High blood pressure in pneumonia. Pressure in pneumonia: symptoms, diagnosis. Objective signs of the disease

Pneumonia is a lung disease in which the inflammatory process of the upper respiratory tract occurs and the lung tissue in humans is affected, as a result of which oxygen exchange in the lungs is difficult. Pneumonia occurs as a result of an infection. The causative agent of infection are streptococcal bacteria, various types of microorganisms: fungal diseases, viral infections, various types of bacteria. If the patient did not seek medical help in a timely manner, then serious complications with pneumonia can occur.

Who is at risk for complications of pneumonia?

The following are at risk for pneumonia:

• Elderly people over 60;
• People with weak immune systems;
• Small children;
• Patients with chronic bronchial diseases;
• Patients who drink alcohol, smokers;
• Patients engaged in self-medication did not complete the course of therapy, they did not drink the prescribed antibiotics to the end;
• Patients with severe disease of the endocrine system, cardiovascular insufficiency, inflammation of other organs.

Complications of pneumonia in adults, with proper diagnosis and timely treatment, end in a complete recovery of the patient within two to three weeks.

Types of complications in pneumonia

The consequences of pneumonia in adults can lead to dangerous complications. Pneumonia is a very dangerous disease, if the patient does not start treatment on time, it can be fatal.

Signs of complications after pneumonia in adults:

• After the disease, the temperature does not stop, keeps within 37 degrees;
• Protracted cough lasts for a long time;
• Shortness of breath becomes more frequent;
• Pain in the chest, in the region of the heart, or in other places.

All of the above signs indicate that the patient develops one of the types of complications.

Complications of pneumonia are of two types: local (pulmonary) or general (extrapulmonary):

1. The pulmonary form includes: respiratory failure, parapneumonic pleurisy, lung abscesses, acute distress syndrome, prolonged pneumonia, obstructive bronchitis.
2. The extrapulmonary form includes: shock caused by infections or toxins, sepsis, cardiovascular failure, acute respiratory failure, meningitis.

The severity of the inflammatory process and the complication of the lungs are determined by the Pneumonia Port scale, and a prognosis is made on it. The scale takes into account the severity of complications and the consequences of pneumonia in adults. A separate category includes pneumonia caused by microorganisms. These microorganisms include: staphylococcus, Pseudomonas aeruginosa, Klebsiella bacillus. With prolonged pneumonia, the mortality rate increases. The cause of pneumonia can be Haemophilus influenzae, mycoplasmas, chlamydia, the risk for such pathologies is minimal. A complication after pneumonia leads to many types of diseases.

Pleurisy can occur in children and adults. With this disease, fluid accumulates in the pleural cavity. This disease is caused by bacteria and viruses. Due to the mass migration of bacteria into the pleura, the body's resistance to infections is reduced. Fever and intoxication may occur. Pleurisy can lead to extremely serious complications - this is the accumulation of pus in the pleura.

lung abscess

In patients suffering from chronic diseases, this pathology occurs. Pus accumulates in the lung cavity. With an abscess, the fingers and toes swell. When the sputum leaves, an unpleasant odor occurs in the mouth. Within three weeks the patient's condition was severe. High temperature 39 degrees, severe headaches, weakness, dry cough. Often patients complain of pain in the side. There is swelling and redness of the face. When the abscess ruptures, a large amount of pus is released. Up to 2 liters of sputum can come out per day. When separating sputum, the patient has an unpleasant smell from the mouth.

Treatment is with intravenous antibiotics. The duration of treatment is from one and a half to two months. Treatment must be carried out completely and cannot be interrupted.

Acute respiratory failure

In acute respiratory failure, the lungs are seriously damaged, breathing worsens, shortness of breath occurs, lips, nose, and cheeks turn blue.

Due to a sharp lack of oxygen, organs are damaged, and this can lead to rapid death. The course of pneumonia is difficult.

This type of complication should be given special attention. The main symptoms that are expressed in acute respiratory failure:

• Lung tissues become denser, ventilation and pulmonary edema worsen, oxygen deficiency occurs;
• Blockage in the bronchi leads to the formation of sputum in the lungs, as a result of which bleeding occurs;
• wheezing;
• Deterioration of the patient's breathing due to the deterioration of blood flow and gas exchange in the lungs.

