{"id":62001,"date":"2025-11-21T10:39:08","date_gmt":"2025-11-21T09:39:08","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=62001"},"modified":"2025-11-21T10:47:28","modified_gmt":"2025-11-21T09:47:28","slug":"vysoky-tlak-v-plicnich-cevach-lecili-martinovi-pomoci-pumpy","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=62001","title":{"rendered":"Vysok\u00fd tlak v\u00a0plicn\u00edch c\u00e9v\u00e1ch l\u00e9\u010dili Martinovi pomoc\u00ed pumpy"},"content":{"rendered":"\n

Probl\u00e9my s d\u00fdch\u00e1n\u00edm za\u010dal m\u00edt Martin (55) z Loun p\u0159ed p\u011bti lety \u2013 pot\u00e9, co prod\u011blal covid-19. \u201eDlouho jsem tomu nev\u011bnoval pozornost. Zad\u00fdch\u00e1v\u00e1n\u00ed jsem p\u0159i\u010d\u00edtal pr\u00e1v\u011b covidu,\u201c<\/em> \u0159\u00edk\u00e1 Martin. Pot\u00ed\u017ee ale p\u0159etrv\u00e1valy a tr\u00e1pily ho st\u00e1le \u010dast\u011bji, v pr\u00e1ci i doma. Martin zpozorn\u011bl a\u017e po t\u0159ech m\u011bs\u00edc\u00edch, kdy u\u017e nedok\u00e1zal vyj\u00edt bez zast\u00e1vky schody ke sv\u00e9mu bytu. \u201eVede k n\u011bmu jen 15 schod\u016f. Musel jsem si ale v\u017edy dvakr\u00e1t odpo\u010dinout, ne\u017e jsem je vy\u0161el,\u201c<\/em> popisuje.<\/p>\n\n\n\n

Martin se proto v b\u0159eznu roku 2021 objednal na vy\u0161et\u0159en\u00ed do plicn\u00ed ambulance na poliklinice v Praze. P\u0159\u00ed\u010dinu zad\u00fdch\u00e1v\u00e1n\u00ed tam v\u0161ak neodhalili. \u201ePan\u00ed doktorka mi na zm\u00edrn\u011bn\u00ed obt\u00ed\u017e\u00ed p\u0159edepsala kortikoidy a doporu\u010dila mi inhalace. To v\u0161e sice na n\u011bjakou dobu pomohlo, po p\u00e1r t\u00fddnech se ale probl\u00e9my s d\u00fdch\u00e1n\u00edm vr\u00e1tily,\u201c<\/em> vzpom\u00edn\u00e1 Martin. O\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159ka ho proto odeslala na podrobn\u011bj\u0161\u00ed vy\u0161et\u0159en\u00ed do Institutu klinick\u00e9 a experiment\u00e1ln\u00ed medic\u00edny (IKEM), kde se dostal do p\u00e9\u010de doc. MUDr. Hikmeta Al-Hitiho, Ph.D. Martin v nemocnici podstoupil katetrizaci \u2013 z\u00e1krok, p\u0159i kter\u00e9m se m\u011b\u0159\u00ed krevn\u00ed tlak v plic\u00edch. \u201eL\u00e9ka\u0159i zjistili, \u017ee u m\u011b doch\u00e1z\u00ed k velk\u00e9mu vzestupu krevn\u00edho tlaku v plicn\u00edch c\u00e9v\u00e1ch. Vysv\u011btlili mi, \u017ee jedn\u00e1 o tzv. idiopatickou plicn\u00ed arteri\u00e1ln\u00ed hypertenzi \u2013 nemoc, p\u0159i kter\u00e9 se spr\u00e1vn\u011b neokysli\u010duje krev v plic\u00edch. Proto jsem se zad\u00fdch\u00e1val,\u201c<\/em> up\u0159es\u0148uje Martin.<\/p>\n\n\n\n

