肺水肿合并左心衰伴二尖瓣不全1例报告

Paolo Ruggero Errante
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摘要

左心功能不全合并二尖瓣功能障碍是一种相关的心脏病理,对肺部有重要的影响,导致肺水肿。肺水肿对应于肺实质和肺泡内积液,可分为心源性和非心源性。临床体征和症状包括呼吸困难、咳嗽、呼吸急促和肺听诊时正常声音的改变。在本病例报告中,一只16岁雌性拉萨阿普索犬以冷漠、缺氧、咳嗽和呼吸困难的信号来到临床设施。经急诊氧疗稳定呼吸后,行影像学检查(x线片、多普勒超声心动图),确认怀疑为左心疾病心源性肺水肿。心功能障碍的治疗建议使用匹莫苯丹,它对心脏有积极的肌力作用,苯并普利,一种血管紧张素转换酶抑制剂。这些药物对控制肺血管压力,降低肺水肿的风险很重要。尽管这是一种兽医临床紧急情况,心源性肺水肿如果得到及时正确的治疗,往往会给受影响的狗带来良好的预后。
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A case report of pulmonary edema associated with left cardiac failure secondary with mitral insufficiency in dog
The cardiac left insufficiency with mitral dysfunction is a relevant cardiac pathology with importante repercussion in the lung, leads to pulmonary edema. Pulmonary edema corresponds to the accumulation of fluid in the lung parenchyma and alveoli, and can be classified as cardiogenic or non-cardiogenic. Clinical signs and symptoms include presence of dyspnea, cough, tachypnea, and alteration of normal sounds during lung auscultation. In this case report, a 16 year old female Lhasa Apso dog breed was presented to the clinical facility with signals of apathy, hyporexia, cough and dyspnea. After emergency treatment with oxygen therapy to stabilize the respiratory condition, imaging tests (radiography, Doppler echocardiography) were performed, confirming the suspicion of cardiogenic pulmonary edema due to left heart disease. The treatment of cardiac dysfunction was recommended through the use of pimobendan, which has a positive inotropic effect on the heart, and benzepril, an angiotensin-converting enzyme inhibitor. These drugs are important to control pulmonary vascular pressure, reducing the risk of developing pulmonary edema. Even though it is a veterinary clinical emergency, cardiogenic pulmonary edema when treated immediately and correctly tends to present a favorable prognosis in affected dogs.
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