{"id":24,"date":"2024-04-04T06:59:26","date_gmt":"2024-04-04T03:59:26","guid":{"rendered":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/kardiomuopaatiad\/"},"modified":"2024-04-04T06:59:56","modified_gmt":"2024-04-04T03:59:56","slug":"kardiomuopaatiad","status":"publish","type":"page","link":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/kardiomuopaatiad\/","title":{"rendered":"Kardiom\u00fcopaatiad"},"content":{"rendered":"<p>\n\tSagedasemad on h\u00fcpertroofiline ja dilatatiivne kardiom\u00fcopaatia.\n<\/p>\n<p>\n\tIseloomulik: s\u00fcdamer\u00fctmih\u00e4ired, valu s\u00fcdame piirkonnas, hingeldus, koormustaluvuse langus. Samas, kardiomuopaatiad v\u00f5ivad kulgeda ka ilma igasuguse s\u00fcmptomaatikata!\n<\/p>\n<p>\n\tMuutused EKG-s: s\u00fcdame r\u00fctmih\u00e4ired, repolarisatsioonih\u00e4ired.\n<\/p>\n<p>\n\tDiagnoosi kinnitab ehhokardiograafia, r\u00f6ntgen\u00fclesv\u00f5te rindkerest.\n<\/p>\n<p>\n\tKardiom\u00fcopaatiate korral on \u00c4S risk t\u00f5usnud (kuna v\u00f5ib tekkida s\u00fcdame diastoolse t\u00e4itumise h\u00e4ire, s\u00fcdame minutimahu langus koormuse ajal, r\u00fctmih\u00e4ired, s\u00fcdamelihase isheemia pingutuse ajal).\n<\/p>\n<p>\n\t<strong>NB! V\u00f5istlus- ja harrastusspordiga tegelemiseks loa andmisel on vajalik individuaalne otsus iga \u00fcksikjuhu puhul!<\/strong>\n<\/p>\n<p style=\"text-align: center\">\n\t<img loading=\"lazy\" decoding=\"async\" width=\"665\" height=\"379\" class=\"alignnone wp-image-80\" src=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-12_at_09.16.39.png\" title=\"screenshot_2021-02-12_at_09.16.39.png\" alt=\"Joonis 6\" srcset=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-12_at_09.16.39.png 665w, https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-12_at_09.16.39-300x171.png 300w\" sizes=\"auto, (max-width: 665px) 100vw, 665px\">\n<\/p>\n<p>\n\t<strong>Joonis 7. Rindkere r\u00f6ntgen\u00fclesv\u00f5te v\u00e4ljendunud kardiom\u00fcopaatia korral.<\/strong>\n<\/p>\n<p>\n\t<b>H\u00fcpertroofiline kardiom\u00fcopaatia<\/b> (<span lang=\"ET\"><span style=\"line-height:115%\"><i>hypertrophic cardiomyopathy \u2013 HCM<\/i>) \u2013 enne kehalise aktiivsuse soovituste andmist on vaja patsienti p\u00f5hjalikult uurida: anamnees (pereanamnees, HCM fenot\u00fc\u00fcbi raskusaste, akksurma\u00a0riskifaktorid; vanematel patsientidel kaasuvate kardioloogiliste patoloogiate \u2013 h\u00fcpertensioon, koronaarhaigus \u2013 esinemine), kardioloogiline uuring (KPKT, EhhoKG, MRT), ESC HCM-\u00c4S riski skoori (vanus, s\u00fcnkoop, \u00c4S perekonnas, VV seina paksus, vasaku koja diameeter, VV v\u00e4ljavoolutrakti obstruktsioon, mittep\u00fcsiv ventrikulaarne tahh\u00fckardia) kalkuleerimine. <\/span><\/span>\n<\/p>\n<p>\n\t<span lang=\"ET\"><span style=\"line-height:115%\">Mida enam on v\u00e4ljendunud koormusaegsed s\u00fcmptomid, seda konservatiivsemad peavad olema liikumissoovitused (tabel 17). Kui anamneesis on s\u00fcdameseiskumine v\u00f5i s\u00fcnkoop, siis on lubatud ainult madala intensiivsusega vabal ajal sportimine. K\u00f5rge intensiivsusega d\u00fcnaamilised start-stop spordialad (korvpall, jalgpall) on k\u00f5rgema \u00c4S riskiga.<\/span><\/span>\n<\/p>\n<p style=\"margin-bottom:0cm\">\n\t<strong><span lang=\"ET\"><span style=\"line-height:115%\">Tabel 17. Liikumisaktiivsuse ja sportimise soovitused h\u00fcpertroofilise kardiom\u00fcopaatia korral.