
Accelerated Junctional Rhytme
HR 100 bpm
Inferior ischemic myocardium.
Conclusion:
Signs of Pulmonal Oedema DD/
Bronchopneumonia
Bilateral diphragma elevation
Description:
Dilated LA and RA
Good LV Contractile, EF 85%
Mitral Insufisiensi Severe and vegetation
Tricuspidal Insufisiensi
PH (PAP= 27 mmHg)
Conclusion:
Heart Diet
O2 3 4 liter/minute
Lasix 2 amp/12jam/iv
Lasix 2 amp/12jam/sp
NTG 10 ug/mnt
Farsorbid 10mg
3x1
Aspilet 80mg
1x1
Dorner 2 x 1
Alravolam
1/2- 0 1
Laxadyn syr 3 x 1 c
PRC transfusion 1 unit
PCT
3 x1
Congestive
failure (CHF)
heart
is an
imbalance in pump
function in which the
heart fails to maintain
the circulation of blood
adequately.
Contractility
disturbance
(eg.
myocardial
overload
such
as
mitral
&
aortic
regurgitation).
Cardiomyopathy
Major Criteria
Minor Criteria
Paroxysmal Nocturnal
Extremity edema
Dyspnea
Cough
Dyspnea deffort
Decreased vital
Cardiomegaly
Gallop S3
Increased of JVP
pulmonary
capasity (1/3 of
maximal)
Hepatojugular reflux
Hepatomegaly
Rales or ronchi
Pleural effusion
Tachycardia
Prolonged circulation
time
(> 25 sec)
II
III
IV
Managing
preload
Managing
contractility
Managing
afterload
Neurohormonal
modulation
Diuretics
Venodilators
Ca2+
channel blockers
Anti adrenergic
Vasodilators
Cardiac
glycosides
adrenergic
Phosphodiesterase inhibitors
blockers
ACE inhibitors
Angiotensin receptor blockers
a condition in
which the mitral
valve does not
seal tightly,
which allows
blood to flow
backward in your
heart
Valvular-leaflets
Myxomatous Disease
Rheumatic
Endocarditis
Congenital-clefts
Annulus
Calcification
Chordae
Fused/inflammatory
Torn/trauma
Degenerative
Papillary Muscles
CAD (Ischemia,
Infarction,Rupture)
Infiltrative disorders
Acute mitral
regurgitation
Electrocardiogram
Normal
Heart size
Normal
Systolic murmur
Apical thrill
Jugular venous
distension
Chronic mitral
regurgitation
P mitrale, atrial
fibrilation, left
ventricular
hypertrophy.
Cardiomegaly, left
atrial enlargement
Present
Absent
Present
Thank You!