{"id":42998,"date":"2023-10-21T09:27:23","date_gmt":"2023-10-21T07:27:23","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=42998"},"modified":"2023-10-21T09:33:39","modified_gmt":"2023-10-21T07:33:39","slug":"infarkt-miloslava-prekvapil-jako-blesk-z-cisteho-nebe","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=42998","title":{"rendered":"Infarkt Miloslava p\u0159ekvapil jako blesk z\u00a0\u010dist\u00e9ho nebe"},"content":{"rendered":"\n<p>Miloslav (73) z&nbsp;Prahy byl a\u017e do sv\u00fdch 49 let aktivn\u00ed a nem\u011bl \u017e\u00e1dn\u00e9 v\u00e1\u017en\u011bj\u0161\u00ed zdravotn\u00ed probl\u00e9my. Srde\u010dn\u00ed infarkt, kter\u00fd jej v&nbsp;tomto v\u011bku postihl, byl proto nemil\u00e9 p\u0159ekvapen\u00ed. A to byl teprve za\u010d\u00e1tek jeho zdravotn\u00edch probl\u00e9m\u016f. <\/p>\n\n\n\n<p><em>\u201eTr\u00e1vili jsem s&nbsp;rodinou Velikonoce na chalup\u011b, a najednou jsem uc\u00edtil velkou bolest na hrudi, kter\u00e1 mi za\u010dala vyst\u0159elovat do ruky a do d\u00e1sn\u011b,\u201c <\/em>vzpom\u00edn\u00e1 Miloslav, kter\u00e9mu rodina hned zavolala z\u00e1chranku. V nemocnici mu l\u00e9ka\u0159i poskytli prvn\u00ed pomoc, a jakmile to bylo mo\u017en\u00e9, p\u0159evezli jej do Prahy do Nemocnice Na Homolce. Zde l\u00e9ka\u0159i Miloslavovi zavedli do srde\u010dn\u00ed c\u00e9vy tzv. stent, dr\u00e1t\u011bnou \u201etrubi\u010dku\u201c, kter\u00e1 zaji\u0161\u0165uje spr\u00e1vn\u00e9 proud\u011bn\u00ed krve. <\/p>\n\n\n\n<p><em>\u201eZ\u00e1krok prob\u011bhl bez probl\u00e9m\u016f a m\u016fj stav se zlep\u0161il, tak\u017ee jsem myslel, \u017ee bude zase v\u0161e jako d\u0159\u00edv,\u201c<\/em> \u0159\u00edk\u00e1 Miloslav. L\u00e9ka\u0159i mu nasadili b\u011b\u017en\u00e9 l\u00e9ky pro prevenci dal\u0161\u00edho infarktu. Po osmi letech v\u0161ak Miloslav prod\u011blal druh\u00fd infarkt a po dal\u0161\u00edm roce dokonce t\u0159et\u00ed. <\/p>\n\n\n\n<p><em>\u201eV obou p\u0159\u00edpadech jsem skon\u010dil v&nbsp;nemocnici. L\u00e9ka\u0159\u016fm se op\u011bt poda\u0159ilo m\u016fj stav stabilizovat a dal\u0161\u00edch osm let jsem \u017eil bez probl\u00e9m\u016f. Pak jsem ale kv\u016fli srde\u010dn\u00ed z\u00e1stav\u011b zkolaboval p\u0159i ob\u011bd\u011b s&nbsp;dcerou p\u0159\u00edmo v restauraci,\u201c<\/em> popisuje a pokra\u010duje: <em>\u201eZnovu jsem skon\u010dil v&nbsp;nemocnici, a tenkr\u00e1t to se mnou bylo hodn\u011b \u0161patn\u00e9. Vypadalo, \u017ee to nep\u0159e\u017eiji, a pokud ano, tak s&nbsp;trval\u00fdmi n\u00e1sledky. Nakonec jsem to ale vybojoval.