Insuficiencia-Cardiaca Congestiva

 

ZGL^JQVLC@C G@FLDG@B CJB V@GS@ N@FZBS@C CJ FLJGFL@V J.U CJ JGNJQHJQÈ@  

@VLKG@SZQ@?  

Jgnjrhjrè` jg fulc`cds frètlfds

CDFJGSJ?   Cr`. Buz N`bb` Ouàrjz Cr`. H`rk`rlt` Mu`ð`p Kuzh`g

SJH@?  

Lgsunlfljgfl` f`rcl`f` fdgkjstlv`

JVSZCL@GSJV? 

K`rfè` Hdrjgd \dmdh`r` Jcltm



O`r` Qdabjs Bjsblj Arlkmltm

 

FLFBD?

^LLL

 

GZJ^D. FMLHADSJ - 1515 L.

LGSQDCZFFLDG B` lgsunlfljgfl` f`rcè`f` fdgkjstlv` (LFF) js ug sègcrdhj fbèglfd fröglfd y prdkrjslvd fu fuy y` prjv prjv`b `bjg jgfl fl``

j lg lgfl flc cjg jgfl fl``

v`g jg `u `uhj hjg gtd js jsp pjfl` jfl`bh bhjg jgtj tj jg bd bdss

p`è `èsj sjss

lgcustrl`blz`cds, cj jxtr`drclg`rl` kr`vjc`c y prdgöstlfd sdharèd, quj fdgstltuyj jb pugtd nlg`b cj hufm`s jgnjrhjc`cjs. Jg b` `ftu`blc`c b` LFF fröglf`, ` b` quj sj m`fj rjnjrjgfl` jxfbuslv`hjgtj jg jst` rjvlslög, fdgstltuyj ug prdabjh` cj s`buc pÿablf` cj prlhjr` h`kgltuc quj df`sldg` fdgslcjr`abjs rjpjrfusldgjs jfdgöhlf`s, sdfl`bjs y, sdarj tdcd, muh`g`s, c`c` b` jbjv`c` hdrt`blc`c y b` kr`vj blhlt`flög cj b` f`blc`c cj vlc` quj drlklg` jg jb lgclvlcud quj b` prjsjgt`.

Bds lgfrjhjgtds jg b` prjv`bjgfl` j lgflcjgfl` cj b` LFF jstàg rjb`fldg`cds fdg jb  prdkrjslvd jgvjojflhljgtd cj b` pdab`flög y jb `uhjgtd cj b`s jgnjrhjc`cjs prdpl`s cjb `gfl`gd, `gfl`g d, jgtrj b`s quj cjst`f`g cjst`f`g b` mlpjrtjgslög mlpjrtjgslög `rtjrl`b (MS@) y b` f`rcld f`rcldp`tè` p`tè` lsquìhlf` (FL). S`halìg lgnbuyj jb mjfmd cj quj m`y` hjodr`cd jb tr`t`hljgtd prjfdz cj dtr`s f`rcldp`tè`s quj `gtjs prdcufè`g ug` hdrt`blc`c ` fdrtd pb`zd? f`rcldp`tè`s fdgkìglt`s, lgn`rtd `kucd cj hldf`rcld, jtf., y quj `mdr` sj h`glnljst`g fdhd LFF ` hjcld y b`rkd  pb`zd. @ pjs`r cj jbbd, b` supjrvlvjgfl` cj b` LFF jstà hjodr`gcd prdkrjslv`hjgtj, bd quj jsjgfl`bhjgtj sj cjaj ` b`s slkuljgtjs r`zdgjs.

B` lgsunl lgsunlflj fljgfl gfl`` f`rcl`f` f`rcl`f` (LF) (LF) js b` lgf`p` lgf`p`flc flc`c `c cjb fdr`zö fdr`zög g p`r` p`r` h`gtjg h`gtjgjr jr ug k`std k`std f`rcl`fd d vdbuhjg-hlgutd `cjfu`cd ` b`s gjfjslc`cjs hjt`aöblf`s cjb drk`glshd, pdr  n`bbd cj bds vjgtrèfubds cjrjfmd d lzquljrcd, lz quljrcd, c`gcd buk`r ` ug` sjrlj cj h`glnjst`fldgjs jg b` tdt`blc`c cjb drk`glshd.

