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Samenvatting cardiologie Problemen van hart en bloedvaten AJ 23-24
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Samenvatting cardiologie Problemen van hart en bloedvaten AJ 23-24 alle hoofdstukken, volledige samenvatting Prof. De Pauw
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Prof. De Pauw AJ 23-24Cardiologie
Inhoudsopgave
1. ANAMNESE EN KLINISCH ONDERZOEK........................................................................................................ 6
1.1. ANAMNESE............................................................................................................................................. 6
1.2. KLINISCH ONDERZOEK............................................................................................................................. 7
1.2.1. ADEMHALING....................................................................................................................................... 7
1.2.2. HARTFREQUENTIE................................................................................................................................ 8
1.2.3. BLOEDDRUKMETING............................................................................................................................. 8
1.2.4. INSPECTIE V. JUGULARIS....................................................................................................................... 9
1.2.5. INSPECTIE HUID EN EXTREMITEITEN..................................................................................................... 9
1.2.6. ARTERIËLE PULSATIES......................................................................................................................... 10
1.2.7. INSPECTIE EN PALPATIE ICTUS CORDIS.................................................................................................11
1.2.8. HARTAUSCULTATIE.............................................................................................................................. 11
2. CARDIALE ONDERZOEKSTECHNIEKEN........................................................................................................ 12
2.1. FUNCTIONELE ONDERZOEKEN............................................................................................................... 12
2.1.1. ELECTROCARDIOGRAM (ECG).............................................................................................................. 12
2.1.2. INSPANNINGSPROEF........................................................................................................................... 12
2.1.3. 24U BP-REGISTRATIE........................................................................................................................... 12
2.1.4. TILT-TESTING....................................................................................................................................... 13
2.1.5. HARTKATHETERISATIE......................................................................................................................... 13
2.1.6. ELEKTROFYSIOLOGISCH ONDERZOEK / ABLATIE...................................................................................13
2.2. BEELDVORMING.................................................................................................................................... 13
2.2.1. RX-THORAX........................................................................................................................................ 13
2.2.2. ECHOCARDIOGRAFIE (TTE) / SLOKDARMECHO (TEE)............................................................................13
2.2.3. VASCULAIRE DUPLEX.......................................................................................................................... 14
2.2.4. NUCLEAIRE BEELDVORMING............................................................................................................... 14
2.2.5. CORONAIRE CT / CT-ANGIOGRAFIE...................................................................................................... 14
2.2.6. CORONAROGRAFIE............................................................................................................................. 14
3. CARDIOVASCULAIRE PREVENTIE............................................................................................................... 15
4. ACUUT CORONAIR SYNDROOM (ACS)....................................................................................................... 18
4.1. ATHEROMATOSE.................................................................................................................................... 18
4.2. KLINISCHE PRESENTATIE ACS.................................................................................................................. 18
4.3. DIAGNOSTIEK ACS................................................................................................................................. 18
4.4. THERAPIE ACS....................................................................................................................................... 20
5. CHRONISCH CORONAIR LIJDEN................................................................................................................. 23
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,Prof. De Pauw AJ 23-24
5.1. ATHEROMATOSE.................................................................................................................................... 23
5.2. KLINISCH ONDERZOEK BIJ ANGOR......................................................................................................... 24
5.3. DIAGNOSTIEK BIJ ANGOR...................................................................................................................... 24
5.4. THERAPIE BIJ CHRONISCH CORONAIR LIJDEN.........................................................................................25
5.4.1. OPTIMALE MEDICAMENTEUZE THERAPIE (OMT).................................................................................25
5.4.2. REVASCULARISATIE............................................................................................................................. 26
6. KLEPLIJDEN – AORTAKLEP EN PULMONAALKLEP.......................................................................................28
6.1. AORTAKLEPSTENOSE............................................................................................................................. 28
6.1.1. OORZAKEN......................................................................................................................................... 28
6.1.2. KLINIEK.............................................................................................................................................. 29
6.1.3. DIAGNOSE.......................................................................................................................................... 29
6.1.4. THERAPIE........................................................................................................................................... 30
6.2. AORTAKLEPREGURGITATIE..................................................................................................................... 30
6.2.1. OORZAKEN......................................................................................................................................... 30
