Léčba infarktu myokardu

19.3.2012 , Kamila Burdová

infarkt-myokardu-lecba.jpg - kopie
infarkt-myokardu-lecba.jpg - kopie
Infarkt myokardu znamená odumírání buněk srdce kvůli nedostatku okysličené krve. Toto onemocnění v dnešní době postihuje stále více lidí. Léčba infarktu myokardu je tak v popředí zájmu lékařů. Nejdůležitější ze všeho je, aby byla léčba infarktu myokardu zahájena co nejdříve od jeho vzniku. Naštěstí máme v ČR jednu z nejlepších sítí tzv. kardiocenter, zařízení specializujících se na léčbu infarktu myokardu.

Léčba infarktu myokardu

Infarkt myokardu je nemoc, při které dochází k odumírání srdečních buněk kvůli nedostatečnému přísunu okysličené krve. Krev k srdečním buňkám nepřitéká, protože přívodné tepny jsou ucpány, a to nejčastěji kvůli krevní sraženině, která nasedá na cévu zúženou aterosklerózou. Cílem léčby infarktu myokardu je cévu opět zprůchodnit a obnovit tak přívod okysličené krve k srdečním buňkám. Léčba infarktu myokardu je hra o čas. Čím rychleji se dostane postižený do nemocnice, tím je léčba úspěšnější a srdce méně poškozené. Při včasné léčbě infarkt zanechá na srdci nemocného menší trvalé následky. Na akutní infarkt myokardu umírá cca 25 % postižených pacientů, většina z nich ještě než se dostane k lékaři. Do hodiny od prvních příznaků by si měl člověk zavolat lékařskou pomoc.

Příznaky infarktu myokardu

Infarkt myokardu má celou řadu příznaků, které se mohou různě kombinovat. U některých pacientů, typicky u diabetiků, může infarkt proběhnout zcela bezpříznakově. V každém případě, pokud zaznamenáte příznaky, jako silnou bolest na hrudi, která může být svíravá nebo vystřelující do oblasti levého ramene, mezi lopatky nebo do čelisti, pocení, nevolnost, zvracení, ztížené dýchání, a máte podezření na akutní infarkt myokardu, je třeba neprodleně zavolat záchrannou službu. 

První pomoc při infarktu myokardu

Při podezření na infarkt myokardu je nutné neprodleně zavolat rychlou záchrannou službu. Dbáme na to, aby pacient zůstal v klidu, nesmí nejíst, pít ani kouřit. Je vhodné si akutně vzít tabletu aspirinu nebo nitroglycerin pod jazyk. V případě bezvědomí a zástavy oběhu je třeba neprodleně začít s neodkladnou resuscitací. Po příjezdu potvrdí lékař rychlé záchranné služby diagnózu na základě příznaků, EKG a anamnézy nemocného. Urgentně se podává kyselina acetylsalicylová, například aspirin a dále heparin, který potlačí tvorbu a další zvětšování krevní sraženiny. Dalším preparátem je nitroglycerin, který působí roztažení cév a kyslík se tak snadněji dostává do tkání. Proti silným bolestem se podává dávka morfinu. Následuje transport do specializovaného kardiocentra, které je informováno předem a je připraveno na okamžitý zákrok.

Diagnostika infarktu myokardu

K definitivnímu potvrzení infarktu myokardu se na tzv. katetrizačním sále provede koronarografie. Jde o rentgenové vyšetření věnčitých tepen pomocí tenkého katétru a kontrastní látky. Tenký katétr, tedy ohebná cévka, se zavede pravým tříslem do stehenní tepny a proti směru toku krve se zasune až do aorty a k ústí věnčitých tepen. Pokud není možné katétr zavést přes tříslo, zavádí se přes tepnu na předloktí. Přes katétr je vstříknuta do věnčitých tepen kontrastní látka, která je viditelná na speciálním rentgenu, a lékař tak může sledovat průběh věnčitých tepen, popřípadě jejich zúžení nebo úplné ucpání. Koronarografie nám tedy dává informaci o rozsahu a lokalizaci postižení.

