{"id":873,"date":"2021-03-16T16:44:45","date_gmt":"2021-03-16T14:44:45","guid":{"rendered":"http:\/\/skmed.sk\/?p=873"},"modified":"2021-03-16T16:44:47","modified_gmt":"2021-03-16T14:44:47","slug":"zdrave-ranajky-s-skmed-ake-komplikacie-hrozia-pacientom-po-prekonani-ochorenia-covid-19-z-kardiologickeho-hladiska","status":"publish","type":"post","link":"http:\/\/skmed.sk\/?p=873","title":{"rendered":"Zdrav\u00e9 ra\u0148ajky s SK+MED: Ak\u00e9 komplik\u00e1cie hrozia pacientom po prekonan\u00ed ochorenia COVID-19 z kardiologick\u00e9ho h\u013eadiska?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Koronav\u00edrusov\u00e1\ninfekcia, s&nbsp;ktorou svet u\u017e rok bojuje, zanech\u00e1va dlhodob\u00e9 n\u00e1sledky u mnoh\u00fdch\npacientov aj v pr\u00edpade, ke\u010f ne\u0161lo o \u0165a\u017eko chor\u00fdch, ktor\u00ed by sa museli lie\u010di\u0165 v\nnemocnici. Jedn\u00fdm z mnoh\u00fdch nebezpe\u010denstiev nov\u00e9ho koronav\u00edrusu je jeho z\u00e1hadn\u00e1\nschopnos\u0165 podporova\u0165 tvorbu krvn\u00fdch zrazen\u00edn v tele, ktor\u00e9 s\u00fa n\u00e1sledne\nzodpovedn\u00e9 za p\u013e\u00facnu emb\u00f3liu. O dlhodob\u00fdch n\u00e1sledkoch COVID-u \u0161t\u00fadie e\u0161te len\nprebiehaj\u00fa, SK+MED v\u0161ak vyz\u00fdva k opatrnosti pr\u00e1ve pre riziko z\u00e1va\u017en\u00fdch\nkardiologick\u00fdch, pneumologick\u00fdch, ale aj neurologick\u00fdch, internistick\u00fdch a\nin\u00fdch komplik\u00e1ci\u00ed, ktor\u00e9 boli doteraz po prekonan\u00ed COVID-u u pacientov\npozorovan\u00e9. Na ot\u00e1zky t\u00fdkaj\u00face sa vplyvu COVID-19 a&nbsp;kardiovaskul\u00e1rnych\nkomplik\u00e1ci\u00ed, odpoved\u00e1 kardiologi\u010dka MUDr. Anna Vachulov\u00e1 PhD.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Ak\u00e9\ns\u00fa naj\u010dastej\u0161ie kardiovaskul\u00e1rne komplik\u00e1cie s\u00favisiace s ochoren\u00edm COVID-19?<\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Pri infekcii COVID-19 m\u00f4\u017ee d\u00f4js\u0165 k&nbsp;po\u0161kodeniu srdca na r\u00f4znych\n\u00farovniach. Jednak m\u00f4\u017ee d\u00f4js\u0165 k&nbsp;rozkol\u00edsaniu hodn\u00f4t krvn\u00e9ho tlaku, vzniku\narytmi\u00ed, z\u00e1palu srdcov\u00e9ho svalu, a\u017e k&nbsp;ak\u00fatnemu srdcov\u00e9mu zlyh\u00e1vaniu.\nOb\u00e1vanou komplik\u00e1ciou m\u00f4\u017ee by\u0165 po\u0161kodenie koron\u00e1rnych ciev tromb\u00f3zou, so\nvznikom po\u0161kodenia koron\u00e1rnych tepien a\u017e infarktu myokardu. Komplik\u00e1cie\ninfekcie COVID-19 sa m\u00f4\u017eu vyskytn\u00fa\u0165 u&nbsp;\u013eud\u00ed bez zn\u00e1meho KV ochorenia, no\nm\u00f4\u017eu vies\u0165 k&nbsp;zhor\u0161eniu preexistuj\u00faceho KV ochorenia. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>M\u00f4\u017eu\nsrdcov\u00e9 komplik\u00e1cie vyvola\u0165 aj lieky pou\u017e\u00edvan\u00e9 na lie\u010dbu COVID-19, resp.\nintenz\u00edvna lie\u010dba? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Pri lie\u010dbe\nCOVID-19 sa vyu\u017e\u00edva cel\u00e1 \u0161k\u00e1la liekov, ktor\u00e9 m\u00f4\u017eu ma\u0165 interakcie\ns&nbsp;u\u017e\u00edvan\u00fdmi liekmi pacienta a&nbsp;to m\u00f4\u017ee vies\u0165 k&nbsp;ovplyvneniu kardiovaskul\u00e1rneho\napar\u00e1tu. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>V&nbsp;prvej\nvlne pand\u00e9mie sa objavili inform\u00e1cie, \u017ee pacienti u\u017e\u00edvaj\u00faci antihypertenz\u00edva\nm\u00f4\u017eu ma\u0165 \u0165a\u017e\u0161\u00ed priebeh ochorenia COVID-19. Mali by ma\u0165 tak\u00fdto pacienti d\u00f4vod na\nobavy? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Tieto\ntvrdenia s\u00fa neopodstatnen\u00e9 a&nbsp;zav\u00e1dzaj\u00face. Preto Eur\u00f3pska kardiologick\u00e1\nspolo\u010dnos\u0165 i&nbsp;Slovensk\u00e1 kardiologick\u00e1 spolo\u010dnos\u0165 vydali u\u017e\nv&nbsp;prvej&nbsp; vlne stanovisko o&nbsp;nutnosti\npokra\u010dovania v&nbsp;lie\u010dbe antihypertenz\u00edvami. Vysadenie antihypertenz\u00edvnej\nlie\u010dby m\u00f4\u017ee vies\u0165 k&nbsp;z\u00e1va\u017en\u00fdm, nielen kardiovaskul\u00e1rnym komplik\u00e1ci\u00e1m, ako\nnapr\u00edklad: vznik cievnej mozgovej pr\u00edhody, ak\u00fatneho infarktu myokardu, zlyhania\nobli\u010diek, at\u010f. Tak\u00fdto stav vy\u017eaduje hospitaliz\u00e1ciu pacienta, \u010do v&nbsp;dobe\npand\u00e9mie zvy\u0161uje riziko n\u00e1kazy COVID-19. Z&nbsp;viacer\u00fdch kraj\u00edn (\u010c\u00edna,\nTaliansko, Franc\u00fazsko, USA) boli publikovan\u00e9 d\u00e1ta, \u017ee ak pacienti d\u00f4sledne\nu\u017e\u00edvali predp\u00edsan\u00e9 antihypertenz\u00edva mali v&nbsp;pr\u00edpade nakazenia COVID-19\n\u013eah\u0161\u00ed priebeh infekcie, ni\u017e\u0161iu potrebu hospitaliz\u00e1ci\u00ed, krat\u0161iu dobu\nhospitaliz\u00e1ci\u00ed a&nbsp;ni\u017e\u0161\u00ed v\u00fdskyt kardiovaskul\u00e1rnych komplik\u00e1ci\u00ed.&nbsp; Preto odkaz pre pacientov &#8211; nepo\u010d\u00favajte\nneopodstatnen\u00e9 f\u00e1my. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Pod\u013ea\nistej <\/strong><a href=\"https:\/\/www.statnews.com\/2020\/07\/27\/covid19-concerns-about-lasting-heart-damage\/\"><strong>nemeckej\n\u0161t\u00fadie<\/strong><\/a><strong> m\u00f4\u017ee COVID-19 zanecha\u0165 na srdci \u0161truktur\u00e1lne zmeny, ak\u00e9 sa na\ntomto org\u00e1ne objavuj\u00fa po infarkte. \u010c\u00edm je to sp\u00f4soben\u00e9? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Je to\nv&nbsp;&nbsp;d\u00f4sledku toho, \u017ee z\u00e1pal vyvolan\u00fd v\u00edrusom COVID-19 vedie k\naktiv\u00e1cii syst\u00e9mu zr\u00e1\u017eania krvi (tzv. prokoagula\u010dn\u00fd efekt). V&nbsp;d\u00f4sledku\ntoho d\u00f4jde k po\u0161kodeniu koron\u00e1rnych\nciev tromb\u00f3zou ako pri infarkte myokardu.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>M\u00f4\u017eu\nsa z\u00e1va\u017en\u00e9 komplik\u00e1cie po prekonan\u00ed COVID-19 objavi\u0165 aj u&nbsp;zdrav\u00fdch \u013eud\u00ed\nz&nbsp;kardiologick\u00e9ho h\u013eadiska? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u00c1no, ako som\nuv\u00e1dzala vy\u0161\u0161ie, z\u00e1va\u017en\u00e9 komplik\u00e1cie sa m\u00f4\u017eu vyskytn\u00fa\u0165 aj u&nbsp;\u013eud\u00ed bez\nzn\u00e1meho KV ochorenia. Av\u0161ak niektor\u00ed \u013eudia nemusia vedie\u0165, \u017ee maj\u00fa KV&nbsp;ochorenie,\nnapr\u00edklad maj\u00fa nediagnostikovan\u00fa art\u00e9riov\u00fa hypertenziu. A&nbsp;v&nbsp;priebehu\ninfekcie alebo po infekcii COVID-19 sa to m\u00f4\u017ee prejavi\u0165 z\u00e1va\u017enej\u0161\u00edm po\u0161koden\u00edm\nKV syst\u00e9mu. Preto je d\u00f4le\u017eit\u00e9, aby \u013eudia nezab\u00fadali na prevenciu a&nbsp;lie\u010dbu\nKV ochoren\u00ed i&nbsp;v&nbsp;dobe pand\u00e9mie COVID-19. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Ak\u00fd\nvplyv m\u00e1 na srdce po\u0161koden\u00e9 p\u013e\u00facne tkanivo? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Sekund\u00e1rne\nm\u00f4\u017ee vies\u0165 k&nbsp;po\u0161kodeniu a&nbsp;pre\u0165a\u017eeniu srdca. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>M\u00f4\u017ee\nsa u&nbsp;pacientov nesk\u00f4r vyskytn\u00fa\u0165 po\u0161kodenie srdcov\u00e9ho svalu aj\nv&nbsp;pr\u00edpade, \u017ee ochorenie COVID-19 malo \u013eahk\u00fd priebeh? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Je to menej\npravdepodobn\u00e9. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>D\u00e1\nsa u\u017e dnes predpoklada\u0165, \u010di pacienti, ktor\u00ed koronav\u00edrusov\u00fa infekciu prekonali\na&nbsp;objavili sa u&nbsp;nich kardiovaskul\u00e1rne komplik\u00e1cie, maj\u00fa srdce\npo\u0161koden\u00e9 do\u010dasne alebo trvalo? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">To treba\nu&nbsp;ka\u017ed\u00e9ho pacienta pos\u00fadi\u0165 pr\u00edsne individu\u00e1lne. Ako som spom\u00ednala, z\u00e1le\u017e\u00ed\nna pr\u00edtomnosti a&nbsp;lie\u010dbe preexistuj\u00faceho KV ochorenia. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Z\u00e1va\u017enou\nkomplik\u00e1ciou v&nbsp;s\u00favislosti s&nbsp;COVID-19 je emb\u00f3lia. U&nbsp;ko\u013ek\u00fdch\npacientov s&nbsp;COVID-19 sa \u0161tatisticky vyskytne? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Na z\u00e1klade\nmetaanal\u00fdzy \u0161t\u00fadi\u00ed publikovanej v&nbsp;minulom roku m\u00f4\u017ee by\u0165&nbsp; riziko tromboemb\u00f3lie a\u017e 20%.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>To,\n\u010do dnes spolo\u010dnos\u0165 ve\u013emi potrebuje je n\u00e1dej. Mali ste od vypuknutia pand\u00e9mie\nu&nbsp;n\u00e1s na Slovensku aj tak\u00fdch pacientov, ktor\u00fdch v&nbsp;s\u00favislosti\ns&nbsp;COVID-19 postihli kardiovaskul\u00e1rne komplik\u00e1cie, no napriek tomu pre\u017eili\na&nbsp;zotavili sa? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u00c1no. M\u00e1me\ntak\u00fdch pacientov. Preto apelujem na v\u0161etk\u00fdch pacientov, dodr\u017eiavajte v\u0161etky\nodpor\u00fa\u010dania lek\u00e1rov a&nbsp;u\u017e\u00edvajte predp\u00edsan\u00fa lie\u010dbu.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>M\u00f4\u017eu\nlieky na riedenie krvi pom\u00f4c\u0165 pacientom minimalizova\u0165 rizik\u00e1 s\u00favisiace\ns&nbsp;krvn\u00fdmi zrazeninami? <\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u00c1no. Av\u0161ak\nlieky na riedenie krvi musia by\u0165 ordinovan\u00e9 odborn\u00edkmi. Preto\u017ee lieky na\nriedenie krvi na jednej strane minimalizuj\u00fa riziko vzniku krvn\u00fdch zrazen\u00edn, ale\nna druhej strane zvy\u0161uj\u00fa riziko krv\u00e1cania. Neodborn\u00e9 a&nbsp;neopodstatnen\u00e9\nu\u017e\u00edvanie liekov na riedenie krvi m\u00f4\u017ee ma\u0165 za n\u00e1sledok krv\u00e1cav\u00e9 komplik\u00e1cie,\nnapr. z&nbsp;tr\u00e1viaceho traku. Lie\u010dba liekmi na riedenie krvi patr\u00ed do r\u00fak\nodborn\u00edkom a&nbsp;riadi sa pr\u00edslu\u0161n\u00fdmi odpor\u00fa\u010daniami.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>M\u00f4\u017eu\nsa vyskytn\u00fa\u0165 komplik\u00e1cie u pacientov s&nbsp;kardiostimul\u00e1torom?