V IKEM mu ihned nasadili l\u00e9\u010dbu a Martin tam pak jezdil na pravideln\u00e9 kontroly. Pot\u00ed\u017ee s dechem m\u011bl ale st\u00e1le, a to i p\u0159i minim\u00e1ln\u00ed z\u00e1t\u011b\u017ei. \u201eMusel jsem p\u0159estat chodit do pr\u00e1ce, nebylo to mo\u017en\u00e9. Skon\u010dil jsem v pln\u00e9m invalidn\u00edm d\u016fchodu,\u201c<\/em> popisuje. Jeho zdravotn\u00ed stav se zlep\u0161il a\u017e pot\u00e9, co mu l\u00e9\u010divou l\u00e1tku za\u010dala v pravideln\u00fdch intervalech d\u00e1vkovat mal\u00e1 pumpa, kterou Martin nosil st\u00e1le u sebe. \u201eVedla z n\u00ed tenk\u00e1 hadi\u010dka do podko\u017e\u00ed v b\u0159i\u0161e. Ka\u017ed\u00fdch 6 t\u00fddn\u016f se p\u0159epichovala na jin\u00e9 m\u00edsto na b\u0159i\u0161e,\u201c<\/em> dopl\u0148uje Martin.<\/p>\n\n\n\n

Pozd\u011bji mu v nemocnici zavedli do t\u011bla je\u0161t\u011b \u010dip, kter\u00fd dok\u00e1\u017ee zm\u011b\u0159it krevn\u00ed tlak v plic\u00edch. \u201eDoma m\u00e1m speci\u00e1ln\u00ed podlo\u017eku a ovlada\u010d. Kdy\u017e si na ni lehnu a ovlada\u010dem ji aktivuji, podlo\u017eka hodnotu krevn\u00edho tlaku sejme a data ode\u0161le do IKEM. Pan docent Al-Hiti tak m\u00e1 p\u0159esn\u00fd p\u0159ehled o tom, jak se m\u016fj krevn\u00ed tlak vyv\u00edj\u00ed, a podle toho upravuje d\u00e1vky l\u00e9ku,\u201c <\/em>popisuje Martin, kter\u00fd po zaveden\u00ed \u010dipu odes\u00edlal data do nemocnice ka\u017ed\u00fd den.<\/p>\n\n\n\n

V roce 2024 Martinovi l\u00e9ka\u0159i zm\u011bnili zp\u016fsob terapie. Nov\u00e9 l\u00e9ky fungovaly tak dob\u0159e, \u017ee mu o n\u011bkolik m\u011bs\u00edc\u016f pozd\u011bji mohli z t\u011bla vyjmout pumpu. \u201eOd t\u00e9 doby chod\u00edm do IKEM u\u017e jen na injekce, a to jednou za t\u0159i t\u00fddny. \u010cip m\u00e1m st\u00e1le a hodnoty krevn\u00edho tlaku v plic\u00edch pos\u00edl\u00e1m do nemocnice dvakr\u00e1t t\u00fddn\u011b. Je neuv\u011b\u0159iteln\u00e9, jak l\u00e9\u010dba za posledn\u00edch p\u00e1r let pokro\u010dila,\u201c<\/em> usm\u00edv\u00e1 se Martin, jeho\u017e zdravotn\u00ed stav je v sou\u010dasn\u00e9 dob\u011b stabilizovan\u00fd. Probl\u00e9my s dechem m\u00e1 jenom p\u0159i vy\u0161\u0161\u00ed z\u00e1t\u011b\u017ei. \u201eNau\u010dil jsem se se svou nemoc\u00ed \u017e\u00edt a nam\u00e1hav\u00fdm aktivit\u00e1m se vyh\u00fdb\u00e1m. D\u0159\u00edv jsem hodn\u011b sportoval, bavilo m\u011b judo a karate. Te\u010f m\u00e1m jin\u00fd kon\u00ed\u010dek \u2013 zaj\u00edm\u00e1m se o historii, \u010dasto nav\u0161t\u011bvuji muzea a prohled\u00e1v\u00e1m archivy. Voln\u00fd \u010das r\u00e1d tr\u00e1v\u00edm i v p\u0159\u00edrod\u011b, na proch\u00e1zk\u00e1ch s man\u017eelkou a synem. Oba jsou mou velkou oporou,\u201c<\/em> uzav\u00edr\u00e1 Martin.<\/p>\n\n\n\n

Plicn\u00ed arteri\u00e1ln\u00ed hypertenze (PAH) postihuje mu\u017ee i \u017eeny v\u0161ech v\u011bkov\u00fdch kategori\u00ed. Krom\u011b zdravotn\u00edch komplikac\u00ed m\u00e1 nemoc i v\u00fdrazn\u00fd socioekonomick\u00fd dopad. P\u0159ibli\u017en\u011b 81 % pacient\u016f pob\u00edr\u00e1 v produktivn\u00edm v\u011bku invalidn\u00ed d\u016fchod, dv\u011b t\u0159etiny z nich dokonce nejvy\u0161\u0161\u00ed, t\u0159et\u00ed stupe\u0148. Jen 31 % nemocn\u00fdch je ekonomicky aktivn\u00edch a pouze 14 % z nich pracuje na pln\u00fd \u00favazek. Nem\u00e9n\u011b velk\u00fd dopad m\u00e1 onemocn\u011bn\u00ed i na pe\u010dovatele o pacienty, kte\u0159\u00ed zpravidla mus\u00ed zastat v\u0161echny \u010dinnosti, kter\u00e9 pacient vlivem nemoci nezvl\u00e1dne, co\u017e je \u010dasov\u011b, finan\u010dn\u011b i psychicky velmi n\u00e1ro\u010dn\u00e9.<\/p>\n\n\n\n