With such a disease, urgent intensive care is required, as this threatens the life of the patient.

infectious and toxic shock

Prolonged pneumonia leads to such a type of complication as infectious and toxic shock. This type of complication occurs due to vascular insufficiency. Infection occurs with toxic food poisoning. There are 3 types of shock:

1. Compensated - severe intoxication of the body, high temperature, fatigue, lethargy of the body, complaints of weakness. The patient has a sharp decrease in appetite, blood pressure begins to rise sharply, pulse and heart rate increase. The patient has a sharp pallor of the face.
2. Subcompensated - a manifestation of aggression in a patient, increased agitation, urinary incontinence, temporary clouding of the mind. Strong sweating, blue skin. The patient begins shortness of breath.
3. Decompensated - the patient begins to have convulsions, the pupils dilate, the person is in a coma. Earthy skin tone. Arterial pressure drops sharply.

In medicine, sepsis is the most dangerous and severe of all existing types of complications of pneumonia. The pathogen enters the blood, which circulates through the blood. As a result, the question arises: what is the danger of pneumonia in adults? The patient is not fully cured, there is such a dangerous type of complication. The main feature of this complication is that pus forms throughout the body. The disease becomes very dangerous for human life. With sepsis, body temperature is from 40 to 41 degrees. The whole body is prone to intoxication syndrome: nausea, vomiting, severe headaches.

With sepsis, physicians recorded a high mortality rate. With proper diagnosis and treatment, the outcome for the patient will be favorable. It is necessary to be treated and not to start the disease.

Complications in the cardiovascular system

With inflammation of the lungs, microorganisms enter the heart. There is a complication in the heart. Complications from the cardiovascular system are divided into three types:

1. Myocarditis - this form of the disease occurs after 2 weeks. The pathogen directly affects the heart muscle. This phase is called the acute phase. In the chronic phase, the body's immune system produces antibodies. Cells begin to show aggression, which leads to increased negative manifestations. The main symptoms are lethargy, with physical exertion, weakness appears. Swelling of the legs, shortness of breath, severe sweating. If the patient applied on time, this will positively affect the outcome of the disease.
2. Pericarditis - the main symptoms are acute pain in the chest, dry cough without sputum production, the patient has severe shortness of breath, complaints of fatigue and severe weakness.
3. Endocarditis - The main symptoms are fever and chills. The heart valve is affected. Endocarditis often occurs in children. It is caused by a staphylococcal infection. In adults, it occurs as a result of taking drugs.

Complications of a mental nature

This type of complication occurs in adults. When the disease is pronounced psychosis. A person becomes insane, inadequately perceives the surrounding reality. The psychosis proceeds in an acute form. The course of the disease is complicated by the high temperature.

Treatment for complications of pneumonia

It must be taken very seriously. Complications after pneumonia can be very serious, so patients are mainly treated in a hospital. Treatment includes antibiotics. Different types of complications are treated according to a specific scheme:

• Physiological solution is prescribed for intoxication of the body, this drug cleanses the body of toxic substances;
• If a patient has difficulty breathing, he is connected to artificial lung ventilation;
• In order to purify the blood of microorganisms, a number of medical procedures are carried out;
• With various symptoms, doctors prescribe certain medications for each patient individually - at high temperature, to eliminate shortness of breath, bleeding, and sputum in case of pneumonia;
• The main factor is antibiotic treatment. The selection of antibiotics is carried out by the doctor, individually for each complication.

conclusions

Complicated pneumonia can affect not only the bronchi and lungs, but also other organs and even the entire body. If pneumonia is not treated, what will happen? There will be bad consequences that will lead to the development of complications. 40% of patients are fatal.

Pneumonia is a very dangerous disease. In no case should the treatment of pneumonia be started, it is necessary to seek medical help in a timely manner.

Doctors recommend getting flu shots to avoid complications that lead to pneumonia. Do not smoke, do not drink alcohol, exercise, eat well and get enough rest. If the doctors provided assistance on time, patients leave the hospital healthy. You need to monitor your health and consult a doctor in time.

Even the most minimal changes in the body can cause fear in any person. At each medical examination, doctors always measure their patients' blood pressure and pulse, since these two indicators can most accurately reflect the state of human health.

The frequency of contraction of the heart muscle depends on many factors independent of the person, such as age, environment, mental health, genetic predisposition. Normally, the pulse will vary between 70-85 beats per minute if the person is completely healthy and at rest.

If this indicator deviates from the normal by more than 20%, doctors call this condition tachycardia.

By medical standards, a healthy body should always show pressure at 120/80, and the pulse should not exceed 85 beats per minute. If these indicators in a person differ from the reference ones, then the doctor will definitely send such a patient for a detailed medical examination.

