{"id":39012,"date":"2023-04-14T14:03:49","date_gmt":"2023-04-14T12:03:49","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=39012"},"modified":"2023-04-14T14:03:49","modified_gmt":"2023-04-14T12:03:49","slug":"rozpoznejte-selhani-srdce-ma-sedm-priznaku","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=39012","title":{"rendered":"Rozpoznejte selh\u00e1n\u00ed srdce. M\u00e1 sedm p\u0159\u00edznak\u016f"},"content":{"rendered":"\n

Jednou z\u00a0hlavn\u00edch p\u0159\u00ed\u010din hospitalizace lid\u00ed star\u0161\u00edch 65 let je srde\u010dn\u00ed selh\u00e1n\u00ed. Jeho p\u0159\u00edznaky se v\u0161ak t\u011b\u017eko rozpozn\u00e1vaj\u00ed, proto\u017ee postupuj\u00ed pl\u00ed\u017eiv\u011b a <\/strong>\u010dasto se prvn\u011b projev\u00ed v\u00a0jin\u00fdch \u010d\u00e1stech t\u011bla ne\u017e u srdce. Jak\u00fdch je tedy 7 nej\u010dast\u011bj\u0161\u00edch p\u0159\u00edznak\u016f, kter\u00e9 mohou signalizovat, \u017ee srdce selh\u00e1v\u00e1? O tom mluvil prof. MUDr. Jan V\u00e1clav\u00edk, p\u0159ednosta Intern\u00ed a kardiologick\u00e9 kliniky FN Ostrava.<\/strong> <\/strong><\/p>\n\n\n\n

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  1. U konce s dechem<\/strong><\/li>\n<\/ol>\n\n\n\n

    Zad\u00fdchat se p\u0159i sportovn\u00edm v\u00fdkonu nebo po \u201ev\u00fdb\u011bhu\u201c do p\u00e1t\u00e9ho patra je zcela p\u0159irozen\u00e9. Zbyst\u0159it bychom v\u0161ak m\u011bli v okam\u017eiku, kdy se zad\u00fdch\u00e1me p\u0159i vys\u00e1v\u00e1n\u00ed, na proch\u00e1zce v m\u00edrn\u00e9m tempu nebo p\u0159i pomal\u00e9 ch\u016fzi do schod\u016f. Zvl\u00e1\u0161\u0165 pokud n\u00e1m d\u0159\u00edve podobn\u00e9 \u010dinnosti ned\u011blaly \u017e\u00e1dn\u00e9 probl\u00e9my. \u201eP\u0159i srde\u010dn\u00edm selh\u00e1n\u00ed m\u016f\u017ee doj\u00edt k hromad\u011bn\u00ed krve v plic\u00edch. Nadbyte\u010dn\u00e1 krev pronik\u00e1 do plicn\u00edch skl\u00edpk\u016f, kde vznik\u00e1 plicn\u00ed otok. Proto se pacient\u016fm h\u016f\u0159 d\u00fdch\u00e1 i ve chv\u00edli, kdy jsou v klidu. N\u011bkdy je du\u0161nost prov\u00e1z\u00ed zejm\u00e9na v noci, kdy le\u017e\u00ed. Musej\u00ed proto sp\u00e1t v polosed\u011b nebo s n\u011bkolika pol\u0161t\u00e1\u0159i, nebo se b\u011bhem noci pro du\u0161nost posazovat,\u201c<\/em> vysv\u011btluje prof. V\u00e1clav\u00edk.<\/p>\n\n\n\n