Koment\u00e1\u0159 doc. MUDr. Hikmeta Al-Hitiho, Ph.D., koordin\u00e1tora centra pro l\u00e9\u010dbu plicn\u00ed hypertenze v IKEM:<\/strong><\/p>\n\n\n\n

\u201eZa posledn\u00edch 30 let do\u0161lo k v\u00fdrazn\u00e9mu pokroku v komplexn\u00edm p\u0159\u00edstupu k l\u00e9\u010db\u011b plicn\u00ed arteri\u00e1ln\u00ed hypertenze, a to d\u00edky pochopen\u00ed nov\u00fdch patofyziologick\u00fdch cest s n\u00e1slednou modern\u00ed farmakoterapi\u00ed. Do\u0161lo tak\u00e9 ke zlep\u0161en\u00ed screeningu rizikov\u00fdch skupin nemocn\u00fdch.<\/em><\/p>\n\n\n\n

D\u016fle\u017eit\u00e9 je v\u011bd\u011bt, \u017ee PAH nem\u00e1 specifick\u00e9 p\u0159\u00edznaky, a proto se \u010dasto rozpozn\u00e1v\u00e1 pozd\u011b. Nej\u010dast\u011bj\u0161\u00edmi pot\u00ed\u017eemi nemocn\u00fdch s PAH jsou progreduj\u00edc\u00ed n\u00e1mahov\u00e1 du\u0161nost a mal\u00e1 v\u00fdkonnost. P\u0159i podez\u0159en\u00ed na PAH je krom\u011b anamn\u00e9zy a fyzik\u00e1ln\u00edho n\u00e1lezu d\u016fle\u017eit\u00e9 proveden\u00ed echokardiografick\u00e9ho vy\u0161et\u0159en\u00ed. Kl\u00ed\u010dov\u00fdm vy\u0161et\u0159en\u00edm, kter\u00e9 se prov\u00e1d\u00ed ve specializovan\u00e9m centru, je pravostrann\u00e1 srde\u010dn\u00ed katetrizace. Ta umo\u017en\u00ed potvrzen\u00ed p\u0159\u00edtomnosti PAH (nebo jin\u00e9ho typu plicn\u00ed hypertenze) a dovoluje odhadnout progn\u00f3zu. Sou\u010d\u00e1st\u00ed vy\u0161et\u0159en\u00ed p\u0159i potvrzen\u00ed PAH je i tzv. test <\/em>plicn\u00ed vazoreaktivity<\/em>, kter\u00fd pom\u00e1h\u00e1 ur\u010dit vhodn\u00fd druh l\u00e9\u010dby.<\/em><\/p>\n\n\n\n

Vzhledem k tomu, \u017ee l\u00e9\u010dba PAH je slo\u017eit\u00e1 a vy\u017eaduje \u010dast\u00e9 hemodynamick\u00e9 monitorov\u00e1n\u00ed, m\u011bla by se soust\u0159e\u010fovat do vysoce specializovan\u00fdch center s dlouhodob\u00fdmi zku\u0161enostmi s testov\u00e1n\u00edm reverzibility PAH. Tato centra by m\u011bla poskytovat i konzulta\u010dn\u00ed slu\u017eby a pom\u00e1hat p\u0159i diagnostice PAH.\u201c<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Probl\u00e9my s d\u00fdch\u00e1n\u00edm za\u010dal m\u00edt Martin (55) z Loun p\u0159ed p\u011bti lety \u2013 pot\u00e9, co prod\u011blal covid-19. \u201eDlouho jsem tomu nev\u011bnoval pozornost. Zad\u00fdch\u00e1v\u00e1n\u00ed jsem p\u0159i\u010d\u00edtal pr\u00e1v\u011b covidu,\u201c […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":62005,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-62001","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\/62001","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=62001"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/62001\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/62005"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=62001"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=62001"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=62001"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}