Caz clinic
INSUFICIENTA CARDIACA (IC)
D.M, barbat, 51 ani, Iasi
Antecedente heredo-colaterale:
Ø 656e412g ; mama:
§ 656e412g ; 656e412g ; HTA
§ 656e412g ; 656e412g ; Reumatism articular acut
Ø 656e412g ; tata:
§ 656e412g ; 656e412g ; HTA
Antecedente personale:
Ø 656e412g ; Ulcer gastric
Ø 656e412g ; HTA
Ø 656e412g ; Rheumatism articular acut
CVM:
Ø 656e412g ; Fost zidar
Ø 656e412g ; Fumator (5-10 tigari / zi)
Ø 656e412g ; Nu consuma alcool
Motivele internarii:
Ø 656e412g ; Tahicardie
Ø 656e412g ; Dispnee de effort progresiva
Ø 656e412g ; Tuse
Ø 656e412g ; Cianoza rece generalizata, mai vizibila la extremitati
Ø 656e412g ; Durere la nivelul ficatului
Examen obiectiv:
Ø 656e412g ; Cianoza rece generalizata
Ø 656e412g ; Jugulare turgide
Ø 656e412g ; Hepatomegalie dureroasa
Ø 656e412g ; Tahicardie
Ø 656e412g ; La ascultatie prezinta suflu sistolic
Ø 656e412g ; Edeme cianotice dure si reci
Ø 656e412g ; Oligurie
Ø 656e412g ; Semnul Harzer present
Examenul paraclinic:
Ø 656e412g ; Radiografie toracica:
§ 656e412g ; 656e412g ; releva bombarea arcului inferior drept (dilatarea AD si largirea mediastinului
§ 656e412g ; 656e412g ; marirea de volum aVD (imagine profil)
Ø 656e412g ; ecografia: cord marit ca volum
Diagnostic pozitiv:
Ø 656e412g ; pe baza semnelor clinice si paraclinice
Ø 656e412g ; HTA - factor declansator
Tratament:
Ø 656e412g ; Digoxin - initial 1 f / 12 ore i.v diluat in 1 f glucoza 33 %, apoi 1 tb / 12 ore (ziua 11), apoi 1 tb / zi permanent
Ø 656e412g ; Cardiotonic
Ø 656e412g ; Enalapril: 2,5 mg * 2 / zi (vasodilatator)
Ø 656e412g ; Nefrix: 25 mg / zi (diuretic)
Ø 656e412g ; Metoprolol: 50 mg * 2 / zi (beta-blocat)
Ø 656e412g ; Regim igienico-dietetic:
§ 656e412g ; 656e412g ; repaus la pat, cu reluarea progresiva a activitatilor curente
§ 656e412g ; 656e412g ; somn eficient, eventual cu ajutorul somniferelor (Diazepam)
§ 656e412g ; 656e412g ;
dieta liposodata
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