      \n
    1. St\u00e1l\u00fd boj s \u00fanavou<\/strong><\/li>\n<\/ol>\n\n\n\n

      Srdce funguje jako ne\u00fanavn\u00e1 pumpa, kter\u00e1 rozh\u00e1n\u00ed krev do v\u0161ech \u010d\u00e1st\u00ed t\u011bla. P\u0159i srde\u010dn\u00edm selh\u00e1n\u00ed nezvl\u00e1d\u00e1 tuto \u010dinnost plnohodnotn\u011b vykon\u00e1vat. Krev, kter\u00e1 zaji\u0161\u0165uje z\u00e1sobov\u00e1n\u00ed v\u0161ech org\u00e1n\u016f \u017eivinami a kysl\u00edkem, tak n\u011bkde p\u0159eb\u00fdv\u00e1, a jinde naopak chyb\u00ed. Jej\u00ed nedostatek ve svalech se projev\u00ed v\u011bt\u0161\u00ed \u00fanavou, kter\u00e1 nemocn\u00e9ho prov\u00e1z\u00ed i ve chv\u00edl\u00edch, kdy prakticky nic ned\u011bl\u00e1. \u201eZv\u00fd\u0161en\u00e1 \u00fanava p\u0159i b\u011b\u017en\u00e9 denn\u00ed \u010dinnosti, nebo nap\u0159\u00edklad kdy\u017e lid\u00e9 nezvl\u00e1dnou don\u00e9st ta\u0161ky z obchodu, m\u016f\u017ee b\u00fdt jedn\u00edm z p\u0159\u00edznak\u016f srde\u010dn\u00edho selh\u00e1n\u00ed,\u201c<\/em> dopl\u0148uje prof. V\u00e1clav\u00edk.<\/p>\n\n\n\n

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      1. Otoky nohou<\/strong><\/li>\n<\/ol>\n\n\n\n

        Otoky doln\u00edch kon\u010detin jsou pravd\u011bpodobn\u011b jedn\u00edm z nejtypi\u010dt\u011bj\u0161\u00edch p\u0159\u00edznak\u016f srde\u010dn\u00edho selh\u00e1n\u00ed. Krom\u011b nemocn\u00e9ho srdce na nich nese sv\u016fj d\u00edl viny tak\u00e9 gravitace. Nejprve se otoky ohl\u00e1s\u00ed za\u0159\u00edznut\u00fdm lemem pono\u017eek, otoky se postupn\u011b mohou z chodidel roz\u0161i\u0159ovat na b\u00e9rce, n\u011bkdy i stehna a h\u00fd\u017ed\u011b. Postupn\u011b bude st\u00e1le obt\u00ed\u017en\u011bj\u0161\u00ed naj\u00edt mezi vlastn\u00edmi botami takov\u00e9, kter\u00e9 na otekl\u00e9 nohy padnou. Nem\u016f\u017ee za to dlouh\u00e9 sezen\u00ed ani hork\u00e9 po\u010das\u00ed. Na vin\u011b je selh\u00e1n\u00ed srdce, kter\u00e9 nezvl\u00e1d\u00e1 udr\u017eet ve\u0161ker\u00e9 tekutiny ob\u011bhu. Za\u010dnou se hromadit a v duchu gravita\u010dn\u00edho z\u00e1kona neomyln\u011b sm\u011b\u0159ovat k doln\u00edm kon\u010detin\u00e1m. Otoky se zm\u00edr\u0148uj\u00ed po pod\u00e1n\u00ed mo\u010dopudn\u00fdch l\u00e9k\u016f \u2013 tzv. diuretik. Pacienti maj\u00ed k dispozici tak\u00e9 modern\u00ed l\u00e9\u010div\u00e9 p\u0159\u00edpravky \u2013 tzv. glifloziny, kter\u00e9 krom\u011b zm\u00edrn\u011bn\u00ed otok\u016f pom\u00e1haj\u00ed zlep\u0161it pr\u00e1ci srde\u010dn\u00edho svalu.<\/p>\n\n\n\n

          \n
        1. Kila jdou nahoru<\/strong><\/li>\n<\/ol>\n\n\n\n

          V\u00fdrazn\u011b t\u011bsn\u011bj\u0161\u00ed oble\u010den\u00ed v pase nebo rafi\u010dka v\u00e1hy, kter\u00e1 se za 3 dny posunula o 2 kg sm\u011brem nahoru, na\u0161\u00ed pozornosti v\u011bt\u0161inou neunikne. Jen m\u00e1lokoho by v\u0161ak napadlo hledat d\u016fvody ve \u0161patn\u011b funguj\u00edc\u00edm srdci. \u201eN\u00e1r\u016fst hmotnosti b\u00fdv\u00e1 u srde\u010dn\u00edho selh\u00e1n\u00ed \u010dasto pom\u011brn\u011b skokov\u00fd. V t\u011ble se toti\u017e hromad\u00ed tekutiny, kter\u00e9 nikam neodch\u00e1zej\u00ed. V org\u00e1nech b\u0159i\u0161n\u00ed dutiny nav\u00edc z\u016fst\u00e1v\u00e1 v\u011bt\u0161\u00ed mno\u017estv\u00ed krve, co\u017e m\u016f\u017ee zhor\u0161it funkci jater nebo ledvin. N\u011bkdy mohou pacienti c\u00edtit tlak pod \u017eebry,\u201c<\/em> dod\u00e1v\u00e1 prof. V\u00e1clav\u00edk. Sou\u010dasn\u011b s nar\u016fstaj\u00edc\u00ed hmotnost\u00ed pacienty mohou tr\u00e1pit tak\u00e9 za\u017e\u00edvac\u00ed pot\u00ed\u017ee a nevolnost.<\/p>\n\n\n\n