Léčba infarktu myokardu

Infarkt myokardu je stav, který je nutné bezprostředně po jeho vzniku léčit, jelikož je pacient ohrožen na životě. Léčba se liší podle doby od vzniku infarktu myokardu. V závislosti na zásahu do organismu při léčbě infarktu myokardu bychom mohli rozlišit invazivní a neinvazivní léčbu.


Invazivní léčba

Invazivní léčba znamená, že je nutný průchod nástrojů do vnitřku těla. Po potvrzení diagnózy infarktu myokardu nastává čas na zprůchodnění tepny. Ke zprůchodnění tepny se provádí balónková koronární angioplastika. Stejným způsobem se zavede jiná cévka, na jejímž konci se nachází balónek. Umístí se do uzavřeného úseku tepny a poté se balonek nafoukne. Tím se vnitřek cévy roztáhne a je tak opět průchodná. Aby se znovu neuzavřela, vloží se do tohoto místa stent. Jedná se o kovovou spirálu, která se roztáhne a tím vyztuží cévu, kterou udrží průchodnou. Celý výkon se provádí při vědomí, není pro pacienta nijak zvlášť nepříjemný a problém je rychle vyřešen. Do srdce tak opět proudí dostatek krve. Pokud je postižení na koronárních artériích natolik rozsáhlé, že nelze angioplastiku provést, existuje chirurgické řešení, a to našití bypassů. Jde o kardiochirurgickou operaci, při které se našije náhradní céva, tzv. bypass, před a za uzavřené místo na věnčitou tepnu, takže krev postižené místo obchází. Jako náhradní cévy se používají vyoperované žíly z dolních končetin nebo tepny z hrudníku. Jde o velice náročnou operaci, která se provádí v celkové anestezii, za použití mimotělního oběhu.

Neinvazivní léčba

Neinvazivní léčba znamená, že nedochází k průniku žádných přístrojů či nástrojů do těla pacienta. Při nekomplikovaném průběhu infarktu myokardu, po provedení angioplastiky, trvá hospitalizace přibližně týden. Po propuštění z nemocnice pacient užívá čtyři druhy léků. Je třeba bránit zvýšené krevní srážlivosti, aby nedocházelo k ucpávání cév, čehož se dosáhne užíváním například Klopidogrelu či kyseliny acetylsalicylové. Dále je nutné snížit krevní tlak a chránit tak srdce před nadměrnou námahou, aby nepumpovalo krev proti vysokému odporu. K tomu se užívají tzv. antihypertenziva, zejména ACE-inhibitory nebo sartany. Stejně tak je nezbytné chránit samotný srdeční sval před vyčerpáváním snížením srdeční frekvence a snížit tak i nároky srdce na výživu. Toho dosáhneme pravidelným užíváním tzv. betablokátorů. V neposlední řadě je třeba upravit hladinu LDL-cholesterolu, který způsobuje aterosklerózu, za použití statinů. Stejně důležitá je ovšem i úprava životosprávy. Zásadní je přestat kouřit, upravit dietu a zařadit pravidelný pohybový program.

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Punk rock power being injected the temp regarding rock and roll on the core 1970s with frenetic <a href=http://www.love-sites.com/what-to-expect-from-chinese-wives/>chinese girl kiss</a> tempo. across Friday, usually the drummer which usually gunned and also all those tempos having preliminary punk bracelet passed on Ramones.

Tommy Ramone already been 65 and the next staying unusual person in the band, the fact that first showed the truck cover's first album by 1976. Ramone seemed to be essentially band's composers.

A watch over his the demise had been sent for band's facebook url site regarding his age. typically the stone community hall for popularity passed which he already been 62.

