Rodinn\u00fd v\u00fdlet na kole nebo standardn\u00ed tr\u00e9nink boxu. Dva r\u016fzn\u00ed mu\u017ei, kte\u0159\u00ed ned\u00e1vno pro\u017eili z\u00e1stavu srdce nebo infarkt, se shoduj\u00ed, \u017ee to p\u0159i\u0161lo z ni\u010deho nic. P\u0159itom byli zdrav\u00ed a chodili na preventivn\u00ed prohl\u00eddky. Podle l\u00e9ka\u0159\u016f se zvy\u0161uje trend onemocn\u011bn\u00ed kardiovaskul\u00e1rn\u00edch chorob u mlad\u00fdch lid\u00ed \u010d\u00edm d\u00e1l t\u00edm v\u00edc. Je\u0161t\u011b p\u0159ed deseti lety by z\u00e1chranu v n\u011bkter\u00fdch p\u0159\u00edpadech rovnou vzdali, nyn\u00ed dok\u00e1\u017eou pomoci i pacient\u016fm, kter\u00fdm srdce nebilo celou hodinu.<\/p>\n\n\n\n
Tehdy \u0161estat\u0159icetilet\u00fd pra\u017esk\u00fd z\u00e1chran\u00e1\u0159 zrovna skon\u010dil hodinu boxu. Po tr\u00e9ninku sed\u011bl na \u017eidli a deset minut na to omdlel. Tren\u00e9r zavolal z\u00e1chranku a za\u010dal s okam\u017eitou resuscitac\u00ed.<\/p>\n\n\n\n
\u201eZ\u00e1chran\u00e1\u0159i m\u011b nahodili po prvn\u00edm v\u00fdboji. M\u011bl jsem z\u00e1stavu srdce, ale pro\u010d se to stalo netu\u0161\u00edm. Cel\u00fd \u017eivot jsem sportoval, kv\u016fli pr\u00e1ci u z\u00e1chran\u00e1\u0159\u016f, ale i boxu, jsem chodil na pravideln\u00e9 kontroly i z\u00e1t\u011b\u017eov\u00e9 testy. Nezjistili mi ani zv\u00fd\u0161en\u00fd cholesterol nebo vysok\u00fd tlak,\u201c vypr\u00e1v\u00ed nyn\u00ed u\u017e jedna\u010dty\u0159icetilet\u00fd Jaroslav P\u011bkn\u00fd. Po p\u011bti letech ho zku\u0161enost v \u017eivot\u011b nijak neomezuje, a\u017e na jedno, u z\u00e1chran\u00e1\u0159\u016f musel skon\u010dit.<\/p>\n\n\n\n
\u201eNem\u016f\u017eu profesion\u00e1ln\u011b \u0159\u00eddit. Tak\u00e9 byl probl\u00e9m v denn\u00edch a no\u010dn\u00edch slu\u017eb\u00e1ch a celkov\u011b velk\u00e9 z\u00e1t\u011b\u017ei,\u201c up\u0159es\u0148uje s t\u00edm, \u017ee nyn\u00ed se \u017eiv\u00ed servisem aut.<\/p>\n\n\n\n
Ned\u00e1vnou zku\u0161enost s infarktem a z\u00e1stavou srdce prod\u011blal i akademik z pra\u017esk\u00e9 \u010cesk\u00e9 zem\u011bd\u011blsk\u00e9 univerzity Luk\u00e1\u0161 B\u00edlek. \u201eByl jsem na rodinn\u00e9m v\u00fdlet\u011b. S man\u017eelkou a d\u011btmi jsme jeli na kolo do Davle. V ur\u010ditou chv\u00edli jsem se zastavil a koukal do pr\u00e1zdna. Pak jsem se slo\u017eil v k\u0159e\u010di. Man\u017eelka zavolala z\u00e1chranku a za\u010dala s resuscitac\u00ed,\u201c vypr\u00e1v\u00ed s t\u00edm, \u017ee nikdy nekou\u0159il a dlouhodob\u011b byl zdrav\u00fd. Sice mu na ja\u0159e zjistili m\u00edrnou arytmii, ale nebylo to v\u00e1\u017en\u00e9 a pravideln\u011b chodil na kontroly.<\/p>\n\n\n\n
