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breathlessness (dyspnea)

Descripción

FOCP- cardio Mapa Mental sobre breathlessness (dyspnea), creado por greenfylde el 19/11/2013.
greenfylde
Mapa Mental por greenfylde, actualizado hace más de 1 año
greenfylde
Creado por greenfylde hace casi 13 años
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Resumen del Recurso

breathlessness (dyspnea)
  1. Anxiety
    1. Asthma
      1. COPD
        1. Lung cancer (py or 2ndry)
          1. Pneumonia
            1. PE
              1. Stridor
                1. Upper airway obstruction (foreign body, anaphylaxis, epiglotttis, extrinsic compression)
                2. Cardiac Failure
                  1. epidem: incidence up w/age, 50% dead 5y
                    1. causes: CAD (also IHD, cardiomyopathy, hypertens)
                      1. types
                        1. R sided
                          1. Cor pulmonale (R sided heart fail due to resp cause eg COPD)
                            1. peripheral edema
                            2. Lsided
                              1. pulmonary edema
                              2. Both = Congestive (CCF)
                                1. Chronic more common, Acute bad prog
                                2. pathphys: compensate -> overwhelmed, activate renin/angiotens/aldost -> periph vasoconstric + sodium retain
                                  1. venous press up -> edema, outflow resist up so CO down, bad for contractility, chronic symp nervous system activation (down reg B receptors)
                                    1. myocard remodelling, abnormal Ca ++ homeostasis, natriuritic peptides released b/c stress, ADH up
                                  2. symps
                                    1. exertional dyspnea (or if bad, resting), orthopnea, PND, fatigue
                                    2. signs
                                      1. cardiomegaly, S3 and S4, tachy, hypotens, bi-basal crackles, pleural effusion, ankle edema, ascites, tender hepatomegaly; with liver symps, can get jaundice later on
                                      2. investigs:
                                        1. bloods
                                          1. FBC, LFT, U+E, tropoins (if acute), BNP, TFT
                                          2. CXR
                                            1. cardiomegaly, pulm congestion, fluid in fissures, Kerley B lines, pulm edema
                                            2. ECG
                                              1. ichemia, hypertension, or arrhythmai
                                              2. Echo
                                                1. chamber dimension, systolic + diastolic funct, regional wall motion abnorms, valvular heart disease, cardiomyopathies
                                                2. Others: Nuclear cardiology, Cardiac MRI, Cardiac catheter, cardiac biopsy, cardiopulm exercise test, 24hr ECG)
                                                3. Treatment
                                                  1. Lifestyle
                                                    1. Monitor
                                                      1. Drugs
                                                        1. diruetics (loop + thiazaide) for symps not surviv
                                                          1. ACE INHIBITORS
                                                            1. improve prog!!!!
                                                            2. B blockers
                                                              1. Aldost antags
                                                                1. spirinolactone + eplerenone: improve survival!
                                                                2. cardiac glycosides eg digox (for symp relief)
                                                                3. Nonpharm
                                                                  1. Revasculariz
                                                                    1. pacemaker
                                                                      1. Heart transplant
                                                                  2. Other: Infect (bronchitis, bronciectasis exac, anaphylaxis, pleural effusion, pneumothorax, fibrosis, tb obesity, chest wall injury, metabolic acidosis)
                                                                    1. valvular disease
                                                                      1. see valvular disease chart
                                                                      2. Arrythmia
                                                                        1. see notes
                                                                        2. Cardiac tamponade
                                                                          1. Acute coronary syndrome (incl MI, angina)
                                                                            1. see 'chest pain' flow chart
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