However, you need to understand that in some people the pulse is always low due to individual characteristics in the body. Only a doctor, with the help of diagnostic results, will be able to say exactly what is considered a norm or deviation and what to do with low pressure and high pulse.

Causes

If a person's pressure drops sharply, but the heartbeat quickens, this is a good reason to sound the alarm. In a healthy, normally functioning organism, such changes cannot appear overnight. Internal bleeding, acute disruption of the endocrine glands, and much more can indicate these phenomena.

It is violations that can cause a sharp decrease in the level of pressure and acceleration of the pulse. Such phenomena can lead to the release of a large amount of progesterone into the blood, which provokes vasodilation. In most cases, low blood pressure and high heart rate are due to:

A number of other factors can also influence the occurrence of low blood pressure and high heart rate. To get rid of this problem, you will have to find out exactly the causes of their appearance.

Symptoms

The first thing that patients notice with low pressure and high pulse is a distinct sensation of all the contractions of the heart bag, which can be easily calculated independently. Patients have a burning sensation and pain in the chest and stomach. Because of this, a person begins to eat less, there is a sharp decrease in body weight.

Also, a person has severe headaches, which are often accompanied by dizziness and a feeling of nausea. In especially advanced cases, patients complain of a feeling of fear that arises deep in the chest, and constant drowsiness and general weakness of the body. You can also recognize low blood pressure and high heart rate by the following manifestations:

Tachycardia is an acute violation of the body, characterized by an acceleration of the heart rate. A number of physiological factors, such as emotional stress or strenuous exercise, can cause these changes. In such cases, low blood pressure and high heart rate gradually return to normal without any therapy.

If such manifestations torment a person on an ongoing basis, then it will not be possible to cope with the problem on your own without the participation of a doctor. If you ignore any manifestations of this disease, sooner or later serious disorders will occur in the body, which will lead to constant fainting and vomiting.

Diagnostics

A decrease in blood pressure and an increase in heart rate torment many people on Earth. And it is not uncommon for such manifestations to occur in healthy people who do not have any problems with the functioning of the body. Usually, such a picture is accompanied by severe nausea, which can develop into vomiting, dizziness, aggressiveness and irritability.

It will be possible to determine the exact treatment regimen only on the basis of the results of a detailed diagnosis. In no case should you prescribe therapy yourself. The examination should include:

It will be possible to determine the scheme of effective treatment only on the basis of the results of detailed functional diagnostics, which should be carried out under the supervision of a treating specialist. Before prescribing treatment, a specialist needs to identify the cause of the lesion, and only after that choose a method of influencing the body. The sooner you start treatment, the easier it will be to get rid of bouts of low blood pressure and high heart rate.

Treatment

The basis of therapy for high heart rate and low blood pressure is a change in the patient's lifestyle - the patient must become an adherent of proper nutrition and a full daily routine. It is very important to eradicate all bad habits such as smoking or drinking large amounts of alcoholic beverages or coffee.

You also need to completely abandon all products that contain caffeine - Coca-Cola, chocolate and much more. Try to minimize any effect of stress on the body, also control mental work. Do not forget about the need for exercise, but they should be in moderation.

It will only be possible to determine drug therapy based on the results of a detailed diagnosis. Only with it will it be possible to fully understand the state of the body, to identify any violations in its functioning.

You should not independently determine the scheme of influence, because with the wrong approach, you can simply harm your body. If you have a sharp attack and you feel acute discomfort in the heart area, immediately call an ambulance. In most cases, high heart rate and low blood pressure are treated as follows:

• If this condition is caused by thrombosis, doctors prescribe drugs such as Coumadin to their patients. It is administered intravenously over a period of time.
• Dehydration can be cured by drinking plenty of fluids and introducing electrolytes into the blood.
• Vasovaginal syncope can be treated with Inderal.
• The only way to minimize the impact of internal blood loss is through transfusion.
• Refusal of certain medications that adversely affect the body.

For the treatment of low blood pressure and high heart rate, medications based on magnesium-containing preparations are always used. With their help, it is possible to strengthen the heart bag, to establish the operation of the valves. However, you should not prescribe yourself such pills on your own, since any drugs have contraindications and side effects.

Never prescribe medications for yourself. Only a specialist will be able to accurately determine which substances will positively affect the state of the body, and which will harm. The occurrence of low pressure and high pulse can be caused by different etymologies, so the treatment in each case is selected individually.