 

Cjalcd ` jstj nr`f`sd, jg jb fdr`zög sj prdcufj ug` clshlguflög cjb nbuod s`gkuègjd ` bds tjolcds cj b` pjrlnjrl` df`sldg`gcd ` su vjz ug` jst`gqujlc`c, y` sj` ` glvjb slstìhlfd (LF cjrjfm`) d pubhdg`r (LF lzquljrc`). Fu`gcd sj `sdfl`g b`s cds sj cjgdhlg` LF kbda`b d fdgkjstlv`.

@cjhàs t`halìg sj bj cjnlgj fdhd jb sègcrdhj fbèglfd prdcuflcd pdr ug` `btjr`flög cjb fdr`zög j lcjgtlnlf`cd pdr ug p`trög f`r`ftjrèstlfd cj rjspujst`s mjhdclgàhlf`s, rjg`b, gjrvlds`

y

mdrhdg`b.

-

B`s h`glnjst`fldgjs fbèglf`s quj fdgbbjv` b` LF cjpjgcjràg cj b` r`plcjz fdg b` quj sj lgst lgst`u `urj rj jb fu`c fu`crd rd fbèg fbèglf lfd d y cj sl m`g m`g fd fdhj hjgz gz`c `cd d ` nu nugf gfld ldg` g`rr bd bdss hjf` hjf`gl glsh shds ds fdhpjgs`cdrjs.

B` LF sj c` hàs jg v`rdgjs pdr b` lgflcjgfl` cj prdabjh`s f`rcl`fds jg jbbds. S`halìg ` h`ydr jc`c h`ydr js jb rljskd cj p`cjfjr LF (f`c` cljz `ðds sj cdab`g b`s pdslalblc`cjs cj p`cjfjrb`).

 

LL. LL.0.

LGVZNLFLJGFL@ F@QCL@F@

Cjnlglflög?

B` lgsunlfljgfl` f`rcl`f` (LF) js b` lgf`p`flc`c cjb fdr`zög p`r` h`gtjgjr ug k`std f`rcl`fd `cjfu`cd p`r` `a`stjfjr b`s gjfjslc`cjs hjt`aöblf`s cj bds tjolcds. Js fu`gcd jb fdr`zög js lgf`p`z cj rj`blz`r ug` fdgtr`fflög quj pjrhlt` b` jxpubslög cj b` f`gtlc`c cj s`gkrj gjfjs`rl` p`r` bdkr`r ug` prjslög cj pjrnuslög sunlfljgtj quj  pjrhlt` ` su vjz b` dxlkjg`flög tlsub`r. Jstj cìnlflt cj fdgtr`fflög vjgtrlfub`r pujcj sjr cjalcd ` c`ðd hldfàrclfd lgtrègsjfd d ` ug` sdarjf`rk` mjhdclgàhlf` jxfjslv`. Cjalcd ` jstj nr`f`sd, jg jb fdr`zög sj prdcufj ug` clshlguflög cjb nbuod s`gkuègjd ` bds tjolcds cj b` pjrlnjrl` df`sldg`gcd ` su vjz ug` jst`gqujlc`c, y` sj` ` glvjb slstìhlfd (LF cjrjfm`) d pubhdg`r (LF lzquljrc`). Fu`gcd sj `sdfl`g b`s cds sj cjgdhlg` LF kbda`b d fdgkjstlv`.  fdgkjstlv`.  Jb tìrhlgd ‒lgsunlfljgfl` f`rcl`f` fdgkjstlv`‘ sj us` fdg h`ydr nrjfujgfl` `b rjnjrlrsj ` b` lgsunlfljgfl` t`gtd lzquljrc` fdhd cjrjfm`. B` lgsunlfljgfl` f`rcl`f` fdgkjstlv` (LFF) js ug sègcrdhj jg jb fu`b jb fdr`zög gd  pujcj adhaj`r ug `pdrtj `cjfu`cd cj s`gkrj jg rjb`flög fdg jb `pdrtj vjgdsd sunlfljgtj p`r` fuarlr b`s gjfjslc`cjs hjt`aöblf`s cj bds tjolcds. B` lgsunlfljgfl` lgsunlfljgfl` f`rcl`f` f`rcl`f` fdgkjstlv` fdgkjstlv` `uhjgt` `uhjgt` cj ndrh` slkglnlf`tlv slkglnlf`tlv`` fdg b` jc`c y  pujcj bbjk`r ` sjr jgtrj = y 05 vjfjs supjrldr jg b` cìf`c` cj bds ;5 `ðds jg fdhp`r`flög fdhp` r`flög fdg b` cj bds :5 `ðds. Gd sujbj `p`rjfjr fdhd ÿglf` prjsjgt`flög, prjsjgt`flög, slgd `sdfl`c`` ` dtr`s jgnjrhjc`cjs `sdfl`c jgnjrhjc`cjs f`rcl`f`s f`rcl`f`s fdhd b` mlpjrtjgslö mlpjrtjgslög g `rtjrl`b, `rtjrl`b, v`bvubdp`t v`bvubdp`tè`s, è`s, jtf.

