Clinical manifestations chronic heart not sufficiency can to arise on normal background or almost normal systolic LV function by according to Echocardiography . A common cause of chronic heart failure is LV diastolic dysfunction .
Diastolic dysfunction is detected at a whole range of cardio – vascular diseases . She is more sensitive at comparing with systolic cal function to natural aging processes . Violations of diastolic function can be iso Rowan , combined with systolic dysfunction or precede a clear violation of systole . Violations of diastole is dominated by about at thirdspatients with chronic heart failure . Required evaluate as systolic , so and diastolic function of the left ventricle , so as the causes of their violations and , that more importantly , their correction methods are different . Simplified times division on systolic and diastolic dysfunction is often unjustified . Systole and diastole – Inter – liyayuschie phase of the cardiac cycle . With minor systolic dysfunction some segments with on ruined local contractility can keep shrinking at diastole , resulting in to decrease in time for ventricular fillingand diastolic dysfunction . On the contrary , a stubborn LV , unable to adequately fill at diastole , provides low stroke volume at systole and leads to systolic dysfunction . High peak BUT It corresponds to the fourth auskultativ Nome tone of the heart , then as high peak E – the third auscultatory tone
Possible errors in identifying dysfunction of the right ventricle.
Echocardiographic assessment of the pancreas is difficult at svya communication with significant trabecular , complex geometry cal form and interaction with other chambers of the heart . More than that , the prostate is located directly behind the breastbone , which hinders its visualization . Evaluation The pancreas is especially difficult with increased airiness of the lung tissue ( emphysema ), pneumosclerosis and torus kotomii at history . For unfortunately , namely with of these states estimation function of the pancreas is the largest zna chenie . RV function depends not only from myocardial contractility , but and on the conditions of load , contractility of the left ventricle , excursions IVS and pressure atpericardium . With analysis of pancreas function should be considered everything these factors . Even an experienced researcher is able to conduct a full study of the pancreas less than in 50% of patients .
The clinical significance of right ventricular dysfunction
Identification of dysfunction of the pancreas is a principled nym with a number of congenital and acquired diseases of the heart for the choice of tactics of treatment , planning the timing of surgical intervention , determine the prognosis .
With congenital defects , such as defect MZhP , defect MPP or tetralogy of Fallot , evaluation function of the pancreas to and after surgery treatment allows define prognosis of the disease .
In a similar manner as possible surgical vmesha ments with defects of the heart , such as mitral ste ERA , stenosis of the mouth of the pulmonary artery or tricuspid regurgitation ( TR ) depends on the availability or lack of dysfunction of the pancreas . Patient long-term prognosis with chronic diseases of the lung ( chronic obstructive disease of the lungs , interstitial for bolevaniya light ) depends on the function of the pancreas . Dilatation of the pancreas , pulmonary hypertension and pulmonary heart are predictors of negative prognosis .
With myocardial infarction pancreas dysfunction observed at following situations :
. lower myocardial infarction with involvement of the pancreas ;
. anterior myocardial infarction with acute defect MZhP .
Tactics treatment pancreatic infarction is different from leche of LV infarction . Dysfunction of the pancreas due postin farktnogo defect IVS is an important cause of death ( see . Chapter ” Coronary disease of the heart ” ). Diastolic kollabirovanie pancreas is an important echocardiographic sign of tamponade of the heart ( see . Chapter ” Diseases of the pericardium ” ).