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diseases of cardiovascular system

Diseases of cardiovascular system at wounded men are observed neyoredko, and both in early, and in late after wound terms. Early functional disturbances of activity of system krovoyoobrashchenija usually are.

During later periods, in joining cases ranevoj inyofektsii, development of inflammatory processes in heart and vessels is observed.

Heart bruise. Morfologicheski focal hemorrhages, the fine centres of a necrosis, a dystrophia take place. Clinic: palpitation, heart faults, a dyspnea, the tendency to BP depression, are possible signs warm nedosyotatochnosti. An electrocardiogram: inversion of tooth T, shift on type infarktopodobnogo damages. EhoKG: hypokinesia zones.

Myocardial dystrophies — the most frequent pathology serdechnoyososudistoj systems at the wounded men, developing in every second case proyonikajushchih breast and stomach wounds already in early terms after wound (peryovye 5 days). Myocardium dystrophias are observed and in later terms as result ranevogo purulent-rezorbtivnogo syndrome, an anaemia, a sepsis, istoyoshchenija. Clinical signs of a dystrophia of a myocardium are tahikaryodija, weakening of cardiac sounds, systolic hum over an apex, is more rare — disturbance of a rhythm of heart. On an electrocardiogram voltage reduction, nayorushenie processes repoljarizatsii in a myocardium (uploshchennyj or a 2-phase tooth), augmentation of duration of an electric systole zheludochyokov is registered. In early terms the myocardium dystrophia is usually bound to an anaemia, gipoyoproteinemiej, and also with a hypopotassemia. In the absence of complications raneyovogo process and after correction of disturbances of a homeostasis at wounded men signs of a dystrophia of a myocardium disappear in 5-7 days. Last years it is offered to name an early myocardial dystrophy a cardiomyopathy of wounded men.

The myocarditis develops at serious getting wounds of a breast and a stomach in 2-5 % cases usually in late terms (in 3-4 weeks after wound) and proceeds without a strongly pronounced symptomatology, as vozyonikaet against is purulent-septic complications at wounded men (a pleura empyema, a sepsis). The myocarditis at wounded men is shown usually by a tachycardia, weakening of tones, majatnikoobraznym a rhythm, augmentation of the sizes of heart, signs of relative insufficiency of the mitral valve, depression of a voltage of an electrocardiogram, disturbance atrioventricular and vnutrizheyoludochkovoj conductions, insufficiency implications krovoobrashcheyonija (a dyspnea, puffiness of anticnemions, augmentation of the sizes of a liver). Quite often thus arrhythmias, more often in the form of atrial and zheludochkoyovyh extrasystoles, migration of the driver of a rhythm are observed. In system complex leyochenija myocardites at wounded men along with antibacterial therapy not both
hodimo to prescribe resolvents, potassium preparations, viyotaminy groups In and With, antiarrhytmic agents.

Pericardites are among early complications of getting wounds of a thorax (5-8 % of cases). Their reason is povrezhyodenie and a pericardium becoming infected at wound. Less often a pericarditis razvivayoetsja on 2-3 week against is purulent-septic complications at wounded men. The most typical symptom of a pericarditis is occurrence pre - a cardial pain of the various intensity amplifying at dyhayonii, tussis, the movements, quite often irradiating in the left shoulder or a neck. A pathognomonic objective sign is pericardial rub occurrence. In process of accumulation of an exsudate of a pain weaken, and ischeyozaet a pericardial rub, the augmentation of warm dullness is observed, rentgenologicheski the heart shade gets the characteristic trapezoid form. At an electrocardiogram-research voltage depression, konkoryodatnoe shift ST in all standard leads, sometimes with vypukloyostju up becomes perceptible. Appreciable and fast increase of quantity of an exsudate (also as well as at a hemopericardium) can lead to a cardiac tamponade with development of an acute heart failure. In these cases with the medical purpose apply a pericardiocentesis and exsudate evacuation.

Infectious endocarditises develop in late terms at mnoyozhestvennyh wounds of internal organs, occurrence gnojnoyosepticheskih complications, at complications of a catheterization of large veins at carrying out of intensive infusional therapy. Their diagnostics osnoyovyvaetsja on occurrence of signs of formation of insufficiency aoryotalnyh semilunums and-or insufficiency of the mitral valve, a nephritis, hemorrhagic vasculitis symptoms, tromboembolicheskih oslozhneyony, results of crops of venous and arterial blood on sterility. At complex treatment of a bacteriemic endocarditis solving znacheyonie has long (1,5-3 months) application of antibiotics in the big doses taking into account repeated researches of sensitivity of flora.

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Scientific source the Therapeutic pathology at wounded and amazed: ucheb. - a method. The grant for students 5, 6 courses of all faculties of medical high schools, doctors of the general practice, therapists, surgeons / E. G.Malaeva [etc.]. — Gomel: GomGMU, 2016 . — 80 with.. 2016

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