            \n
          1. Nab\u011bhl\u00e1 kr\u010dn\u00ed \u017e\u00edla<\/strong><\/li>\n<\/ol>\n\n\n\n

            Za norm\u00e1ln\u00edch okolnost\u00ed neb\u00fdvaj\u00ed \u017e\u00edly na krku viditeln\u00e9 nebo vystoupl\u00e9. \u201eVy\u0161\u0161\u00ed tlak, kter\u00fd prov\u00e1z\u00ed srde\u010dn\u00ed selh\u00e1n\u00ed, m\u016f\u017ee zp\u016fsobit tzv. zv\u00fd\u0161enou n\u00e1pl\u0148 kr\u010dn\u00edch \u017eil. Znamen\u00e1 to, \u017ee pacient m\u00e1 viditeln\u011b nab\u011bhl\u00e9 \u017e\u00edly na krku. Nejl\u00e9pe je to patrn\u00e9 u pacient\u016f v polosed\u011b nebo v sed\u011b,\u201c<\/em> \u0159\u00edk\u00e1 prof. V\u00e1clav\u00edk. Viditeln\u00e9 \u017e\u00edly na krku mohou krom\u011b srde\u010dn\u00edho selh\u00e1n\u00ed p\u0159edznamen\u00e1vat nap\u0159\u00edklad tak\u00e9 chlopenn\u00ed vady.<\/p>\n\n\n\n

              \n
            1. Srde\u010dn\u00ed arytmie<\/strong><\/li>\n<\/ol>\n\n\n\n

              \u201eU pacient\u016f se srde\u010dn\u00edm selh\u00e1n\u00edm je \u010dasto p\u0159\u00edtomna fibrilace s\u00edn\u00ed. Pacienti ji vn\u00edmaj\u00ed jako nepravideln\u00e9 nebo rychl\u00e9 bu\u0161en\u00ed srdce. Z\u00e1va\u017enou komplikac\u00ed srde\u010dn\u00edho selh\u00e1n\u00ed se sn\u00ed\u017eenou ejek\u010dn\u00ed frakc\u00ed lev\u00e9 komory mohou b\u00fdt komorov\u00e9 arytmie, jako nap\u0159\u00edklad fibrilace komor. V takov\u00fdch p\u0159\u00edpadech pak \u010dasto mus\u00edme pacient\u016fm aplikovat defibril\u00e1tor, kter\u00fd pak tyto \u017eivot ohro\u017euj\u00edc\u00ed arytmie kontroluje,\u201c<\/em> uv\u00e1d\u00ed prof. V\u00e1clav\u00edk.<\/p>\n\n\n\n

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              1. Chyb\u011bj\u00edc\u00ed krev v mozku<\/strong><\/li>\n<\/ol>\n\n\n\n