LL.1.

Jtldböklf`

 

Jb rjsubt`cd fdhÿg cj hufm`s jgnjrhjc`cjs js b` `btjr`flög cj b` nugflög vjgtrlfub`r  y, pdr t`gtd, sdg hufmds bds prdfjsds quj pujcjg f`us`r jb sègcrdhj fbèglfd cj lgsunlfljgfl` f`rcl`f` fdgkjstlv` (LFF)? •

Clsh Clshlg lguf uflö lög g cj b` fdgt fdgtr` r`ft ftlb lblc lc`c `c hldf hldfàr àrcl clf` f`,, qu qujj lhpd lhpdgj gj `b fd fdr` r`zö zög g ug vdbuhjg supjrldr `b gdrh`b y `uhjgt` jb tr`a`od? -

Jgnj njrh rhjc jc`c `c fdrd fdrdg g`r `rl` l`..

-

Hldf`rcltls.

-

Hldf`rcldp`tè`s.

-

L` L`tr trdk dkjg jgl` l`ss (n (nàrh àrh`fd `fdss aj ajt` t`ab abdq dquj uj`g `gtj tjs, s, `g `gt` t`kd kdgl glst` st`ss cj cjbb f`bfl f`bfld d -F`-F`-,, jtf.).

•

Jst`cd Jst`cdss f`rjg f`rjgfl`b fl`bjs js (ajrla (ajrlajrl jrl,, c cjsg jsgutr utrlfl lflög, ög, jtf.). jtf.).

@uhj @uhjgt gtd d cjb cjb tr`a tr`a`o `od d hldf hldfàr àrcl clfd fd?? -

Ml Mlpj pjrt rtjg jgsl slög ög `r `rtj tjrl rl`b `b (MS@ (MS@). ).

-

Ml Mlpj pjrt rtjg jgslö slög g pub pubhd hdg` g`rr (fdr (fdr pu pubh bhdg dg`b `bj). j).

-

Jgnj Jgnjrh rhjc jc`c `c v`bv v`bvub ub`r `r f`r f`rcl cl`f `f`. `.

-

Cjsvèd Cjsvèd lgtr`f` lgtr`f`rcl rcl`fd `fd (fdhug (fdhuglf` lf`flö flög g @@, @@, @^, jtf.). jtf.).

-

Jst`cd Jst`cd cj cj h`ydr h`ydr k`std k`std (`gjhl (`gjhl`, `, mlpjrt mlpjrtlrd lrdlcl lclshd shd,, nèstub` nèstub` `rtjrld `rtjrldvjg vjgds` ds`,, jtf.).

