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Vladimir Jovanović Kliničko bolnički centar Zemun Medicinski fakultet u Beogradu

2019. Heart Team Slučaj 1. Vladimir Jovanović Kliničko bolnički centar Zemun Medicinski fakultet u Beogradu. Gospodja , 78 godina Pre 6 meseci imala jak bol u grudima sa preznojavanjem u trajanju od 4 sata, javila se lekaru - dobila Ranisan Stabilna angina, CCS I/II

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Vladimir Jovanović Kliničko bolnički centar Zemun Medicinski fakultet u Beogradu

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  1. 2019 Heart Team Slučaj 1 Vladimir Jovanović KliničkobolničkicentarZemun Medicinskifakultet u Beogradu

  2. Gospodja, 78 godina • Pre 6 meseci imala jak bol u grudima sa preznojavanjem u trajanju od 4 sata, javila se lekaru - dobila Ranisan • Stabilna angina, CCS I/II • Upućena na Dobutamin stres eho test • Faktori rizika: HTA,HLP

  3. DBT stres eho Basal Low Peak Rest

  4. DBT stres eho Basal Low Peak Rest

  5. DBT stres eho Basal Low Peak Rest

  6. DBT stres eho Basal Low Peak Rest

  7. DBT stres eho Basal Low Peak Rest

  8. DBT test/EKG:početak testa

  9. DBT test/EKG:peak- bez bola !

  10. DBT test/EKG:peak- bez bola !

  11. DBT test/EKG:nakon testa

  12. Koronarografija - RCA

  13. Koronarografija - LCA

  14. Klinički tok • Bez bolova u grudima • hs Troponin negativan

  15. Laboratorijskeanalize KKS: Le: 7.7Er: 4.02Hgb: 132 Hct:0.39Tr:210 Gl: 5,8CRP: 1.1 Fib: 4.60Trig:1.72Hol:4,93 K: 4.1Na:137Ca:2.51 Cl: 96AST: 34ALT: 21 Urea: 6.0Kreat: 79 hs Troponin I: 13.8…35.8…17.8…16.8 GFR 64ml/min/1.73 m²BMI 29.7kg/m2

  16. SKOROVI • SYNTAX I: 24 • SYNTAX II: CABG or PCI - PCISYNTAX Score II:38.9,PCI 4-Year Mortality: 13.9% - CABGSYNTAX Score II:35,CABG4-Year Mortality: 10.2% • EUROSCORE II: 1.39% • STS SCORE mortality: 1,77%

  17. Šta je vaš predlog ? • Medikamentozna terapija • PCI • CABG • Dodatna dijagnostika

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