L\u00e9ka\u0159\u016fm pom\u00e1h\u00e1 funk\u010dn\u00ed syst\u00e9m z\u00e1chrany<\/p>\n\n\n\n
Srde\u010dn\u00ed z\u00e1stava postihne ro\u010dn\u011b v Praze a\u017e 700 lid\u00ed nejr\u016fzn\u011bj\u0161\u00edho v\u011bku, z toho p\u0159ibli\u017en\u011b 150 o\u0161et\u0159\u00ed kardiologov\u00e9 pr\u00e1v\u011b ve V\u0161eobecn\u00e9 fakultn\u00ed nemocnici. P\u0159itom syst\u00e9m pro z\u00e1chranu \u017eivota dok\u00e1\u017ee vr\u00e1tit zp\u011bt do \u017eivota pacienty se srde\u010dn\u00ed z\u00e1stavou nej\u010dast\u011bji p\u0159i infarktu myokardu, kte\u0159\u00ed d\u0159\u00edve m\u011bli mizivou \u0161anci na p\u0159e\u017eit\u00ed.<\/p>\n\n\n\n
P\u0159\u00edkladem je z\u00e1chrana pacienta, u kter\u00e9ho trvala srde\u010dn\u00ed z\u00e1stava celou hodinu. Podle zku\u0161enost\u00ed l\u00e9ka\u0159\u016f je Praha unik\u00e1tn\u00ed v tom, \u017ee jej\u00ed obyvatel\u00e9 v 80 % laici, poskytnou prvn\u00ed pomoc, tedy zah\u00e1j\u00ed laickou resuscitaci pacientovi, kter\u00fd zkolabuje na ulici. N\u00e1sleduje \u0159\u00edzen\u00e1 telefonicky prost\u0159edkovan\u00e1 resuscitace na lince 155, p\u0159\u00edpadn\u011b 112.<\/p>\n\n\n\n
Katetrizace a rehabilitace<\/p>\n\n\n\n
Potom, co je pacient p\u0159ijat do nemocnice, n\u00e1sleduje souhra rychl\u00fdch krok\u016f. \u201eMy se postar\u00e1me o odstran\u011bn\u00ed p\u0159\u00ed\u010diny z\u00e1stavy srdce, co\u017e je a\u017e v 60 procentech ischemick\u00e1 choroba srde\u010dn\u00ed, typicky akutn\u00ed infarkt myokardu,\u201c popisuje prim\u00e1\u0159 2. intern\u00ed kliniky kardiologie a angiologie 1. LF UK a VFN Jan B\u011blohl\u00e1vek a dopl\u0148uje: \u201eNa katetriza\u010dn\u00edm s\u00e1le zpr\u016fchodn\u00edme uzav\u0159enou nebo kriticky z\u00fa\u017eenou koron\u00e1rn\u00ed tepnu a pacienta d\u00e1le sledujeme na resuscita\u010dn\u00edm l\u016f\u017eku, kde prob\u00edhaj\u00ed dal\u0161\u00ed diagnostick\u00e9 a l\u00e9\u010debn\u00e9 postupy. Z\u00e1sadn\u00ed je komplexn\u00ed intenzivn\u00ed p\u00e9\u010de, org\u00e1nov\u00e1 podpora a p\u0159edev\u0161\u00edm neuroprognostifikace, tedy \u010dasn\u00e9 zji\u0161t\u011bn\u00ed, zda do\u0161lo \u010di nedo\u0161lo k po\u0161kozen\u00ed mozku.\u201c<\/p>\n\n\n\n
V optim\u00e1ln\u00edm p\u0159\u00edpad\u011b, co\u017e u srde\u010dn\u00edch z\u00e1stav trvaj\u00edc\u00edch kolem 60 minut nast\u00e1v\u00e1 v cca 25\u201330 % p\u0159\u00edpad\u016f, se pacient probere k v\u011bdom\u00ed a n\u00e1sleduje n\u011bkdy zna\u010dn\u011b komplikovan\u00e1 rehabilitace.<\/p>\n\n\n\n