•

@btjr` @btjr`flö flög g cjb vdbuh vdbuhjg jg jxpubs jxpubs`cd `cd quj quj lgtjrn lgtjrnljrj ljrj jg b` f`p`f f`p`flc` lc`c c cjb fdr`zö fdr`zög g  p`r` adhaj`r s`gkrj fdg jnjftlvlc`c y prdcufjg ug` ug` f`èc` cjb k`std f`rcl`fd?

LL.6.

-

S`p `pd dg`h g`hljgt ljgtd d ff`r `rcl cl`f `fd d.

-

Uj Ujrl rlf` f`rc rclt ltls ls fdgs fdgstr trlf lftl tlv` v`..

-

@rrlth @rrlthl`s l`s pjrsl pjrslstjg stjgtjs tjs (t`q (t`qulf ulf`rcl `rcl`s `s d ar`c ar`clf` lf`rcl rcl`s `s jxtrj jxtrjh`s h`s). ).

Fb`slnlf`flög

 

Fb`slnlf`flög

cj

b`

Gjw

\dri

Mj`rt

@ssdfl`tldg

(G\M@)

(03)?

 Fb`sj L? p`fljgtj fdg jgnjrhjc`c cjb fdr`zög quj gd blhlt`g sus `ftlvlc`cjs nèslf`s. B`

`ftlvlc`c

nèslf`

m`altu`b

gd

prdcufj

clsgj`

d

n`tlk`

jxfjslv`.

Fb`sj Fb` sj LL?  p`fljg p`fljgtj tj fdg jgnjrh jgnjrhjc` jc`c c f`rcl`f` f`rcl`f` quj prdcuf prdcufjj bjvj bjvj blhlt`f blhlt`flög lög cj sus `ftlvlc`cjs nèslf`s. Gd sj prdcufjg `btjr`fldgjs jg rjpdsd y b` `ftlvlc`c nèslf` gdrh`b  prdcufj

clsgj`

d

n`tlk`.

Fb`sj LLL?  p`fljgtj fdg jgnjrhjc`c f`rcl`f`  fdg kr`g blhlt`flög cj sus `ftlvlc`cjs nèslf`s. Gd sj prdcufjg `btjr`fldgjs jg rjpdsd y tljgj ug` `ftlvlc`c nèslf` lgnjrldr ` b` gdrh`b

y

prdcufj

n`tlk`.

Fb`sj L^? p`fljgtj fdg jgnjrhjc`cjs f`rcl`f`s fdg lgf`p`flc`c p`r` m`fjr fu`bquljr  `ftlvlc `ftl vlc`c `c nèslf` nèslf` slg hdbjstl hdbjstl`s. `s. Vlgtdh Vlgtdh`td `tdbdk bdkè` è` lgfbus lgfbusd d jg rjpdsd rjpdsd.. B`s `btjr`f `btjr`fldg ldgjs js `uhjgt`g fdg lgtjgtds cj rj`blz`r fu`bquljr `ftlvlc`c nèslf`.

LL.3.

Nlsldp`tdbdkè`

 B` LF `kuc` sj jgtljgcj fdhd ug` jhjrkjgfl` jhjrkjgfl` hìclf` f`sl sljhprj blk`c` `b jcjh` `kucd cj pubhög. Jg b` LF fröglf` b` sltu`flög fbèglf` y mjhdclgàhlf` cjb p`fljgtj pjrh`gjfj jst`abj ` bd b`rkd cjb tljhpd fdg rjf`èc`s y rjhlsldgjs. B`s f`r`ftjrèstlf`s fbèglf`s cj b` LF fröglf` y `kuc` sdg slhlb`rjs p`r` b`s clvjrs`s v`rljc`cjs jtldböklf`s. Lgcj Lgcjpj pjgc gclj ljgt gtjh jhjg jgtj tj cj b` f` f`us us`, `, b` clsnu clsnugf gflö lög g pr prlg lgfl flp` p`bb jg b` LF fr frög öglf lf`` js b` lgf`p`flc`c cjb fdr`zög p`r` nugfldg`r fdhd adha`. @p`rjfjg f`halds jg bds hjf`glshds nlsldp`tdböklfds aàslfds cj?



Urjf`rk`.



Udstf`rk`.