\u201c<\/em> To u\u017e m\u011bl podle l\u00e9ka\u0159\u016f oslabenou funkci srde\u010dn\u00edch komor a trp\u011bl chronick\u00fdm srde\u010dn\u00edm selh\u00e1n\u00edm. Proto kardiologov\u00e9 Miloslavovi voperovali defibril\u00e1tor a upravili l\u00e9\u010dbu, kter\u00e1 nov\u011b zahrnovala i l\u00e9ky na sn\u00ed\u017een\u00ed sr\u00e1\u017elivosti krve. Situace se zase na n\u011bjakou dobu uklidnila. P\u0159ed dv\u011bma roky se v\u0161ak jeho stav kv\u016fli nepravideln\u00e9mu srde\u010dn\u00edmu rytmu (tzv. arytmii) znovu zhor\u0161il. Miloslav podstoupil n\u011bkolik z\u00e1krok\u016f, nebyly v\u0161ak \u00fasp\u011b\u0161n\u00e9. Jeho kardiolog mu proto doporu\u010dil vy\u0161et\u0159en\u00ed ve specializovan\u00e9 ambulanci srde\u010dn\u00edho selh\u00e1n\u00ed. Tam l\u00e9ka\u0159i zjistili, \u017ee defibril\u00e1tor ji\u017e selh\u00e1vaj\u00edc\u00edmu srdci nesta\u010d\u00ed.<\/p>\n\n\n\n<p>\u201e<em>Dostal jsem jin\u00fd typ defibril\u00e1toru a nov\u00e9 l\u00e9ky. Arytmie mi ale z\u016fstaly a letos na za\u010d\u00e1tku roku jsem nav\u00edc za\u010dal m\u00edt v\u00fdrazn\u00e9 probl\u00e9my s&nbsp;d\u00fdch\u00e1n\u00edm,\u201c<\/em> \u0159\u00edk\u00e1 Miloslav a dopl\u0148uje: <em>\u201eD\u0159\u00edve jsem se tak\u00e9 p\u0159i n\u00e1maze zad\u00fdch\u00e1val, ale dalo se to zvl\u00e1dnout. Tohle bylo mnohem hor\u0161\u00ed. Nav\u00edc mi ot\u00e9kaly nohy a byl jsem hodn\u011b unaven\u00fd. Do\u0161lo to a\u017e tak daleko, \u017ee jsem se nemohl nadechnout a&nbsp;v jednu chv\u00edli jsem se skoro dusil. Dcera m\u011b proto odvezla op\u011bt do nemocnice,\u201c<\/em> popisuje. <\/p>\n\n\n\n<p>Po stabilizaci jeho stavu konzilium l\u00e9ka\u0159\u016f rozhodlo, \u017ee mu provedou tzv. ablaci, d\u00edky kter\u00e9 se jim poda\u0159ilo odstranit zdroj srde\u010dn\u00edch arytmi\u00ed. Z\u00e1rove\u0148 Miloslavovi znovu upravili l\u00e9\u010dbu. Nasadili mu mimo jin\u00e9 i nov\u00e9 l\u00e9ky na srde\u010dn\u00ed selh\u00e1n\u00ed, tzv. glifloziny. V&nbsp;sou\u010dasn\u00e9 dob\u011b ji\u017e sice Miloslav trp\u00ed pokro\u010dil\u00fdm srde\u010dn\u00edm selh\u00e1n\u00edm, d\u00edky modern\u00ed l\u00e9\u010db\u011b se u n\u011bj ale da\u0159\u00ed tlumit p\u0159\u00edznaky, jako jsou v\u00fdrazn\u00e9 pot\u00ed\u017ee s&nbsp;dechem nebo otoky doln\u00edch kon\u010detin.<\/p>\n\n\n\n<p>\u201e<em>Te\u010f je mi celkem dob\u0159e. Je to sice o n\u011bco hor\u0161\u00ed ne\u017e d\u0159\u00edve, ale beru to pozitivn\u011b. L\u00e9ka\u0159i d\u011blaj\u00ed maximum, abych se c\u00edtil co nejl\u00e9pe, a za to jsem jim moc vd\u011b\u010dn\u00fd,\u201c<\/em> \u0159\u00edk\u00e1 Miloslav a dod\u00e1v\u00e1: <em>\u201eZa t\u011bch skoro dvacet p\u011bt let od prvn\u00edho infarktu se medic\u00edna neskute\u010dn\u011b posunula, a to jak v&nbsp;mo\u017enostech z\u00e1krok\u016f a l\u00e9\u010dby, tak v&nbsp;p\u0159\u00edstupu k&nbsp;pacient\u016fm. To pozn\u00e1m i j\u00e1 jako laik. A d\u00edky tomu tady i p\u0159esto, \u017ee mi srdce selh\u00e1v\u00e1, je\u0161t\u011b jsem a mohu, i kdy\u017e s&nbsp;ur\u010dit\u00fdmi omezen\u00edmi, fungovat.