如何治疗心脏肥大

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共同创作者是 Carmen W. Landrau, MD

参考

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心脏肥大也被称为肥心症，指的是心脏体积比正常体积大。这不是一种病，反而更像是其它疾病和状况的征兆。 [1] 怀疑自己的心脏肥大？不妨按照本文的简单步骤，学习如何识别和治疗这种状况。

方法 1
方法 1 的 4:

检测心脏肥大

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    许多疾病会造成心脏肥大，包括心瓣膜或心肌疾病、心律不整、心肌衰弱、心包积液、高血压和肺动脉高压症。甲状腺疾病或慢性贫血也会引发心脏肥大。过多铁质和不正常的蛋白质沉积在心脏，也会引发心脏肥大。
    • 其它会引起心脏肥大的状况包括怀孕、肥胖、营养不良、生活压力大、某类感染、摄入特定毒素（比如毒品和酒精）和某些药物。 [2] [3]
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    某些人更容易心脏肥大。如果你有高血压、动脉阻塞、先天性心脏病、瓣膜病或曾经心肌梗死，那么心脏肥大的风险很高。它也有家族遗传性，如果家族有心脏肥大的病史，你的风险也会增加。
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    虽然心脏肥大不是病，但还是会出现一些症状，其中包括心律不整、呼吸短促、头晕喝咳嗽。病因不同，症状也会不一样。
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    心脏肥大会引发多个并发症。你会更容易出现血凝块和心搏停止。由于血液流动时的摩擦力增加，影响了心律，心脏可能会一直有杂音。如果不加以治疗，心脏肥大也会导致猝死。
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    医生可以通过几种方式诊断心脏肥大。第一个步骤通常是X射线检查，观察心脏的体积。如果无法从X射线结果做出确切的判断，那么他也会进行超声波心动图或心电图检查。医生可能还会进行心脏负荷试验、电脑断层扫描或核磁共振成像检查。
    • 之后，医生会进行检查找出心脏肥大的根本原因，从而制定最合适的治疗方案。 [7]
方法 2
方法 2 的 4:

改变生活方式

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    你可以通过饮食降低心脏肥大对身体的影响，并对抗心脏肥大的根本原因。吃饱和脂肪、盐和胆固醇含量低的食物。多吃水果、蔬菜、精瘦肉和健康蛋白质。
    • 每天喝1400至1900毫升水。 [8] [9]
    • 多吃鱼、绿叶蔬菜、水果和菜豆，帮助降低胆固醇、血钠和血压。
    • 你也可以让医生根据你的具体状况，建议最适合你的饮食计划。
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    每天多做运动。医生会根据根本病因，建议不同的运动。如果你的心脏太弱，无法承受过多压力，他可能会建议你从事轻松的有氧运动，比如步行或游泳。
    • 随着你的身体越来越强壮，或者如果你需要减掉一定的体重，医生可能建议你做更加剧烈的有氧运动和力量训练，比如骑自行车或跑步。
    • 进行任何运动前，最好先问过医生（特别是如果你有心脏问题）。
    • 健康饮食结合运动有助于减肥。这对治疗引发心脏肥大的多个潜在病因十分有用。 [10] [11]
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    如果你被诊断出心脏肥大，应该避开或戒掉某些坏习惯。你必须立刻戒烟，因为抽烟会增加心脏和血管压力。你也不能摄取太多酒精和咖啡因，以免心律不整，并增加心肌承受的压力。
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    在康复期间，你需要经常去看医生。这样他才能密切监测心脏状态，让你知道病情是否好转或恶化。
方法 3
方法 3 的 4:

考虑其它治疗程序和手术

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    如果心脏肥大引起严重心力衰竭或心律不整，医生可能会建议你装一个植入型心律转复除颤器。它只有火柴盒那么大，通过电击帮助心脏维持正常心律。
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    如果心脏肥大是心瓣膜受损造成的，那么医生可能建议你进行心瓣膜置换术。在手术过程中，医生会取出变窄或损坏的瓣膜，换一个新的瓣膜。
    • 新的瓣膜可以是来自过世的捐赠者、牛或猪的组织瓣膜，也可能是人工瓣膜。
    • 你也可能需要动手术修复或更换有漏洞的瓣膜，也就是瓣膜闭锁不全。这种情况也会导致心脏肥大，造成血液逆流。 [16]
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    如果心脏肥大是动脉病变造成的，你可能需要接受冠状动脉支架手术，或冠状动脉搭桥手术修复心脏问题。如果心脏肥大引发心力衰竭，医生会建议你植入左心室辅助装置，帮助衰竭的心脏正常泵血。
    • 左心室辅助装置可以是心力衰竭的长期治疗，或是等待心脏移植期间的救命措施。
    • 心脏移植是治疗心脏肥大的最后手段，只有在排除其它方法后才能选择这个方法。要取得一个合适的心脏供体并不容易，你可能需要等上好几年。 [17]
方法 4
方法 4 的 4:

吃药

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    当你被诊断出患有某种导致心脏肥大的疾病，医生可能会给你开血管紧张素转化酶抑制剂。如果心脏肥大是肌肉衰弱造成的，血管紧张素转化酶抑制剂可以帮助心脏恢复正常的泵血功能。它也能降低血压。
    • 如果你对血管紧张素转化酶抑制剂不耐受，医生会改用血管紧张素受体阻滞剂。 [18]
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    如果你的心脏肥大（尤其是心肌病造成的），那么医生可能会开利尿剂。它们有助于降低体内的水分和钠水平，减小心肌厚度。
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    如果心脏肥大的主要症状是高血压，医生可能给你开β-受体阻滞药。这取决于你的整体状况。β-受体阻滞药帮助改善血压，减少心律不整，并减慢心跳速度。
    • 地高辛等药物也有助于改善心脏泵血功能，以免你因为心力衰竭，而必须住院治疗。 [20] [21]
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    医生会根据造成心脏肥大的原因开其它药，帮助改善病情。如果他担心你可能会有血凝块，就会给你开抗凝剂。这些药减少血凝块形成风险，进而降低中风或心肌梗死的几率。

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参考

  1. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/definition/con-20034346
  2. ↑ http://www.medicinenet.com/enlarged_heart/symptoms.htm
  3. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/causes/con-20034346
  4. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/risk-factors/con-20034346
  5. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/symptoms/con-20034346
  6. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/complications/con-20034346
  7. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/tests-diagnosis/con-20034346
  8. ↑ http://www.medicinenet.com/cardiomyopathy_hypertrophic/page2.htm#what_lifestyle_changes_are_recommended_to_treat_hcm
  9. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/lifestyle-home-remedies/con-20034346
  1. ↑ http://www.medicinenet.com/cardiomyopathy_hypertrophic/page2.htm#what_lifestyle_changes_are_recommended_to_treat_hcm
  2. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/lifestyle-home-remedies/con-20034346
  3. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/lifestyle-home-remedies/con-20034346
  4. ↑ http://www.medicinenet.com/cardiomyopathy_hypertrophic/page2.htm#what_lifestyle_changes_are_recommended_to_treat_hcm
  5. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/lifestyle-home-remedies/con-20034346
  6. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/treatment/con-20034346
  7. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/treatment/con-20034346
  8. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/treatment/con-20034346
  9. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/treatment/con-20034346
  10. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/treatment/con-20034346
  11. ↑ http://www.medicinenet.com/cardiomyopathy_hypertrophic/page3.htm#what_medications_are_used
  12. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/treatment/con-20034346
  13. ↑ http://www.mayoclinic.org/diseases-conditions/enlarged-heart/basics/treatment/con-20034346

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