 



K`std f`rcl`fd (KF).

Jb fdr`zög jg b` LFF fröglf` clspdgj cj ug` sjrlj cj hjf`glshds fdhpjgs`tdrlds fdhd sdg? •

F`rcl`fds lgtrègsjfds?

-

Hjf`g Hj f`glsh lshd d cj Nr Nr`g `gii-Vt Vt`r `rbl blgk gk?? hjf` hjf`gl glsh shd d cj `c `c`p `pt` t`fl flög ög cj b` b`ss nlar`s nlar`s hldfàrclf`s `b jst`cd cj LFF fröglf`. B` clstjgslög cj b`s nlar`s husfub`rjs  pjrhltj ug` fdgtr`fflög f`rcl`f` hàs jgìrklf` y `uhjgt` jb vdbuhjg slstöblfd.

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Mlpjrtrdnl` vjgtrlfub`r? sj prdcufj jg rjspujst` ` ug `uhjgtd cj prjslög cj b` f`rk` cj tr`a`od hjcl`gtj jb lgfrjhjgtd cjb krdsdr cj b`s p`rjcjs cj bds vjgtrèfubds.

B` h`s` husfub`r `uhjgt` cj ug` h`gjr` fdgfìgtrlf` fdg pdfds d glgkÿg f`hald jg jb t`h`ðd cj b` f`vlc`c. •

Gjurdjgcdfrlgds? - @ftlv` @ftlv`flö flög g cjb slstjh slstjh`` gjrvld gjrvldsd sd slhpàt slhpàtlfd lfd?? rjprjsj rjprjsjgt` gt` b` rjspujs rjspujst` t` hàs tjhpr`g` ` b` rjcufflög cjb KF y drlklg` ug `uhjgtd cj b` nrjfujgfl` f`rcl`f` (NF) y cj b` fdgtr`ftlblc`c. - Fdhpjgs`flög rjg`b? js dtrd hjf`glshd `ftlv`cd pdr b` f`èc` cjb KF. B` `ftlvlc`c slhpàtlf`?



Qjstrlgkj jb nbuod s`gkuègjd rjg`b bd quj ` su vjz rjcufj b` vjbdflc`c cj nlbtr`flög kbdhjrub`r (rjtjgflög cj bèqulcd).

 

Clsp`r Cls p`r`` jb hjf`gl hjf`glshd shd rjglg` rjglg`-`g -`gkld kldtjg tjgslg slg`` quj fdgcuf fdgcufjj ` ug `uhjgt `uhjgtd d cj b`



 prdcufflög cj `bcdstjrdg` y b` rj`asdrflög tuaub`r cj sdcld cj hdcd quj sj jxp`gcj jb vdbuhjg pb`shàtlfd y `uhjgt` jb KF. Jg b` S`ab` 0 sj pujcj dasjrv`r jb kr`cd cj kr`vjc`c cj b` LF jg glðds cj : `ðds cj jc`c.

LL.:. Vdg

F@ZV@V cjalc`s

`

`bkug`

`btjr`flög

jg

bds

hjf`glshds

rjkub`cdrjs

cj

b`

nugflög f`rcl`f` (prjf`rk`, pdstf`rk`, nrjfujgfl` f`rcl`f` -NF- y fdgtr`falblc`c). Jgtrj b`s f`us`s hàs nrjfujgtjs cjst`f`g?



F`rcldp`tè` lsquìhlf`.



Hldf`rcldp`tè`s.



Mlpjrtjgslög `rtjrl`b.



^`bvubdp`tè`s.



@rrlthl`s.



Vdarjf`rk` cj vdbuhjg.



F`rcldp`tè`s fdgkìglt`s

 

LL.>.

VLKGDV

\

VLGSDH@V

Bdss slkg Bd slkgds ds nèslf nèslfds ds cj b` lg lgsu sunl nlflj fljgf gfl` l` f`rcl f`rcl`f` `f` fd fdgk gkjst jstlv lv`` `n `njft jft`g `g `b slstjh slstjh`` f`rcldv`sfub`r y ` bds pubhdgjs y bds sègtdh`s prlgflp`bjs sdg b` clsgj` y bds jcjh`s, lgfbusd fu`gcd jb p`fljgtj jstà jgf`h`cd.