6.2.2. KLINIEK.............................................................................................................................................. 30
6.2.3. DIAGNOSE.......................................................................................................................................... 31
6.2.4. THERAPIE........................................................................................................................................... 32
6.3. PULMONAALKLEPSTENOSE.................................................................................................................... 32
6.3.1. KLINIEK.............................................................................................................................................. 32
6.3.2. DIAGNOSE.......................................................................................................................................... 32
6.3.3. THERAPIE........................................................................................................................................... 33
6.4. PULMONAALKLEPREGURGITATIE........................................................................................................... 33
6.4.1. OORZAKEN......................................................................................................................................... 33
6.4.2. DIAGNOSE.......................................................................................................................................... 33
6.4.3. THERAPIE........................................................................................................................................... 33
7. KLEPLIJDEN – MITRALISKLEP EN TRICUSPIDALISKLEP.................................................................................34
7.1. MITRALISKLEP....................................................................................................................................... 34
7.2. MITRAALKLEPSTENOSE.......................................................................................................................... 34
7.2.1. OORZAKEN......................................................................................................................................... 34
7.2.2. KLINIEK.............................................................................................................................................. 34
7.2.3. DIAGNOSE.......................................................................................................................................... 35
7.2.4. THERAPIE........................................................................................................................................... 35
7.3. MITRAALKLEPREGURGITATIE................................................................................................................. 36
7.3.1. OORZAKEN......................................................................................................................................... 36
7.3.2. KLINIEK.............................................................................................................................................. 37
7.3.3. DIAGNOSE.......................................................................................................................................... 37
7.3.4. THERAPIE........................................................................................................................................... 38
7.4. TRICUSPIDALISKLEPSTENOSE................................................................................................................. 38
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,Prof. De Pauw AJ 23-24
7.5. TRICUSPIDALISKLEPREGURGITATIE......................................................................................................... 39
8. ENDOCARDITIS – PROFYLAXIE.................................................................................................................. 40
8.1. INFECTIEUZE ENDOCARDITIS.................................................................................................................. 40
8.2. PATHOGENESE....................................................................................................................................... 40
8.3. KLINIEK VAN ENDOCARDITIS.................................................................................................................. 41
8.4. DIAGNOSE............................................................................................................................................. 41
8.5. THERAPIE.............................................................................................................................................. 42
8.6. PREVENTIE VAN ENDOCARDITIS............................................................................................................. 43
9. AANGEBOREN HARTAFWIJKINGEN OP VOLWASSEN LEEFTIJD (ACHD)........................................................44
9.1. VENTRIKEL SEPTUM DEFECT (VSD)......................................................................................................... 45
9.2. PULMONALE HYPERTENSIE (PAH) EN EISENMENGER SYNDROOM..........................................................45
9.3. ATRIUM SEPTUM DEFECT (ASD)............................................................................................................. 46
9.4. PATENTE DUCTUS ARTERIOSUS (PDA).................................................................................................... 47
9.5. COARCTATIO AORTAE............................................................................................................................. 47
9.6. TETRALOGIE VAN FALLOT....................................................................................................................... 48
9.7. TRANSPOSITIE VAN DE GROTE VATEN (TGA)........................................................................................... 49
9.8. FONTAN CIRCULATIE.............................................................................................................................. 49
9.9. MARFAN SYNDROOM............................................................................................................................ 50
10. CARDIALE PATHOFYSIOLOGIE.................................................................................................................. 51
10.1. ATHEROMATOSE, PLAQUERUPTUUR EN ISCHEMISCH HARTLIJDEN........................................................51
10.2. CARDIALE FUNCTIE, DISFUNCTIE EN HARTFALEN..................................................................................51
11. CARDIOMYOPATHIE................................................................................................................................ 53
11.1. GEDILATEERDE CARDIOMYOPATHIE (DCM)...........................................................................................53
11.2. HYPERTROFE CARDIOMYOPATHIE (HCM)..............................................................................................55
11.3. RESTRICTIEVE CARDIOMYOPATHIE (RCM)............................................................................................. 57