                Pokud se nedost\u00e1v\u00e1 krev do mozku, m\u016f\u017ee se pacient pot\u00fdkat se zmatenost\u00ed, poruchami my\u0161len\u00ed nebo dokonce s depres\u00ed. \u201eP\u0159\u00edznaky souvisej\u00edc\u00ed s men\u0161\u00edm prokrven\u00edm mozku pozorujeme u pacient\u016f, kdy nemoc v\u00fdrazn\u011b pokro\u010dila,\u201c<\/em> dod\u00e1v\u00e1 prof. V\u00e1clav\u00edk. P\u0159i podez\u0159en\u00ed na srde\u010dn\u00ed selh\u00e1n\u00ed je nutn\u00e9 neprodlen\u011b nav\u0161t\u00edvit l\u00e9ka\u0159e. \u201ePraktick\u00fd l\u00e9ka\u0159 provede rozbor anamn\u00e9zy, z\u00e1kladn\u00ed fyzik\u00e1ln\u00ed vy\u0161et\u0159en\u00ed a odb\u011br vzorku krve, kter\u00fd ov\u011b\u0159\u00ed, zda nedo\u0161lo ke zv\u00fd\u0161en\u00ed hladiny tzv. natriuretick\u00fdch peptid\u016f, kter\u00e9 citliv\u011b reaguj\u00ed na tlakov\u00e9 a objemov\u00e9 p\u0159et\u00ed\u017een\u00ed svalu srdce, je\u017e je pro srde\u010dn\u00ed selh\u00e1n\u00ed typick\u00e9. Pokud je n\u00e1lez pozitivn\u00ed, absolvuje pacient echokardiografick\u00e9 vy\u0161et\u0159en\u00ed. Je pot\u0159eba vylou\u010dit, \u017ee p\u0159\u00edznaky souvis\u00ed s jin\u00fdm onemocn\u011bn\u00edm,\u201c<\/em> up\u0159es\u0148uje prof. V\u00e1clav\u00edk.<\/p>\n\n\n\n

                Srde\u010dn\u00ed selh\u00e1n\u00ed<\/strong><\/p>\n\n\n\n

                Srde\u010dn\u00ed selh\u00e1n\u00ed je stav, kdy srdce nedok\u00e1\u017ee plnit svoji funkci, kterou je \u201epumpov\u00e1n\u00ed\u201c krve do v\u0161ech \u010d\u00e1st\u00ed lidsk\u00e9ho t\u011bla. Ro\u010dn\u011b p\u0159ib\u00fdv\u00e1 p\u0159ibli\u017en\u011b 60 tis\u00edc nov\u00fdch pacient\u016f s touto nemoc\u00ed. P\u0159\u00ed\u010dinou je nej\u010dast\u011bji infarkt myokardu nebo srde\u010dn\u00ed arytmie. V\u010dasn\u00e9 zah\u00e1jen\u00ed l\u00e9\u010dby dok\u00e1\u017ee prodlou\u017eit \u017eivot pacient\u016f a zlep\u0161it jeho kvalitu. Z\u00e1kladem \u00fasp\u011b\u0161n\u00e9 l\u00e9\u010dby je pravideln\u00e9 u\u017e\u00edv\u00e1n\u00ed l\u00e9\u010div\u00fdch p\u0159\u00edpravk\u016f podle pokyn\u016f l\u00e9ka\u0159e, p\u0159im\u011b\u0159en\u00e1 pohybov\u00e1 aktivita a v p\u0159\u00edpad\u011b nadv\u00e1hy tak\u00e9 dieta, kter\u00e1 pom\u016f\u017ee pacientovi zhubnout. L\u00e9ka\u0159i maj\u00ed k dispozici modern\u00ed l\u00e9ky \u2013 tzv. glifloziny, kter\u00e9 zlep\u0161uj\u00ed \u010dinnost srde\u010dn\u00edho svalu a v\u00fdrazn\u011b zm\u00edr\u0148uj\u00ed du\u0161nost i otoky. D\u0159\u00edve se doporu\u010dovalo tak\u00e9 sn\u00ed\u017eit p\u0159\u00edjem soli. Posledn\u00ed studie v\u0161ak neprok\u00e1zaly, \u017ee m\u00e9n\u011b soli pozitivn\u011b ovliv\u0148uje stav pacienta. V pokro\u010dil\u00fdch stadi\u00edch srde\u010dn\u00edho selh\u00e1n\u00ed doporu\u010duj\u00ed l\u00e9ka\u0159i omezit mno\u017estv\u00ed tekutin.<\/p>\n","protected":false},"excerpt":{"rendered":"

                Jednou z\u00a0hlavn\u00edch p\u0159\u00ed\u010din hospitalizace lid\u00ed star\u0161\u00edch 65 let je srde\u010dn\u00ed selh\u00e1n\u00ed. Jeho p\u0159\u00edznaky se v\u0161ak t\u011b\u017eko rozpozn\u00e1vaj\u00ed, proto\u017ee postupuj\u00ed pl\u00ed\u017eiv\u011b a \u010dasto se prvn\u011b projev\u00ed […]<\/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":[11],"tags":[],"class_list":["post-39012","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/39012","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=39012"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/39012\/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=39012"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=39012"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=39012"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}