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91. Kongreß: Gehalten Zu Wiesbaden Vom 14. Bis 18. April 1985

91. Kongreß: Gehalten Zu Wiesbaden Vom 14. Bis 18. April 1985

          
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About the Book

Kiibler, W., Manthey, J. (Abteilung Innere Medizin III (Kardiologie) der Universitat Heidelberg) Eine auf die iibliche Medikation mit Digitalisglycosiden und Diuretika nicht oder nur unzureichend ansprechende Herzinsuffizienz wird in der Regel als "therapie-refraktar" bezeichnet. Das therapeutisch kaum noch zu beeinflussende Terminalstadium sollte allerdings nur dann angenommen werden, wenn die in Tabelle 1 angefiihrten diagnosti schen und therapeutischen Ursachen einer erfolglosen Behandlung ausgeschlossen wer den konnen. Tabelle 1. Ursachen einer erfolglosen Behandlung der Herzinsuffizienz A. Diagnostische Problerne 1. Unbekannte Ursache einer Herzinsuffizienz 2. Unerkannte Begleiterkrankung 3. Unerkannte Komplikationen der Herzinsuffizienz 4. Fehldiagnose B. Therapeutische Problerne 5. Unzureichende medikamentose Behandlung 6. Unerwiinschte Nebenwirkungen der eingesetzten Medikamente 7. Unzureichende Wirkung der Medikamente 1. Unbekannte Ursache einer Herzinsuffizienz "Herzinsuffizienz" stellt letztlich eine Kombination von klinischen Symptomen und Zeichen, aber kein causal erklartes Krankheitsbild dar. Eine genaue atiologische Abkla rung in der Regel mit selektiver Koronarangiographie und Links-, ggf. auch Rechts herzkatheterisierung erscheint deshalb erforderlich, wenn nicht schwere Begleiterkran kungen oder das Alter des Patienten eine Kontraindikation darstellen. 1m Stadium der Herzinsuffizienz konnen die iiblichen diagnostischen Symptome und Zeichen maskiert sein, so daB die klinische Vorfelddiagnostik oft erheblich erschwert ist: 1m Falle einer koronaren Herzerkrankung kann bei ausgedehntem ischamischen Myokardbezirk das Symptom der Atemnot und nicht des pectanginosen Schmerzes fUhrend sein. Dies gilt fUr Patienten mit Stammstenose und mit ausgepragter 3- GefaBerkrankung. Bei jiingeren Patienten kann bei Herzinsuffizienz eine Koronarano malie, z. B. in Form des Bland-White-Garland-Syndroms zu Grunde liegen, das im Erwachsenenalter vor allem zur Dyspnoe und zur Herzinsuffizienz fUhrt."


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Product Details
  • ISBN-13: 9783807003528
  • Publisher: JF Bergmann Verlag
  • Binding: Paperback
  • Language: German
  • Returnable: Y
  • Spine Width: 24 mm
  • Weight: 648 gr
  • ISBN-10: 3807003525
  • Publisher Date: 09 Dec 1985
  • Height: 234 mm
  • No of Pages: 432
  • Series Title: Verhandlungen Der Deutschen Gesellschaft Für Innere Medizin
  • Sub Title: Gehalten Zu Wiesbaden Vom 14. Bis 18. April 1985
  • Width: 156 mm


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91. Kongreß: Gehalten Zu Wiesbaden Vom 14. Bis 18. April 1985
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