\u201c<\/em><\/p>\n\n\n\n<p>Miloslav se cel\u00fd \u017eivot v\u011bnoval fotografov\u00e1n\u00ed. Za\u010d\u00ednal jako fotograf v&nbsp;\u010ceskoslovensk\u00e9 televizi, pot\u00e9 d\u011blal asistenta profesoru Plickovi p\u0159i tvorb\u011b knihy \u010ceskoslovensko, v\u011bt\u0161inu profesn\u00edho \u017eivota pracoval jako fotograf na voln\u00e9 noze. Fotografov\u00e1n\u00ed, i kdy\u017e u\u017e jen jako kon\u00ed\u010dek, je jeho v\u00e1\u0161n\u00ed dodnes.<\/p>\n\n\n\n<p><em><strong>Koment\u00e1\u0159 prof. MUDr. Filipa M\u00e1lka, Ph.D., MBA, m\u00edstop\u0159edsedy \u010cesk\u00e9 asociace srde\u010dn\u00edho selh\u00e1n\u00ed \u010cesk\u00e9 kardiologick\u00e9 spole\u010dnosti a vedouc\u00edho l\u00e9ka\u0159e ambulance srde\u010dn\u00edho selh\u00e1n\u00ed v Nemocnici Na Homolce:<\/strong><\/em><\/p>\n\n\n\n<p>\u201e<em>P\u0159\u00edb\u011bh pana Miloslava je typick\u00fd pro v\u011bt\u0161inu pacient\u016f se syndromem chronick\u00e9ho srde\u010dn\u00edho selh\u00e1n\u00ed. Dokumentuje v\u00fdvoj onemocn\u011bn\u00ed u pacienta s&nbsp;ischemickou chorobou srde\u010dn\u00ed po infarktu myokardu, kter\u00e1 je st\u00e1le hlavn\u00ed p\u0159\u00ed\u010dinou chronick\u00e9ho srde\u010dn\u00edho selh\u00e1n\u00ed. Pacient podstoupil \u0159adu z\u00e1krok\u016f, kter\u00e9 mu nepochybn\u011b prodlou\u017eily \u017eivot. Jeho p\u0159\u00edb\u011bh tak\u00e9 dokumentuje v\u00fdvoj nefarmakologick\u00e9 l\u00e9\u010dby (nejprve zaveden\u00ed defibril\u00e1toru, pak roz\u0161\u00ed\u0159en\u00ed p\u0159\u00edstrojov\u00e9 terapie na srde\u010dn\u00ed resynchroniza\u010dn\u00ed l\u00e9\u010dbu a \u00fasp\u011b\u0161n\u00e1 ablace perzistuj\u00edc\u00ed fibrilace s\u00edn\u00ed) a farmakoterapie (mezi hlavn\u00ed mezn\u00edky pat\u0159\u00ed zaveden\u00ed modern\u00edch p\u0159\u00edpravk\u016f ze skupiny gliflozin\u016f a dal\u0161\u00edch l\u00e9k\u016f modifikuj\u00edc\u00edch pr\u016fb\u011bh srde\u010dn\u00edho selh\u00e1n\u00ed). L\u00e9\u010debn\u00e9 mo\u017enosti se v&nbsp;pr\u016fb\u011bhu pacientova \u017eivota v\u00fdrazn\u011b zlep\u0161ily. Nyn\u00ed je na optim\u00e1ln\u00ed farmakoterapii, kter\u00e1 mu umo\u017e\u0148uje pobyt mimo nemocnici a p\u0159ijatelnou kvalitu \u017eivota. Srde\u010dn\u00ed selh\u00e1n\u00ed je nevyl\u00e9\u010diteln\u00e9, ale jak dokumentuje p\u0159\u00edb\u011bh pacienta, m\u016f\u017eeme jeho pr\u016fb\u011bh ovlivnit.<\/em><\/p>\n\n\n\n<p><em>Kvalita \u017eivota nemocn\u00fdch se srde\u010dn\u00edm selh\u00e1n\u00edm je ovlivn\u011bna \u0159adou faktor\u016f. Za prv\u00e9 jsou to p\u0159\u00edznaky jako du\u0161nost, otoky doln\u00edch kon\u010detin \u010di \u00fanava, pacient nezvl\u00e1dne \u010dasto ani aktivity b\u011b\u017en\u00e9 denn\u00ed \u010dinnosti, co\u017e z\u00e1vis\u00ed na pokro\u010dilosti onemocn\u011bn\u00ed. D\u00e1le jsou to \u010dast\u00e9 kontroly u l\u00e9ka\u0159e, nutnost dodr\u017eovat re\u017eimov\u00e1 opat\u0159en\u00ed (denn\u00ed kontroly hmotnosti a krevn\u00edho tlaku, restrikce p\u0159\u00edjmu tekutin, dietn\u00ed omezen\u00ed) a v neposledn\u00ed \u0159ad\u011b v\u00fddaje za l\u00e9ky. Pacienti v produktivn\u00edm v\u011bku nejsou \u010dasto schopni pln\u00e9 pracovn\u00ed z\u00e1t\u011b\u017ee. Je proto d\u016fle\u017eit\u00e9 srde\u010dn\u00edmu selh\u00e1n\u00ed p\u0159edch\u00e1zet zdrav\u00fdm \u017eivotn\u00edm stylem a v&nbsp;p\u0159\u00edpad\u011b jak\u00fdchkoliv pot\u00ed\u017e\u00ed co nejd\u0159\u00edve vyhledat l\u00e9ka\u0159e.