<\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Neexistuje\nd\u00f4kaz, \u017ee v\u00edrus \u00fato\u010d\u00ed a infikuje implantovan\u00e9 zariadenia ako s\u00fa\nkardiostimul\u00e1tory alebo sp\u00f4sobuje infek\u010dn\u00fa endokardit\u00eddu u pacientov s\nochoreniami srdcov\u00fdch chlopn\u00ed. Av\u0161ak samozrejme plat\u00ed, \u017ee ka\u017ed\u00fd pacient\ns&nbsp;chronick\u00fdm srdcovo-cievnym ochoren\u00edm m\u00e1 predispoz\u00edciu \u0165a\u017e\u0161ieho priebehu\nochorenia. Napriek tomu, \u017ee t\u00edto pacienti patria do ohrozenej skupiny \u013eud\u00ed,\nnevieme vopred predpoklada\u0165 a&nbsp;generalizova\u0165 ak\u00e1 bude imunitn\u00e1 odpove\u010f\nu&nbsp;jednotliv\u00fdch pacientov. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Je\nn\u00e1stroj ako telemedic\u00edna efekt\u00edvny v lie\u010dbe alebo prevencii kardiovaskul\u00e1rnych\nkomplik\u00e1ci\u00ed?<\/strong><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Telemedic\u00edna\nje efekt\u00edvny n\u00e1stroj, ktor\u00fd v\u00fdznamne pom\u00e1ha najm\u00e4 po\u010das pand\u00e9mi\u00ed. Mnoh\u00ed lek\u00e1ri\nkomunikuj\u00fa s&nbsp;ve\u013ek\u00fdm mno\u017estvom svojich pacientov pr\u00e1ve telefonicky alebo\nemailovo aj dnes, av\u0161ak robia to z&nbsp;vlastnej v\u00f4le a&nbsp;na \u00fakor svojho\n\u010dasu, preto\u017ee za tak\u00fdto v\u00fdkon nemaj\u00fa zaplaten\u00e9. Okrem toho by sme v\u0161ak prostredn\u00edctvom\ninovat\u00edvnych medic\u00ednskych technol\u00f3gi\u00ed v kardiol\u00f3gii vedeli pacientov mana\u017eova\u0165\nove\u013ea efekt\u00edvnej\u0161ie. Modern\u00e9 technol\u00f3gie n\u00e1m umo\u017e\u0148uj\u00fa&nbsp; ove\u013ea jednoduch\u0161ie detekova\u0165 napr\u00edklad\nporuchy srdcov\u00e9ho rytmu a zah\u00e1ji\u0165 v\u010dasn\u00fa a spr\u00e1vnu lie\u010dbu.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Koronav\u00edrusov\u00e1 infekcia, s&nbsp;ktorou svet u\u017e rok bojuje, zanech\u00e1va dlhodob\u00e9 n\u00e1sledky u mnoh\u00fdch pacientov aj v pr\u00edpade, ke\u010f ne\u0161lo o \u0165a\u017eko chor\u00fdch, ktor\u00ed by sa museli lie\u010di\u0165 v nemocnici. Jedn\u00fdm z mnoh\u00fdch nebezpe\u010denstiev nov\u00e9ho koronav\u00edrusu je jeho z\u00e1hadn\u00e1 schopnos\u0165 podporova\u0165 tvorbu krvn\u00fdch zrazen\u00edn v tele, ktor\u00e9 s\u00fa n\u00e1sledne zodpovedn\u00e9 za p\u013e\u00facnu emb\u00f3liu. O dlhodob\u00fdch n\u00e1sledkoch COVID-u \u0161t\u00fadie e\u0161te len prebiehaj\u00fa, SK+MED v\u0161ak vyz\u00fdva k opatrnosti pr\u00e1ve pre riziko z\u00e1va\u017en\u00fdch kardiologick\u00fdch, pneumologick\u00fdch,&hellip;<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-873","post","type-post","status-publish","format-standard","hentry","category-nezaradene"],"_links":{"self":[{"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/posts\/873","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"http:\/\/skmed.sk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=873"}],"version-history":[{"count":1,"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/posts\/873\/revisions"}],"predecessor-version":[{"id":874,"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/posts\/873\/revisions\/874"}],"wp:attachment":[{"href":"http:\/\/skmed.sk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=873"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/skmed.sk\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=873"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/skmed.sk\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=873"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}