You do not need to deal with the problem on your own, and even more so do not engage in traditional medicine. Only a doctor can accurately answer the question of what to do with low pressure and high pulse.

Why does shortness of breath occur with pneumonia

Often, with inflammation of the lungs, the patient has a respiratory disorder. However, shortness of breath with pneumonia may not be for everyone. What does this symptom depend on? Pneumonia is a fairly severe form of the disease that develops as a result of the introduction of various pathogenic bacteria, viruses, and sometimes fungi.

Causes of shortness of breath

With this ailment, shortness of breath manifests itself in the form of difficulty breathing both at the slightest physical or emotional stress, and at rest.

If a manifestation such as dyspnea begins, the patient is likely to develop respiratory failure. This occurs when the lungs become unable to perform their physiological task - to provide organs and tissues with sufficient oxygen.

As a result, everything ends with a sharp deterioration in the condition, and even poses a threat to the life of the patient. The proportion of carbon dioxide as a result of respiratory failure increases, and the amount of oxygen decreases sharply. Toxic substances that are formed as a result of metabolism are not fully eliminated, and begin to accumulate, acidosis develops.

With pneumonia, shortness of breath occurs as a result of the fact that exudative fluid begins to collect in the alveoli, and makes it difficult or completely stops the process of oxygen exchange with the capillary system.

The nature of shortness of breath in pneumonia can be different, with such a pathological condition it happens:

1. Hypoxemic. At the same time, normal ventilation is maintained, but oxygen exchange is disturbed.
2. Hypercapnic. Occurs when there is a lack of ventilation.
3. Mixed. Combines both types, and occurs most often in pneumonia.

In addition to shortness of breath, a number of signs confirm the development of respiratory failure. This is the development of acrocyanosis, tachycardia, restless behavior, various types of arrhythmias.

Help with shortness of breath

If shortness of breath with pneumonia leads to the development of such symptoms, then this is an indication for urgent hospitalization of such a patient. And in the future, the treatment of shortness of breath with pneumonia occurs only under the supervision of specialists, sometimes the condition can be so severe that the patient is placed in the intensive care unit.

In case of insufficiency of the third degree, mechanical ventilation is used (it can be non-invasive, with the help of a mask, auxiliary and complete, with tracheal intubation) and oxygen therapy.

Such a patient in the most difficult period should remain in a semi-sitting position, sometimes he is placed on his stomach.

To successfully get rid of shortness of breath, the underlying disease, as a result of which this symptom develops, should be treated. For this purpose, antibacterial therapy is used (with a preliminary identification of the type of pathogen), expectorants, vitamins, drugs to restore immunity.

There are cases of development of shortness of breath after pneumonia. If this happens, it is recommended to immediately consult a doctor, as this is an unfavorable sign. It can manifest itself as a result of improper or insufficient treatment.

If such a state is left to chance, then this will lead to the development of very dangerous complications, including:

• multiple organ failure;
• adhesive pleurisy;
• pleural empyema;
• lung abscess;
• blood poisoning (sepsis).

Diagnostics

Inflammation of the lungs is diagnosed with the help of auscultatory examination. At the same time, fine bubbling rales are heard in the affected area, and crepitus is clearly audible in the first days of the disease.

An objective confirmation of the diagnosis is the picture of pneumonia on an x-ray.

Features of shortness of breath in pneumonia in childhood

Pneumonia in newborns is very difficult. This is due to the fact that at this age the immune forces of the body do not yet fully work, the likelihood of developing the disease increases the fact of artificial feeding, and violation of hygiene rules.

The disease in babies is often common, which means that the severity of shortness of breath and impaired respiratory function can cause death. Therefore, at the slightest sign, you should immediately put the child in the hospital.

The cause of the development of inflammation and shortness of breath in children can also be a congenital disorder - a defect in the surfactant. This leads to a change in the elastic properties of the alveoli and their collapse. With such a pathology, the likelihood of developing shortness of breath and respiratory failure is very high. At this age, the nature of shortness of breath can be observed mixed, sometimes with a predominance of the expiratory component.

In addition, there are symptoms:

• increased heart rate;
• confluence during breathing of the intercostal spaces;
• stable high temperature;
• blue skin around the nome and lips, and further development of total acrocyanosis;
• symptoms of intoxication - lethargy, weakness, blanching of the skin, capriciousness, sleep disturbance, loss of appetite.

