诊断学疾病部分英文讲解课件.ppt

1、Mitral stenosis CausesRHD-rheumatic heart diseasesenile retrogradecongenital heart diseaseMitral stenosis Symptomsdyspnea coughhemoptysis dysphagia Hoarseness Signs inspection mitral complexapex impulse may be displaced to the left palpationdiastolic thrill percussionnormal heart borderspear shape h

2、eart Auscultation diastolic murmurs:apical area,mild and late diastolic,crescendo,rumbling,more clearly when lying on ones left side S1 opening snap mar be auscultatory accentuation of pulmonary second sound(P2),splitting Graham Steels murmur(PV diastolic)systolic mumur(TV area)atrial fibrillation(l

3、ate stage)Mitral insufficiencyacute:infection ischemiachronic:RHD-rheumatic heart disease mitral prolapse coronary heart disease senile retrograde Mitral insufficiency Symptomspalpitationfatiguecoughdyspnea on exertion Signs inspection apex impulse displaced to left downward palpationheaving apex im

4、pulse,systolic thrill(severe)percussionthe border of dullness enlarged to left downward,both sides enlarged at late stage Auscultation murmurs:apical area,pansystolic period,harsh,blowing,3/6 grade transmitted to left oxter and left infrascapular angle S1 P2,splittingAortic stenosis CausesRHD-rheuma

5、tic heart diseasecongenital heart disease senile retrograde Symptoms dyspnea,angina pectoris,syncope Signs inspection apex impulse increased and displaced to left downward palpationapex beat is elevated and forcefulsystolic thrill(AV1)pulse tardus percussionnormal heart borders or the border of dull

6、ness enlarged to left downward Auscultation murmurs:AV1 area,systolic period,harsh,ejection sound,3/6 grade transmitted to neck S2 (AV),reversed splitting S4Aortic insufficiency Symptomspalpitationfatiguedizzinesspulsating sense(head)angina pectoris dyspnea Signs inspection apex impulse displaced to

7、 left downward palpationheaving apex impulse and displaced to left downward percussionthe border of dullness enlarged to left downward,boot shape Auscultation murmurs:aortic valvular area,diastolic period,decrescendo sighing heard clearly sitting erect and forward transmitted to left inferior sternu

8、m and apical area Austin Flint murmur Peripheral vascular signs head nodding capillary pulsation water hammer pulse pistol shot soumd Duroziezs MUEMUE visible pulsation of carotid arteriesPericardial effusion Causesinfectivenon-infective Symptomspalpitation,dyspnea,cough,abdominal distention,edema,f

9、ever,shock Signs inspection apex impulse diminution palpationapex beat is palpated uneasily percussionenlargement of the cardiac dullness bilaterally,changed with posture Auscultationpericardial friction,rapid HR,pericardial knocking sound,heart sound decreased Large PEjugular venous enlargementhepa

10、tomeglyhepatojugular reflux positiveEwart sign:(Subscapularis area )vocal fremitus dullness brochovesicular breath soundparadoxical pulseHeart failure Symptomsleft side heart failure:fatigue,progressive exertional dyspnea-nocturnal paroxysmal dyspnea-orthopnoeacough,foam sputum hemoptysis Symptomsri

11、ght side heart failure:abdominal distentionoliguriaanorexia nausea and vomiting Signs(LHF)inspection Tachypnea,cyanosis,to sit up straight.Pink foam sputum,palpationpulsus alternans percussion auscultationgallop rhythm,HR,P2 ,fine crackles,bronchial asthma Signs(RHF)inspection:jugular venous enlargement peripheral cyanosis,edema palpation:hepatomegly hepatojugular reflux positive edema percussion:pleural and ascitic fluid auscultation:systolic murmur(TV),gallop rhythmsymptoms and signs of primary heart disease