Cardiac Auscultation for Noncardiologists: Application in Cardiac Rehabilitation Programs: PART I: PATIENTS AFTER ACUTE CORONARY SYNDROMES AND HEART FAILURE.

摘要: During outpatient cardiac rehabilitation after an acute coronary syndrome or episode of congestive heart failure, a careful, periodic evaluation patients' clinical and hemodynamic status is essential. Simple traditional auscultation could play role in providing useful prognostic information.Reduced intensity the first sound (S1), especially when associated with prolonged apical impulse appearance added sounds, may help identify left ventricular (LV) dysfunction conduction disturbances, sometimes transient myocardial ischemia. If both S1 second (S2) are reduced intensity, pericardial effusion be suspected, whereas increased S2 indicate pulmonary artery pressure. The persistence protodiastolic (S3) indicator severe LV poor prognosis. In patients association S3 elevated rate impending decompensation. A presystolic (S4) often although it also present hypertensive aneurysm. Careful systolic murmurs identifying possible mitral valve pathology, differentiate them from ruptured papillary muscle septal rupture. Friction rubs infarction, due to reactive pericarditis Dressler syndrome, complicated course.During rehabilitation, provide information about clinical-hemodynamic allow timely detection signs, heralding complications efficient low-cost manner.