Takov\u00fdto pr\u016fb\u011bh je samoz\u0159ejm\u011b ide\u00e1ln\u00ed, ale \u0159ada pacient\u016f m\u00e1 dal\u0161\u00ed komplikace, nap\u0159\u00edklad z\u00e1n\u011btlivou reakci organismu, org\u00e1nov\u00e9 poruchy, jako jsou nefunk\u010dn\u00ed ledviny, j\u00e1tra, po\u0161kozen\u00ed st\u0159ev, nav\u00edc jsou pacienti \u010dasto i metabolicky nestabiln\u00ed, co\u017e v\u0161e pat\u0159\u00ed k takzvan\u00e9 poresuscita\u010dn\u00ed chorob\u011b.<\/p>\n\n\n\n
Operace bij\u00edc\u00edho srdce bez zastaven\u00ed<\/p>\n\n\n\n
N\u00e1vrat do pln\u00e9ho \u017eivota u pacienta po tak t\u011b\u017ek\u00e9m inzultu, jako je protrahovan\u00e1 srde\u010dn\u00ed z\u00e1stava, neb\u00fdv\u00e1 jednoduch\u00fd. Po \u0159ad\u011b dn\u00ed na intenzivn\u00ed p\u00e9\u010di doch\u00e1z\u00ed k ochabnut\u00ed sval\u016f, vy\u010derp\u00e1n\u00ed energetick\u00fdch z\u00e1sob, a proto komplexn\u00ed rekonvalescence je p\u0159edpokladem dal\u0161\u00edho p\u0159\u00edzniv\u00e9ho pr\u016fb\u011bhu. \u0158ada nemocn\u00fdch toti\u017e v uveden\u00fdch p\u0159\u00edpadech trp\u00ed v\u00edce\u010detn\u00fdm posti\u017een\u00edm v\u011bn\u010dit\u00fdch tepen a pot\u0159ebuje tzv. kompletn\u00ed revaskularizaci v\u010detn\u011b proveden\u00ed chirurgick\u00fdch srde\u010dn\u00edch bypass\u016f. Jen pln\u011b revaskularizovan\u00fd pacient m\u00e1 dostate\u010dn\u011b sn\u00ed\u017een\u00e9 riziko dal\u0161\u00ed srde\u010dn\u00ed z\u00e1stavy. Proto je problematika pacienta v\u017edy diskutov\u00e1na v r\u00e1mci takzvan\u00e9ho \u201eHeart t\u00fdmu\u201c kardiocentra a pacient je ve vhodn\u00fdch p\u0159\u00edpadech indikov\u00e1n k chirurgick\u00e9mu v\u00fdkonu.<\/p>\n\n\n\n
Na 2. chirurgick\u00e9 klinice kardiovaskul\u00e1rn\u00ed chirurgie 1. LF UK a VFN prov\u00e1d\u011bj\u00ed l\u00e9ka\u0159i revaskularizaci myokardu (srde\u010dn\u00edho svalu) bypassy \u2013 p\u0159i nich se p\u0159emost\u00ed uzav\u0159en\u00e9 \u010di v\u00fdznamn\u011b z\u00fa\u017een\u00e9 m\u00edsto v c\u00e9vn\u00edm \u0159e\u010di\u0161ti pomoc\u00ed tepenn\u00fdch \u0161t\u011bp\u016f nebo \u017eil z doln\u00edch kon\u010detin.<\/p>\n\n\n\n
\u201eNaprostou v\u011bt\u0161inu opera\u010dn\u00edch v\u00fdkon\u016f tohoto typu prov\u00e1d\u00edme na bij\u00edc\u00edm srdci, co\u017e je technicky n\u00e1ro\u010dn\u011bj\u0161\u00ed pro chirurga, ale m\u00e9n\u011b zat\u011b\u017euj\u00edc\u00ed pro pacienta,\u201c vysv\u011btluje p\u0159ednosta 2. chirurgick\u00e9 kliniky 1. LF UK a VFN Tom\u00e1\u0161 Grus a pokra\u010duje: \u201eZ\u00e1t\u011b\u017e pro srdce i cel\u00fd organismus je daleko ni\u017e\u0161\u00ed, v\u00fdkon trv\u00e1 o n\u011bco krat\u0161\u00ed dobu, pacient m\u00e1 ni\u017e\u0161\u00ed krevn\u00ed ztr\u00e1ty a takov\u00e1 operace t\u00e9\u017e m\u00e9n\u011b zat\u011b\u017euje ledviny a pl\u00edce nemocn\u00e9ho.\u201c<\/p>\n\n\n\n
