摘要
在讲授《内科学》肥厚型心肌病时,发现部分医学工具书在上述章节中疑将“作Valsalva动作、取直立位、含服硝酸甘油”等归入减轻心脏后负荷的措施。从解剖学、病理生理学等角度来看,上述措施的主要作用是减少回心血量,减轻心脏前负荷,这符合权威医学专著中针对上述措施如何发挥病理生理学作用的机制描述。本文参考医学专著及文献,详细阐述梗阻性肥厚型心肌病心脏杂音变化的机制,对现有医学工具书中相关阐述提供修改意见,以供同行教学时作为参考。
When teaching hypertrophic cardiomyopathy in Internal Medicine,it was found that some medical reference books suspected that"performing Valsalva maneuver,taking an upright position,and taking nitroglycerin"were included as measures to reduce cardiac afterload in the above chapters.From the perspectives of anatomy,pathophysiology,etc.,the main function of the above measures is to reduce the amount of cardiac return blood and alleviate cardiac preload,which is consistent with the mechanism description in authoritative medical monographs on how the above measures exert their pathophysiological effects.This article refers to medical monographs and literature to elaborate on the mechanism of heart murmur changes in obstructive hypertrophic cardiomyopathy,and provides revision suggestions for relevant explanations in existing medical reference books for reference in peer teaching.
作者
金虹云
陈兴
JIN Hong-yun;CHEN Xing(Department of Geriatrics,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,Guangdong,China)
出处
《继续医学教育》
2025年第7期126-129,共4页
Continuing Medical Education
基金
广东省教育科学规划课题(2021GXJK446)。
关键词
内科学
肥厚型心肌病
心脏杂音
心脏前负荷
心脏后负荷
medicine
hypertrophic cardiomyopathy
heart murmur
cardiac preload
cardiac afterload
