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Chronische Herzinsuffizienz im Gefolge von Herzmuskelerkrankungen — Herzdynamik, Klinik und Therapie

  • H.-D. Bolte
Part of the Handbuch der inneren Medizin book series (INNEREN, volume 9 / 4)

Zusammenfassung

Das Syndrom der chronischen Herzinsuffizienz kann sehr vielfältige Ursachen haben, die nicht allein in Störungen der Myokardfunktion selbst zu suchen sind. So sind zahlreiche Störungen durch Druck- und Volumenbelastungen des Herzmuskels als Pumpe bedingt im Sinne von Erhöhungen der sog. Vorlast und Nachlast des Herzens, wobei zumindest im Beginn Störungen der Funktion des kontraktilen Myokards nicht anzunehmen sind. So ist z.B. eine chronische Herzinsuffizienz im Rahmen einer Perikardtamponade nicht als Stöning einer Funktion des Herzmuskels im engeren Sinne aufzufassen. Außerdem ist z.B. bei Aortenstenose die Funktionsfähigkeit des Myokards im allgemeinen nicht eingeschränkt, wenn man einmal von Begriffen und Phänomenen der sog. inadäquaten Hypertrophie absieht. Im Unterschied zu Störungen der Pumpfunktion die durch chronische Überlastung (Druck oder Volumen) oder eingeschränkte ventrikuläre Füllung (Herzbeuteltamponade) hervorgerufen werden, sollen im folgenden Herzerkrankungen als Folgen einer Verminderung der kontraktilen Funktion der Muskulatur im Sinne von Herzmuskelerkrankungen erörtert werden.

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