<\/span><\/span><\/strong>\n<\/p>\n<p>\n\t<img loading=\"lazy\" decoding=\"async\" width=\"725\" height=\"363\" class=\"alignnone wp-image-83\" src=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-19_at_10.58.44.png\" title=\"screenshot_2021-02-19_at_10.58.44.png\" alt=\"Tabel 13 a\" srcset=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-19_at_10.58.44.png 725w, https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-19_at_10.58.44-300x150.png 300w\" sizes=\"auto, (max-width: 725px) 100vw, 725px\"><img loading=\"lazy\" decoding=\"async\" width=\"725\" height=\"199\" class=\"alignnone wp-image-84\" src=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-19_at_11.00.16.png\" title=\"screenshot_2021-02-19_at_11.00.16.png\" alt=\"Tabel 13 B\" srcset=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-19_at_11.00.16.png 725w, https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-19_at_11.00.16-300x82.png 300w\" sizes=\"auto, (max-width: 725px) 100vw, 725px\">\n<\/p>\n<p>\n\tHCM k\u00f5rgenenud riski n\u00e4itajateks on: kardiaalsed s\u00fcmptomid v\u00f5i s\u00fcdameseiskus v\u00f5i seletamatu s\u00fcnkoop, m\u00f5\u00f5dukas ESC 5-aasta suremuse riski skoor (&gt;4%), vasaku vatsakese v\u00e4javoolutrakti\u00a0gradient puhkeolekus &gt; 30 mmHg, patoloogiline verer\u00f5hu\u00a0reaktsioon koormusele, koormusel vallanduvad ar\u00fctmiad.\n<\/p>\n<p>\n\t<strong>NB! V\u00e4ljendunud \u201eSportlase s\u00fcdame\u201c korral on vajalik diferentsiaaldiagnostika s\u00fcdamehaigusest (joonis 8).<\/strong>\n<\/p>\n<p style=\"text-align: center\">\n\t<img loading=\"lazy\" decoding=\"async\" width=\"691\" height=\"390\" class=\"alignnone wp-image-81\" src=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-12_at_09.18.10.png\" title=\"screenshot_2021-02-12_at_09.18.10.png\" alt=\"Joonis 7\" srcset=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-12_at_09.18.10.png 691w, https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-12_at_09.18.10-300x169.png 300w\" sizes=\"auto, (max-width: 691px) 100vw, 691px\">\n<\/p>\n<p style=\"margin-bottom: 0cm\">\n\t<strong><span style=\"line-height:150%\"><span lang=\"ET\"><span style=\"line-height:150%\">Joonis 8. \u201eSportlase s\u00fcdame\u201c ja kardiom\u00fcopaatiate diferentsiaaldiagnostika (<i>Maron BJ. Sudden Death in Young Athletes. N Engl J Med. 2003;349:1064\u20131075<\/i>).\u00a0<\/span><\/span><\/span><\/strong>\n<\/p>\n<p style=\"margin-bottom: 0cm\">\n\t<span style=\"line-height:150%\"><span lang=\"ET\"><span style=\"line-height:150%\">AC \u2013 ar\u00fctmogeenne kardiom\u00fcopaatia (<i>arrhythmogenic cardiomyopathy<\/i>), <\/span><\/span><\/span><span style=\"line-height:150%\"><span lang=\"ET\"><span style=\"line-height:150%\">HCM \u2013 h\u00fcpertroofiline kardiom\u00fcopaatia (<i>hypertrophic cardiomyopathy<\/i>), <\/span><\/span><\/span><span style=\"line-height:150%\"><span lang=\"ET\"><span style=\"line-height:150%\">VV \u2013 vasak vatsake, <\/span><\/span><\/span><span style=\"line-height:150%\"><span lang=\"ET\"><span style=\"line-height:150%\">VD \u2013 vasaku vatsakese diameeter diastolis<\/span><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Sagedasemad on h\u00fcpertroofiline ja dilatatiivne kardiom\u00fcopaatia. Iseloomulik: s\u00fcdamer\u00fctmih\u00e4ired, valu s\u00fcdame piirkonnas, hingeldus, koormustaluvuse langus. Samas, kardiomuopaatiad v\u00f5ivad kulgeda ka ilma igasuguse s\u00fcmptomaatikata! Muutused EKG-s: s\u00fcdame r\u00fctmih\u00e4ired, repolarisatsioonih\u00e4ired. Diagnoosi kinnitab ehhokardiograafia, r\u00f6ntgen\u00fclesv\u00f5te rindkerest. Kardiom\u00fcopaatiate korral on \u00c4S risk t\u00f5usnud (kuna v\u00f5ib &#8230;<\/p>\n","protected":false},"author":243,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-24","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/pages\/24","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/users\/243"}],"replies":[{"embeddable":true,"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/comments?post=24"}],"version-history":[{"count":1,"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/pages\/24\/revisions"}],"predecessor-version":[{"id":186,"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/pages\/24\/revisions\/186"}],"wp:attachment":[{"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/media?parent=24"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}