{"id":33282,"date":"2020-01-22T10:33:03","date_gmt":"2020-01-22T09:33:03","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=33282"},"modified":"2020-01-22T11:16:17","modified_gmt":"2020-01-22T10:16:17","slug":"dostanu-id-3-stupne-na-plicni-hypertenzi","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=33282","title":{"rendered":"Dostanu ID 3. stupn\u011b na plicn\u00ed hypertenzi?"},"content":{"rendered":"\n

DOTAZ: Na Echu srdce mi byla objevena t\u011b\u017ek\u00e1 PH, je to na invalidn\u00ed d\u016fchod III. stupn\u011b?<\/strong><\/p>\n\n\n\n

Odpov\u011b\u010f<\/strong>:<\/p>\n\n\n\n

Invalidn\u00ed d\u016fchod je p\u0159izn\u00e1v\u00e1n jako kompenzace ztr\u00e1ty v p\u0159\u00edjmu pro podstatn\u00e9 sn\u00ed\u017een\u00ed pracovn\u00ed schopnosti v d\u016fsledku zdravotn\u00edho posti\u017een\u00ed.<\/p>\n\n\n\n

Podle m\u00edry poklesu pracovn\u00ed schopnosti se invalidn\u00ed d\u016fchod d\u011bl\u00ed na t\u0159i stupn\u011b invalidity:<\/p>\n\n\n\n

Jestli\u017ee pracovn\u00ed schopnost poji\u0161t\u011bnce poklesla:
\n\u2022 nejm\u00e9n\u011b o 35 %, av\u0161ak nejv\u00edce o 49 %, jedn\u00e1 se o invaliditu prvn\u00edho stupn\u011b
\n\u2022 nejm\u00e9n\u011b o 50 %, av\u0161ak nejv\u00edce o 69 %, jedn\u00e1 se o invaliditu druh\u00e9ho stupn\u011b
\n\u2022 nejm\u00e9n\u011b o 70 %, jedn\u00e1 se o invaliditu t\u0159et\u00edho stupn\u011b.<\/p>\n\n\n\n

Uv\u00e1d\u00edte, \u017ee dle n\u00e1lezu p\u0159i echokardiografick\u00e9m vy\u0161et\u0159en\u00ed v\u00e1m byla zji\u0161t\u011bna t\u011b\u017ek\u00e1 plicn\u00ed hypertenze<\/strong>. <\/p>\n\n\n\n

P\u0159i hodnocen\u00ed m\u00edry poklesu pracovn\u00ed schopnosti se vych\u00e1z\u00ed z funk\u010dn\u00edho posti\u017een\u00ed, mo\u017enost\u00ed a v\u00fdsledku l\u00e9\u010dby, v\u00fdvoje a progn\u00f3zy posti\u017een\u00ed. Pro hodnocen\u00ed je nejd\u016fle\u017eit\u011bj\u0161\u00ed posouzen\u00ed funk\u010dn\u00edho stavu, kter\u00e9 vych\u00e1z\u00ed jak z vyhodnocen\u00ed subjektivn\u00edch kriteri\u00ed (NYHA, CCS, dotazn\u00edky, sk\u00f3rovac\u00ed syst\u00e9my), tak z objektivn\u011b zji\u0161t\u011bn\u00fdch kriteri\u00ed (hodnoty ejek\u010dn\u00ed frakce-EF, plazmatick\u00e9 koncentrace natriuretick\u00fdch peptid\u016f-NP, v\u00fdsledku Holterova monitorov\u00e1n\u00ed, hodnot metabolick\u00e9ho ekvivalentu-MET, spot\u0159eby kysl\u00edku-VO2max., z\u00e1t\u011b\u017ee vzta\u017een\u00e9 k t\u011blesn\u00e9 hmotnosti – W\/kg t\u011blesn\u00e9 hmotnosti). Pro za\u0159azen\u00ed do p\u0159\u00edslu\u0161n\u00e9 funk\u010dn\u00ed skupiny mus\u00ed b\u00fdt spln\u011bna 3 pop\u0159. i v\u00edce krit\u00e9ri\u00ed. Pro stanoven\u00ed m\u00edry poklesu pracovn\u00ed schopnosti je rozhoduj\u00edc\u00ed dopad zji\u0161t\u011bn\u00e9ho funk\u010dn\u00edho omezen\u00ed na celkovou v\u00fdkonnost a schopnost vykon\u00e1vat denn\u00ed aktivity. P\u0159i hodnocen\u00ed by sledovan\u00e9 obdob\u00ed, rozhodn\u00e9 pro posouzen\u00ed m\u00edry poklesu pracovn\u00ed schopnosti, m\u011blo trvat zpravidla jeden rok. <\/p>\n\n\n\n