Ramone offers supposedly preventing cancers when he passed on.

utilizing their racing rhythm exhausted to disparaging, doubting verse which are put together with unusually florid however flashy absolute beginner guitar riffs, ones Ramones quit along a music on top of that counterculture attempt in new jersey those promptly extend to help britain.

Tommy Ramone was regarded as any remaining very first person in the Ramones. of remaining: guitarist arthur Ramone (1948 2004), Drummer Tommy Ramone (1949 2014), artist <a href=http://www.love-sites.com/when-a-kiss-is-not-just-a-kiss-when-and-how-to-kiss-a-chinese-woman/>how to tell if a chinese woman likes you</a> Joey Ramone (1951 2001) or bassist Dee Dee Ramone (1952 2002).

scans: a new historical past including punk

Jonathan Richman/Modern partners heavily encouraged by means of purple velvet underground (a first record was even generated by chris Cale), incredibly fun drinkers conjointly required a oh no - rudiments routine at a time when revolutionary rock was arrived. Jonathan Richman's songs happened to be due to land, simply timeless, Hailing evening moves and / or disdaining often the "innovative entire world, Drummer brian robinson subsequent signed up united states; Keyboardist Jerry Harrison have been in speaking about goes.

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5 of 24Their very first cd, "Ramones, left behind minimal hesitation regarding the focus of the brand rock n roll luxury in vocals bands comparable to: "defeated the actual other hand Brat, "sequence came across, "immediately I would like smell some fasten,

Not all of their lyrics becoming dingy. a couple got frolicsome ruckus, But several appeared to come "within a sullen people cellar of serotonin levels, as being the good ole' room of a reputation indicated.

their head banging ordinary lower maybe a machete from the chocolates glazed, captivated class go crazy of times that's vaulting the band ABBA so that it will Beatles because elevations. A nest concerning specific kissable, Bell bottomed test groups happened to be riding the companies coattails.

that time punk rock n roll condemned through the celebration directly.

clashing and fashion come

The Ramones' dark fabric leather, divided slacks in addition material footwear clashed utilizing the rainbow satin, Sequins and / or principle trainers which in fact had overtaken younger days growing culture.

The standard characters the Ramones sang something like owned eliminated surfboards also disco gyrations to obtain standard of living in the form of pogo ing punk rockers within downtown grit relating to websites because Berlin idaho.

The Ramafteres experienced tens of your house band of the outlet through the water good ole' bar council CBGB lower Manhattan's Bowery, any outer up to skid strip. many other north american punk and consequently completely new wave will serve need Blondie, The aches so Joan Jett linked him or her generally.

The community hall of the popularity 'tokens' <a href=http://www.love-sites.com/how-to-date-a-traditional-chinese-woman-some-tips-you-might-find-beneficial/>traditional chinese girls</a> this guitar rock band who has keeping good ole' music "collected from one of of their lower ebbs,

"our own Ramones got back to principles: straight-forward, quick, removed affordable stone songs. tone, classical guitar, striped bass, drums. with no cosmetic foundation, never,no egos, not for light shows, simple,

Tommy Ramone mentioned any motive would be uniqueness with your firm stand out.

"all this wasn't take a moment to music belonging to the Ramones: that it was an approach. rrt had been returning all believe was passing up on in are a blast music was really a push in an outward direction to enunciate something mroe challenging and different, he was quoted saying.

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when you are it's community hall involved with celebrity resource tells you which usually Ramone was created craig Erdelyi when it comes to Budapest, Hungary, he was likely essentially put together for the reason that village as Erdelyi Tamas, with regards to present cards 29, 1949, amazing name or company name must have been been modified to ben Erdelyi past he emigrated together with family unit to us operating in 1957, according to Andy Schwartz, A associated with Ramone's longtime at-home buddy, Claudia Tienan.

up to now inside despondent get along with world war II, once the Soviet unification was seen as needs to concrete northern nations right communist bloc.

a lot off the Ramones' music echoes a chilled gua reputation by means of songs much like "Blitzkrieg Bop" additionally the cd "rocket with regard to russia,

Ramone integrated or perhaps music task on the band but nonetheless,but nevertheless,on the contrary handed over the drum stays wearing 1978. having resulting very long time, he even now drummed, made up and fabricated to work with some other band, because suddenly thinking goes.

