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Samenvatting Cardiorespiratoire Pathologie - Ischemisch Hartlijden
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onderdeel van het vak cardiorespiratoire kine samenvatting van het hoofdstuk : Ischemisch hartlijden
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3. Ischemisch hartlijden ................................................................................................................................................... 3Definitie : Myocardale Ischemie ................................................................................................................................... 3
A. Progressie van atherosclerose .......................................................................................................................... 3
Stabiele” versus “onstabiele” letsels ............................................................................................................................ 3
A. Indeling ischemisch hartlijden .......................................................................................................................... 4
Angina pectoris of “Angor” ................................................................................................................................... 4
Etiology chest pain in general practice ................................................................................................................. 4
1. Coronary Flow Reserve ............................................................................................................................. 4
Ischemische cascade ............................................................................................................................................. 4
B. Diagnose angor pectoris: kliniek+ECG .............................................................................................................. 5
Aanvullende Testen............................................................................................................................................... 5
1. stress echografie ....................................................................................................................................... 5
2. Echocardiografie ....................................................................................................................................... 5
3. Stress scintigrafie ...................................................................................................................................... 6
4. Multi-detector coronaire CT-scan ............................................................................................................. 6
5. Coronaire CT-scan ..................................................................................................................................... 6
Hartkatheterisatie ................................................................................................................................................. 7
Anti-anginosa ........................................................................................................................................................ 7
C. Behandeling stabiele angor pectoris................................................................................................................. 7
D. Coronaire Revascularisatie: indicaties .............................................................................................................. 7
REVASCULARISATIE ............................................................................................................................................... 8
PTCA (percutane transluminale coronaire angioplastie) .................................................................................. 8
Coronaire stent ................................................................................................................................................. 8
Drug eluting stent (DES) .................................................................................................................................... 8
E. Coronaire bypasschirurgie CABG ...................................................................................................................... 9
F. Hartoperatie ...................................................................................................................................................... 9
Hart-long machine ................................................................................................................................................ 9
Herstel na hartoperatie......................................................................................................................................... 9
Acuut coronair syndroom (acuut/instabiel ischemisch hartlijden)............................................................................. 9
A. Pathophysiologie ACS ....................................................................................................................................... 9
B. Acuut Hartinfarct .............................................................................................................................................. 9
C. TRIADE VAN ACS .............................................................................................................................................. 9
Anamnese ........................................................................................................................................................... 10
Electrocardiogram (ECG) ..................................................................................................................................... 10
D. Locatie acuut hartinfarct ................................................................................................................................. 10
Anterior infarct.................................................................................................................................................... 10
1. ECG: acuut anterior infarct ..................................................................................................................... 11
E. Hartenzymen : Troponine ............................................................................................................................... 11
F. Acuut hartinfarct: prognosis ........................................................................................................................... 11
, AMI- case fatality ............................................................................................................................................... 12
Ventrikel fibrillatie .............................................................................................................................................. 12
Mortality and total ischemic time delay ............................................................................................................. 12
Chest pain and the patient.......................................................................................................................................... 12
A. Early recognition of Alarming symptoms !!! .................................................................................................. 12
B. Hartfalen post infarct ...................................................................................................................................... 12
C. Progressie myocardnecrose ............................................................................................................................ 13
Reperfusie therapie .................................................................................................................................................... 13
A. Primary PCI vs thrombolytic therapy? ............................................................................................................ 13
B. Ontstollende medicatie................................................................................................................................... 13
C. Behandeling Acuut Hartinfarct ....................................................................................................................... 13
D. STEMI networks .............................................................................................................................................. 14
Mechanische complicaties acuut MI................................................................................................................... 14
E. Aanpak hartinfarct .......................................................................................................................................... 14
F. Revalidatieprogramma bij hartpatienten ....................................................................................................... 14
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