Heart failure: classification, symptoms and treatment photo
Shortness of breath, swelling and fatigue — these are familiar to virtually all adults the symptoms may indicate heart failure. In this clinical syndrome can develop at any age, rapidly or gradually. In order to avoid serious consequences and often to save the life of every man should know how to define heart failure, and what urgent measures in identifying dangerous signs of heart disease.
Heart failure: the essence of disease and its causes
Heart failure is the inability of the heart to pump blood at full volume, causing the tissues of the body experience oxygen deprivation, the metabolic process. Insufficiency of coronary circulation is not a separate disease, this syndrome is caused by heart disease, leading to impaired filling of blood in the heart chambers or insufficient evacuation. The main reasons:
- high stress on the heart hypertension;
- heart disease — myocarditis, myocardial infarction (acute circulatory disorders of the myocardium), hypertrophic cardiomyopathy, arrhythmia, valvular disease (cause severe dysfunction of the heart in children);
- pulmonary pathology of all diseases, with acute and chronic pulmonary obstruction;
- other diseases — diabetes, Hypo — and hyperthyroidism, obesity, anemia, AIDS, renal insufficiency, Basedow’s disease, amyloidosis, hemochromatosis.
Coronary insufficiency may be provoked by external factors:
- Smoking and alcohol abuse;
- uncontrolled reception of some drugs (NSAID), or side effects of potent medicines (e.g. cytotoxic drugs during chemotherapy);
- infections accompanied by fever; the higher the temperature, the more pronounced the symptoms of heart failure;
- poor diet — excess salt and water;
- pregnancy — hormonal changes provokes compensated heart failure.
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Classification of heart failure and its symptoms
Symptoms of insufficiency of coronary circulation is directly dependent on the speed of development and the location of the lesion. Depending on the flow distinguish following forms of the disease:
- Acute symptoms increases over minutes or hours, manifests with severe symptoms of cardiac asthma, pulmonary edema and cardiogenic shock.
- Chronic — provoked sustained damage (hypertension, anemia, chronic pulmonary insufficiency).
On the site of the lesion there are currently 3 types of coronary heart disease:
- Left ventricular — congestive provokes damage of the pulmonary circulation, cyanosis of lips and extremities, manifested by shortness of breath, dry rales (often at night), and sometimes hemoptysis. Perhaps frequent dizziness and angina.
- Right ventricular — circulation in a large circle causing shortness of breath, swelling of extremities, tenderness in the right upper quadrant and enlargement of the liver, swelling of neck veins.
- Combined — overload of both ventricles.
According to the severity of symptoms of heart failure is divided into stages:
- 1. — the dyspnea occurs only with exertion, comparable to climb the flight of stairs up to 3 floors, physical activity is not disrupted.
- 2 tbsp. — shortness of breath in heart failure on the 2nd stage occurs when walking fast or climbing to the 1st floor, the usual physical exertion causes increased symptoms of coronary heart disease (moist rales and crepitation in the lower segments of lungs, swelling to ankles) that are fixed after a night’s sleep. Daily physical activity is lowered.
- 3. — the minimum load provoke shortness of breath, which itself is at rest. The patient is diagnosed ascites, oliguria, edema spread along the entire length of the lower limbs and torso, in cardiac cirrhosis.
- Article 4. — the most severe, decompensated stage is expressed by the appearance of shortness of breath even at rest and low activity causes serious disruption of the heart. Irreversible degenerative changes in the tissues — pulmonary fibrosis, congestive kidney, cirrhosis. Often on the background of exhaustion and fall of the upper (systolic) and/d below the level of 90 mm Hg. the article develops cardiogenic shock. Any therapy does not bring tangible improvement of the patient’s condition.
Examination of the patient with suspected heart failure includes:
- percussion (tapping) of the lungs is at a standstill is determined dull sound box;
- auscultation of the lungs — noisy breathing, wheezing, dry;
- percussion of the heart (definition of its boundaries) chronic pulmonary emphysema makes the study uninformative;
- auscultation of the heart, tachyarrhythmia, heart murmur – double reinforced II tone above the main artery.
- measurement a/d — variations are possible in the higher levels (hypertension), so with the downside (cardiogenic shock);
- Resting ECG and a test load;
- The echo-KG — differentiation of left and right ventricular failure;
- blood — shift in biochemistry;
- x — ray shadows Curley (horizontal lines) in the lower lobes of the lung, increased pulmonary drawing, the lumen of large bronchi does not see, the heart size increased;
- rescattering coronary angiography is the detection of atherosclerotic narrowing of the major vessels of the heart;
- CT, MRI — highly informative in terms of clarifying the causal pathology and the location of the lesion, but quite expensive;
- a myocardial biopsy is painful for patients examination, identify the cause of the disease.
Treatment scheme for heart failure is prescribed only by a qualified cardiologist. Self-treatment, nor agreed with the attending physician treatment of folk remedies is fraught with the deterioration and even deadly threat.
Treatment of acute forms of coronary insufficiency
Signs of acute heart failure and development failure of its functions require emergency measures to restore blood flow. First aid:
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- To seat the patient, to undo the collar, to ensure supply to the room fresh air.
- To call the ambulance.
- To measure pressure and to calm the patient.
- When the a/d to 90 mm Hg. art to give the Nitro/Nitrosorbid to 3 – 4 tab. with an interval 5 – 10 min and 1 tab. diuretic (Furosemide, Lasix).
- 15 minutes after sitting the patient on the thigh overlaps the harness, pull it should be every 20 – 30 min.
- When you stop the heart, ventilation and cardiac massage before the ambulance.
At the hospital the patient, a comprehensive treatment of the disease, causing coronary insufficiency.
The treatment of chronic heart failure
Treatment scheme for chronic heart failure includes the following fields:
- Drug therapy — drugs of magnesium and cardiac glycosides to facilitate the work of the heart, ACE inhibitors and diuretics to reduce the a/d, treatment of dyspnea, nitrate, attenuating the load on the myocardium.
- Security measures — diet (with the exception of salt, reducing the amount of fluid you drink), weight loss, stop Smoking/alcohol, proportionate to exercise.
- Surgical intervention is appropriate in severe cases and in the absence of effective drug therapy. Depending on the nature of the lesion is carried out coronary artery bypass grafting, valve replacement, pacemaker implantation, ablation of the myocardium, and in extreme cases a heart transplant.