Pokud je t\u0159eba opravit pouze jednu, hlavn\u00ed tepnu na srdci, vol\u00ed chirurgov\u00e9 miniinvazivn\u00ed postup, kdy pouze z kr\u00e1tk\u00e9ho \u0159ezu pod prsn\u00ed bradavkou odeberou vnit\u0159n\u00ed prsn\u00ed tepnu a tou p\u0159emost\u00ed posti\u017een\u00fd \u00fasek koron\u00e1rn\u00ed tepny. U star\u0161\u00edch a nemocn\u00fdch pacient\u016f postupuj\u00ed ve spolupr\u00e1ci s kardiology cestou takzvan\u00e9 hybridn\u00ed revaskularizace myokardu, kdy provedou miniinvazivn\u00ed operaci a ostatn\u00ed z\u00fa\u017een\u00e9 tepny na srdci o\u0161et\u0159\u00ed katetriza\u010dn\u011b s pomoc\u00ed koron\u00e1rn\u00edch stent\u016f. Obecn\u00fdm trendem je \u010dasn\u00e1 poopera\u010dn\u00ed rehabilitace.<\/p>\n\n\n\n
N\u00e1vrat do b\u011b\u017en\u00e9ho \u017eivota<\/p>\n\n\n\n
Pacienti se probouz\u00ed za n\u011bkolik des\u00edtek minut po operaci. \u201ePo dosp\u00e1n\u00ed pacientovi tlum\u00edme poopera\u010dn\u00ed bolest l\u00e9ky a u\u017e druh\u00fd den za\u010d\u00edn\u00e1 op\u011bt rehabilitovat,\u201c dod\u00e1v\u00e1 Grus. N\u00e1sleduje konzultace s dal\u0161\u00edmi l\u00e9ka\u0159i, kter\u00e1 se t\u00fdk\u00e1 i zm\u011bny \u017eivotn\u00edho stylu a t\u0159eba i l\u00e9\u010dby z\u00e1vislosti na kou\u0159en\u00ed.<\/p>\n\n\n\n
V p\u0159\u00edpad\u011b pacient\u016f Luk\u00e1\u0161e B\u00edlka a Jaroslava P\u011bkn\u00e9ho byl pobyt v nemocnici dlouh\u00fd jen zhruba t\u00fdden. Nyn\u00ed doch\u00e1z\u00ed na pravideln\u00e9 p\u016flro\u010dn\u00ed kontroly, ale sv\u016fj \u017eivot \u017eij\u00ed prakticky bez omezen\u00ed.<\/p>\n\n\n\n
Eli\u0161ka Stodolov\u00e1<\/p>\n\n\n\n
Pra\u017esk\u00fd den\u00edk<\/p>\n\n\n\n
https:\/\/prazsky.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Rodinn\u00fd v\u00fdlet na kole nebo standardn\u00ed tr\u00e9nink boxu. Dva r\u016fzn\u00ed mu\u017ei, kte\u0159\u00ed ned\u00e1vno pro\u017eili z\u00e1stavu srdce nebo infarkt, se shoduj\u00ed, \u017ee to p\u0159i\u0161lo z ni\u010deho […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14098,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-43550","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/43550","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=43550"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/43550\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14098"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=43550"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=43550"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=43550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}