Author/Editor		Golob-Gulič, Tatjana; Bombek, Mirko; Podlesnikar, Tomaž
Title		Vodnje bolnika z okvaro srčnih zaklopk v ambulanti družinske medicine
Type		članek
Source		In: Hojs R, editor. Zbornik prispevkov 20. srečanje internistov in zdravnikov družinske medicine "Iz prakse za prakso" ; 2009 maj 8-9; Maribor. Maribor: Univerzitetni klinični center,
Publication year		2009
Volume		str. 133-42
Language		slo
Abstract		A general practitioner is frequently encountered with patients with valvular heart disease (VHD), which might be congenital or acquired. It is important to consider this option so that the patient can be appropriately directed for further diagnostic evaluation. Patients with severe VHD are predominantly supervised by a cardiologists, who are in charge of further management of patient's disease, namely directing patients for invasive, surgical treatment or taking more conservative approach using medications. Patients before and after the surgery, as well as those who are treated conservatively, keep returning to the general practitioner's office due to VHD related complications or concomitant diseases. The general practitioner should differentiate between symptoms and signs that are a consequence of VHD and indicate worsening of the disease, as well as those signs and symptoms which speak in favor of another concomitant disease. It is important to decide correctly which patients need an urgent specialist's examination, which should be checked preferentially by a cardiologist and which patients would benefit from the modification of therapy. The latter don't need to be referred to a specialist, however in case of any doubt, a general practitioner is always welcome to consult patient's personal cardiologist.
Summary		Družinski zdravnik v svoji ambulanti pogosto sreča bolnike z napakami srčnih zaklopk (NSZ); te so lahko prirojene ali pridobljene. Pomembno je, da pomisli na to možnost in bolnika ustrezno usmeri na dodatne preiskave, ki diagnozo potrdijo ali ovržejo. Praviloma bolnike s težko NSZ vodijo specialisti kardiologi, lahko jih usmerijo v invazivno, operativno zdravljenje ali zdravijo konzervativno, medikamentno, torej z zdravili. Bolniki pred ali po operaciji, kakor tudi bolniki, ki so zdravljeni konzervativno, se vračajo k družinskemu zdravniku zaradi pridruženih bolezni in zapletov, ki so vezani na NSZ. Pomembno je, da le-ta zna oceniti, kdaj so težave povezane z boleznijo NSZ, kdaj pomislimo na poslabšanje znane bolezni, kdaj simptomi in znaki govorijo za nastanek pridružene srčne bolezni. Pomembno je, da zna oceniti, kdaj je napotitev k specialistu nujna, prednostna in kdaj lahko s prilagoditvijo medikamentnega zdravljenja prepreči nadaljnje poslabšanje sam ali se posvetuje z lečečim kardiologom.
Descriptors		HEART VALVE DISEASES HEART VALVE DISEASES HEART VALVE DISEASES