Jestli\u017ee tedy va\u0161i diagn\u00f3zu potvrzuje pouze vy\u0161et\u0159en\u00ed echokardiografick\u00e9, je t\u0159eba prov\u00e9st v\u00edce vy\u0161et\u0159en\u00ed, kter\u00e9 umo\u017en\u00ed posouzen\u00ed funk\u010dn\u00edho stavu a za\u0159azen\u00ed do p\u0159\u00edslu\u0161n\u00e9 funk\u010dn\u00ed skupiny a tedy i zv\u00e1\u017een\u00ed p\u0159izn\u00e1n\u00ed invalidn\u00edho d\u016fchodu 3. stupn\u011b<\/strong>. <\/p>\n\n\n\n

Ve va\u0161em p\u0159\u00edpad\u011b je posuzovan\u00fdm stavem dle vyhl\u00e1\u0161ky Cor pulmonale chronicum. <\/strong>
P\u0159i stanoven\u00ed m\u00edry poklesu pracovn\u00ed schopnosti se vych\u00e1z\u00ed z posti\u017een\u00ed, kter\u00e9 vedlo k rozvoji cor pulmonale, z p\u0159\u00edtomnosti \u010di nep\u0159\u00edtomnosti ob\u011bhov\u00e9 nedostate\u010dnosti, ze zji\u0161t\u011bn\u00ed zn\u00e1mek plicn\u00ed hypertenze v echokardiografick\u00e9m n\u00e1lezu, event. z hodnot tlaku v plicnici, z efektu l\u00e9\u010dby, t\u00ed\u017ee dechov\u00e9 nedostate\u010dnosti a dopadu stavu na celkovou v\u00fdkonnost. K objektivizaci funk\u010dn\u00edho posti\u017een\u00ed se pou\u017e\u00edv\u00e1 i test 6 minutov\u00e9 ch\u016fze (hodnoty do 350 m sv\u011bd\u010d\u00ed pro \u0161patnou progn\u00f3zu, hodnoty nad 350 m jsou prognosticky p\u0159\u00edzniv\u011bj\u0161\u00ed).<\/p>\n\n\n\n

Doporu\u010duji konzultovat pod\u00e1n\u00ed \u017e\u00e1dosti o invalidn\u00ed d\u016fchod 3. stupn\u011b na p\u0159\u00edslu\u0161n\u00e9 pobo\u010dce \u010cSSZ a spolupracovat s praktick\u00fdm l\u00e9ka\u0159em p\u0159i vytvo\u0159en\u00ed pot\u0159ebn\u00e9 dokumentace pro posouzen\u00ed funk\u010dn\u00edho posti\u017een\u00ed posudkov\u00fdm l\u00e9ka\u0159em. <\/p>\n\n\n\n

MUDr. Jan \u010cin\u010dura

<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

DOTAZ: Na Echu srdce mi byla objevena t\u011b\u017ek\u00e1 PH, je to na invalidn\u00ed d\u016fchod III. stupn\u011b? Odpov\u011b\u010f: Invalidn\u00ed d\u016fchod je p\u0159izn\u00e1v\u00e1n jako kompenzace ztr\u00e1ty v […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":29445,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"class_list":["post-33282","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-poradna"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/33282","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=33282"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/33282\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/29445"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=33282"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=33282"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=33282"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}