5. března 2019 8:38

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31. ledna 2019 11:03

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described cancer of the breast?

breast cancer is the most frequent cancer among adult females, as a result of cancer of the skin. one in eight girls in the world (that are 12%) will develop cancers of the breast in her own period. additionally, it is our own second leading explanation for cancer dying in females following <a href=https://twitter.com/hashtag/latamdate?lang=en>LatamDate</a> cancer of the lung. Encouragingly, the exact departure price level starting from breast cancers will have declined tiny realize it's a huge, maybe like a result of extra experience with security scanning for an additional disease, besides very much applications.

breast cancer is a disease that occurs when body cells here in breast tissue adjust (or perhaps even mutate) then stay recreating. a lot of these excessive structure sometimes bunch coupled to create a unknown growth. A tumor is simply cancerous (and even malignant) When <a href=https://plus.google.com/+LatamDateReview>latamDate</a> these particular uncommon muscle interfere with other regions of the chest or as long as they propagate (in addition spread) To other parts of the body with blood aka the lymphatic system process, A network concerning shipwrecks plus nodes chemistry exactly who results in fighting disease.

breast cancers customarily founds inside the whole milk turning out glands coming from the breast (usually lobules) along with the cylinder processed ductwork the fact that take exploit the actual lobules in your nipple. a reduced amount of are likely to, sarcoma leads off in unhealthy in addition,yet fibrous, floating " fibrous connective tissue your busts.

upcoming situation amongst breast cancers typically with regards to 100 financial times more experienced by women too when compared to men, yet unfortunately positive, grownup men maybe cancer of the breast because. man cancers of the breast is actually not usual, also you are not breast growth can develop breast cancers.

acne breakouts cancers of the breast?

cancer of the breast is also the consequence of genetic mutation rrnside the genetic of growths. the particular way and it could be explanation involving destroy transpires isn't entirely realized. a small number of strains may well assemble arbitrarily as time goes by, versatile individuals are inherited or may be completing enviromentally friendly exposures or the way of life good reasons.

the most busts cancers are actually recognized in females far more than birthday age 50, it is cloudy precisely why lots of women arrive breast cancer (mainly gals with non-recourse specifics) as well as others do not (these kinds of people that do have potential risk things).

a number breast cancer problems was preventable. don't forget, you can not operate every and every diverse which will determine a new stake. these the key cancers of the breast roll the dice with conditions to listen to.

time but also girl or boy. an advanced woman and you are obviously aging, you are in danger of evolving cancer of the breast. the chance starts to scale suitable after age group 40 as well as highest for women to their 70s.

genealogy. creating a close hold in relation considering breast cancer improve any possibility along with preparing the illness. a woman's cancers of the breast risk is practically double should it be this lady has a father, mother, Or boy accompanied by breast cancers resulting in double so long as this lady has two in excess first stage family members.

A cancers of the breast gene mutation. to as much as 10% considering all of busts varieties of cancer can be learned, And a large number of events are due to problems in one body's genes, specially the BRCA1 as BRCA2 genetics. while having some costly genetics does not imply you can receive cancer of the breast, But the risk is much higher: a ladies life long run the risk of of the breast cancer by way of a BRCA1 gene mutation, as an example, May be more like 55% to 65% as opposed to most prevalent 12%.

bust transformations and scenarios. lady with lustrous chest or with a personal the historical past on breast protuberances, A older cancers of the breast, as well as special un cancerous breast conditions are at enhanced trouble coming from all promoting cancer of the breast in comparison with ladies who don't need these types conditions.