\u201c<\/em><\/p>\n\n\n\n<p>V\u00edce informac\u00ed o srde\u010dn\u00edm selh\u00e1n\u00ed na <a href=\"http:\/\/www.srdcedycha.cz\/\">www.srdcedycha.cz<\/a>.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><em>Srde\u010dn\u00ed resynchroniza\u010dn\u00ed l\u00e9\u010dba = l\u00e9\u010debn\u00e1 metoda, kter\u00e1 se pou\u017e\u00edv\u00e1 u n\u011bkter\u00fdch pacient\u016f se srde\u010dn\u00edm selh\u00e1n\u00edm. Spo\u010d\u00edv\u00e1 v&nbsp;zaveden\u00ed speci\u00e1ln\u00edch elektrod do lev\u00e9 i prav\u00e9 komory srde\u010dn\u00ed, n\u011bkdy i do prav\u00e9 s\u00edn\u011b srde\u010dn\u00ed. Jejich \u010dinnost pak \u0159\u00edd\u00ed kardiostimul\u00e1tor, kter\u00fd je rovn\u011b\u017e zaveden do pacientova hrudn\u00edku.<\/em><\/li>\n\n\n\n<li><em>Ablace perzistuj\u00edc\u00ed fibrilace s\u00edn\u00ed = l\u00e9\u010debn\u00e1 metoda, p\u0159i kter\u00e9 se vpichem p\u0159es t\u0159\u00edsla do c\u00e9v zavedou katetry. Tyto ohebn\u00e9 n\u00e1stroje dok\u00e1\u017eou sn\u00edmat elektrick\u00e9 sign\u00e1ly a stimulovat srdce. P\u0159es takov\u00fd abla\u010dn\u00ed katetr se vy\u0161le do srdce vysokofrekven\u010dn\u00ed proud, kter\u00fd odstran\u00ed srde\u010dn\u00ed tk\u00e1\u0148 v m\u00edst\u011b, kde fibrilace s\u00edn\u00ed vznik\u00e1, a t\u00edm odstran\u00ed arytmii.<\/em><\/li>\n<\/ol>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"173\" height=\"260\" src=\"https:\/\/www.invarena.cz\/wp-content\/uploads\/14155-2-173x260.jpeg\" alt=\"\" class=\"wp-image-42999\"\/><figcaption class=\"wp-element-caption\">Autorem fotografie je pan Miloslav<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Miloslav (73) z&nbsp;Prahy byl a\u017e do sv\u00fdch 49 let aktivn\u00ed a nem\u011bl \u017e\u00e1dn\u00e9 v\u00e1\u017en\u011bj\u0161\u00ed zdravotn\u00ed probl\u00e9my. Srde\u010dn\u00ed infarkt, kter\u00fd jej v&nbsp;tomto v\u011bku postihl, byl proto <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=42998\" title=\"Infarkt Miloslava p\u0159ekvapil jako blesk z\u00a0\u010dist\u00e9ho nebe\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":43001,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-42998","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\/42998","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=42998"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/42998\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/43001"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=42998"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=42998"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=42998"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}