-

unlfljgfl` F`rcl`f` lzquljrc`?



N`tlk` y cjalblc`c.

Lgs

 

-



@gsljc`c.



Sds.



Jsputds mjhdptdlfds.



Clsgj`, drtdpgj` y clsgj` p`rdxèstlf` gdfturg`.



U`blcjz.



Vucdr`flög (cl`ndrjsls).



Jstjrtdrjs.



S`qulf`rcl` d ar`cl`rrlthl`s.



Mlpjrtjgslög `rtjrl`b (MS@).



Sjrfjr rulcd f`rcl`fd.

Lgsunlfljgfl` F`rcl`f` cjrjfm`?



@uhjgtd cj b` U^F.



Lgkurklt`flög yukub`r.



Mjp`tdhjk`bl`.



Jspbjgdhjk`bl`.



N`tlk`, h`rjds.



Jcjh` pjrlnìrlfd.

LL.;.

CL@KGÖVSLFDV

 Bds prdfjclhljgtds bbjv`cds ` f`ad p`r` cjtjrhlg`r jb cl`kgöstlfd sdg bds hlshds jg tdc`s b`s jc`cjs? •

Q`c Q`cldk ldkr` r`nè nè`` cj tö tör` r`x? x? jg b` quj sj jg jgfd fdg gtr`r tr`ràg àg f` f`rc rcld ldhj hjk k`b `bl` l` y jc jcjh jh``  pubhdg`r.

 

•

Jbjft Jbjftrd rdf`r f`rcl cldk dkr` r`h` h` (JFK)? (JFK)? jg jb quj sj pr prjt jtjg jgcj cj cjtjr cjtjrhl hlg` g`rr b` prjsjg prjsjgfl fl`` cj mlpjrtrdnl` vjgtrlfub`r, `rrlthl`s j lgn`rtd.

•

Jfdf Jfdf`r `rcl cldk dkr` r`nè nè`? `? jg b` quj quj sj pujc pujcjj jg jgfd fdgt gtr` r`rr jg jgkr krds ds`h `hlj ljgt gtd d cj b` p` p`rj rjc c vjgtrlfub`r y `uhjgtd cj b` prjslög `örtlf`.

•

Uru Uruja`s ja`s cj b`a b`adr dr`t `tdr drld ld fd fdh hd b` k`s `sd dhjtr hjtrè` è` p`r `r`` v`b `bd dr` r`rr jb js jst` t`c cd cj dxlkjg`flög cjb p`fljgtj y pruja`s aldquèhlf`s quj cjtjrhlgjg jb jst`cd cj bèqulcds y jbjftrdbltds, `sè fdhd jb jst`cd cj b` nugflög rjg`b.

LL.=.

UQDGDVSLFD

B` lgsunl lgsunlflj fljgfl gfl`` f`rcl`f` f`rcl`f` fdgkjs fdgkjstlv tlv`` jg bds `gfl`g `gfl`gds ds cj jc`cjs jc`cjs hàs `v`gz` `v`gz`c`s c`s rjprjsjgt` b` ÿbtlh` n`sj cj b` jgnjrhjc`c f`rcl`f`. B` f`p`flc`c cj b`s pjrsdg`s h`ydrjs p`r` `fjpt`r b`s blhlt`fldgjs lhpujst`s pdr b` jgnjrhjc`c v` ` v`rl`r jg nugflög cj b`s jxpjft`tlv`s y bds màaltds cj vlc` h`gtjglcds jg bds `ðds `gtjrldrjs. B` jgnjrhjc`c sj `kr`v` fu`gcd sj cjs`rrdbb`g dtr`s jgnjrhjc`cjs drkàglf`s fdhd rjsubt`cd cj b` clshlguflög cj b` pjrnuslög, fdhd pujcjg sjr b`s lgnjffldgjs y b` lgsunlfljgfl` rjg`b d mjpàtlf`.

LL.