11.4. ARITMOGENE RECHTER VENTRIKEL DYSPLASIE (ARVD).........................................................................58
11.5. LINKER VENTRIKEL NON COMPACTIE (LVNC)......................................................................................... 59
11.6. NIET GEDILATEERDE LV CARDIOMYOPATHIE (NDLVC)............................................................................59
11.7. VERWORVEN CARDIOMYOPATHIEËN.................................................................................................... 59
12. HARTFALEN............................................................................................................................................ 60
12.1. ACUUT HARTFALEN (AHFS)................................................................................................................... 60
12.1.1. ACUUT LONGOEDEEM...................................................................................................................... 60
12.1.2. ACUUT GEDECOMPENSEERD HARTFALEN..........................................................................................61
12.1.3. CARDIOGENE SHOCK........................................................................................................................ 61
12.1.4. ACUUT COR PULMONALE.................................................................................................................. 61
12.1.5. THERAPIE VAN ACUUT HARTFALEN................................................................................................... 62
12.2. CHRONISCH HARTFALEN (CHF)............................................................................................................. 63
12.2.1. KLINIEK............................................................................................................................................. 63
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, Prof. De Pauw AJ 23-24
12.2.2. DIAGNOSE CHF................................................................................................................................. 64
12.2.3. THERAPIE CHRONISCH HARTFALEN................................................................................................... 65
13. BRADYARITMIE EN GELEIDINGSSTOORNISSEN.........................................................................................68
13.1. SINUSALE ARITMIE.............................................................................................................................. 68
13.2. SINUSBRADYCARDIE............................................................................................................................ 68
13.3. SICK SINUS SYNDROME........................................................................................................................ 69
13.4. ATRIOVENTRICULAIR BLOK.................................................................................................................. 69
13.5. BUNDELTAKBLOK................................................................................................................................. 71
13.6. BEHANDELING GELEIDINGSSTOORNISSEN............................................................................................ 72
14. TACHYARITMIE....................................................................................................................................... 73
14.1. SUPRAVENTRICULAIRE TACHYCARDIE................................................................................................... 74
14.1.1. SINUSTACHYCARDIE.......................................................................................................................... 74
14.1.2. ATRIOVENTRICULAIRE JUNCTIE TACHYCARDIE...................................................................................74
14.1.2.1. ATRIOVENTRICULAIRE NODALE RE-ENTRY TACHYCARDIE (AVNRT)...................................................74
14.1.2.2. ATRIOVENTRICULAIRE RE-ENTRY TACHYCARDIE (AVRT)...................................................................75
14.1.3. ATRIALE TACHYCARDIE...................................................................................................................... 76
14.1.3.1. ATRIALE TACHYCARDIE................................................................................................................... 76
14.1.3.2. MULTIFOCALE ATRIALE TACHYCARDIE (MAT)..................................................................................77
14.1.3.3. ATRIALE FLUTTER........................................................................................................................... 77
14.1.3.4. ATRIALE FIBRILLATIE....................................................................................................................... 77
14.2. VENTRICULAIRE TACHYARITMIE........................................................................................................... 81
14.2.1. VENTRIKELTACHYCARDIE EN VF BIJ STRUCTUREEL HARTLIJDEN..........................................................81
14.2.2. LONG QT-SYNDROOM – TORSADES DE POINT....................................................................................82
14.2.3. BRUGADA SYNDROOM..................................................................................................................... 83
14.2.4. CATECHOLAMINERGE POLYMORFE VT (CPVT)....................................................................................83
14.2.5. VENTRIKELTACHYCARDIE IN HET NORMALE HART..............................................................................84
14.2.6. NIET ONDERHOUDEN KAMERTACHYCARDIE (NSVT)...........................................................................84
15. SYNCOPE................................................................................................................................................ 86
15.1. OORZAKEN VAN SYNCOPE................................................................................................................... 86
15.2. BIJKOMENDE INVESTIGATIES................................................................................................................ 87
15.3. BEHANDELING SYNCOPE...................................................................................................................... 87
15.4. SPORTSCREENING................................................................................................................................ 88
16. ARTERIËLE HYPERTENSIE........................................................................................................................ 89
16.1. HYPERTENSIE: ALGEMEEN.................................................................................................................... 89
16.2. OORZAKEN VAN HYPERTENSIE............................................................................................................. 89
16.3. DIAGNOSE VAN HYPERTENSIE.............................................................................................................. 90
16.4. BLOEDDRUKMETING............................................................................................................................ 90
16.5. RISICOSTRATIFICATIE........................................................................................................................... 90
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