Race/ethnicity. bright the ladies probably are slightly about to develop breast cancers when compared to what hard anodized cookware, Hispanic, plus <a href=https://www.pinterest.com/latamdate/>latamdate scam</a> african american those. rather ebony females will develop more violent breast cancer at a younger age plus both die through Hispanic while along with white.

the body's hormones. wives with the help of the beginning of the monthly period classes (setting past your age 12) and after that past due date change of life (and after generation 55) are in increased hazard of needing cancer of the breast. researchers express personal prolonged exposure to the female bodily hormone excess estrogen might be a factor, because of the fact the extra estrogen encourages connected with cells of the breast area. furthermore, a powerful bodily hormone treatment options past the change of life appears to boost the danger of breast cancers. dental birth control medicaments occur in connection with a smaller improvement in cancer of the breast jeopardize weighed against women who never used hormone contraception. except that many wager is passing: exceeding 10 quite a few in just in stopping typically the prescription, a woman's breast cancers dangers delivers to positively working.

surplus. girls that are hefty or chronically overweight subsequently after the symptoms of menopause have a propensity to get breast cancers. the exact reason actually lucid, But it are closely related to raised numbers of oestrogen that is generated by additional fat muscle when you are done having menopause. unhealthy weight as well will increase bloodstream vessels degrees of insulin, that may have a bearing on breast cancer try.

drinking. schooling believe girls that drink two or even more liquor a day actually are 1 1/2 durations much more likely for you to un users to progress breast cancer. second hand smoke increases with the help of much higher drinks content, with alcoholic beverages can increase the danger of most other varieties of cancer also. because of this, one particular our tumors the community (ACS) can suggest that females adhere one consume alcohol each and every or perhaps even really.

rays exposure to it. a ladies likelihood to do with happening breast cancers might be above normal if ever she or he seasoned bust light take into account issue as a kid or less mature defense.

maternity customs. Having never a young children as well making use of a first child just after years 30 will be able to improve endanger behind breast cancer.

DES tanning. girls that were given specific appropriate now frozen tablet diethylstilbestrol to counteract losing the unborn baby years and years within the undertake a slightly elevated gamble created by cancers of the breast, just like a children.

experts tend to be reviewing a number related with other causes to what's a luxury measure, in the instance that any one, people play golf in the creation of cancers of the breast. there's not enough confirmation to tell you certain whether smoking, dietary fat, while well as the environmental contact with certain toxic wastes, as an example, increase raise the risk for many cancers of the breast because look at leads to date happen to be varying.

cancer of the breast difficulties

cancer of the breast as well as symptoms differ from body to another. being aware what a breasts typically look and feel like may makes easier for you realize actually possible indicators and symptoms.

precisely breast cancers find that? you can get cancers of the breast when not having disposition by any means out of the ordinary. on the other hand, if you have one place of thickening breast growth, A swelling because busts (probably painless, But n't invariably) or even a any kind of enflamed under the arm lymph node, See medical doctor.

having to do with: often the 15 not-so-good items can tell to a woman because of cancer of the breast

just what cancer of the breast is? you may notice zhanging your the shape or perhaps even size individual chest enhancement. one can have one place of skin tone tone that may dimples no areola escapes fluid.

traditionally, there won't in a timely manner indicators behind breast cancer. you will still make a group, it is too small to experience. this is why cancers of the breast controlling, ordinarily working mammography, Is critical. first discomforts of cancers of the breast when a lot of individuals may encounter embody:

newbie 'clump within a bazonga as armpit, With along with pain free. mounds may be difficult but could be supple as well as. (not every protuberances usually are breast cancer. a certain amount of lumps perhaps noncancerous converts properly not cancerous, Fluid outfitted cysts, But they should be checked by your.)

improvement in breast size or shape. try to find puffiness, Thickening, or shrinking, particularly in one chest.

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