Bilateral inflammation in newborns can be fatal, so treatment is carried out only in a specialized department. It is impossible to delay in such a situation, since the prognosis for recovery can worsen every hour.

Everything you need to know about tachycardia: symptoms and treatment

Tachycardia refers to an increase in heart rate. This condition is a type of arrhythmia. The physiological norm of heart rate (HR) is 60-80 beats/minute. Indicators that are recorded above 90 indicate the development of tachycardia of the heart. What it is, and how to save yourself from serious complications, both the elderly and young people should know.

What is tachycardia?

It can be triggered by serious pathologies or physiological causes. But tachycardia is never considered as a separate disease. It is perceived solely as a symptom of a disease or a reaction of the body to the influence of certain factors. Based on this, in medicine, a physiological and pathological form of tachycardia is distinguished. The first occurs against the background of physical, or strong psycho-emotional stress.

Pathological tachycardia is caused by various diseases. It can also be associated with a nervous breakdown, alcohol poisoning, abnormal thyroid function. This condition is often a consequence of failures occurring in the work of the heart muscle. In this regard, there is a high risk of heart failure.

When making a diagnosis, it is very important to understand what kind of tachycardia is inherent in the patient. It is chronic and paroxysmal. This can be determined by listening to the heart and measuring the heartbeat. After confirming the diagnosis, an appropriate treatment is selected, which should be aimed at eliminating the factors that caused the problem to appear.

Causes

Moderate tachycardia can be caused by different mechanisms. When activated, the heart rate increases. Moreover, these mechanisms can manifest themselves even in a healthy person. Therefore, the causes of tachycardia are usually divided into two groups: physiological and pathological. The first one is:

Therefore, only external stimuli can provoke physiological tachycardia. It is temporary and does not pose a danger to humans. Very rarely, its presence aggravates the course of chronic diseases, increasing the risk of certain complications. Normally, with this tachycardia, heart rate indicators quickly stabilize.

If we talk about the pathological form, then it usually acts as a result of diseases associated not only with the cardiovascular system. The degree of its severity and duration depends on the underlying pathology. It may accompany the following diseases:

• infection of the body;
• shock state;
• inflammatory processes occurring in the heart;
• trauma;
• congenital pathologies of development;
• hypertension with a persistent increase in blood pressure;
• large-scale bleeding;

• pheochromocytoma;
• hyperthyroidism;
• anemia;
• vegetovascular dystonia (VVD);
• neurocirculatory asthenia.

When the body is infected, tachycardia occurs against the background of an increase in body temperature. Thus, the fight against pathogenic microorganisms occurs. But many of them at the same time release specific toxins that harm the body. Cardiomyocytes and the nervous system responsible for the work of the heart can suffer from them. Some of them are pyrogens, which contribute to the activation of a complex biochemical chain. Because of this, temperature regulation starts in the human body, against which the temperature rises.

Fever can cause tachycardia. Even with a slight increase in temperature, the heart rate can rise by 9 beats, and in children by 15. But at the same time, the sequence of contraction of the heart chambers remains normal.

There are generalized and focal infectious process. The first type manifests itself in diseases when there are viruses in the blood that affect important systems. The focal form is diagnosed with abscesses and other conditions in which pus accumulates. Not the last role in this is played by the pain syndrome, which often accompanies diseases with suppuration. Stabilization of heart rate and lowering the temperature is achieved after the removal of purulent contents and disinfection of the inflammatory focus.

In inflammatory conditions of the heart, damage to its departments is noted. Based on the localization of inflammation, pericarditis, endocarditis and myocarditis are distinguished. When this process covers all layers of the heart, then we can talk about pancarditis. Due to inflammation, the contraction of cardiomyocytes is disrupted, the condition of the conduction system, as well as the nerve fibers responsible for the work of the heart, worsens. Such problems can cause tachycardia. As a rule, it has an unstable character.

Forms of tachycardia

In medicine, there is no classification of tachycardia, since it is not regarded as a separate disease. But, despite this, in many countries there are several types of this condition, which depends mainly on the symptoms. This applies mainly to the pathological form, which is called paroxysmal. Some experts classify it as a group of independent diseases, due to the fact that it can manifest itself without good reason even in healthy people. The duration of such an attack can be several minutes or days.

Based on the localization of tachycardia, the following types are distinguished:

Depending on the systematic nature of the heart rhythm, sinus and arrhythmic tachycardia are distinguished. In the presence of the first impulse generation occurs in the area of ​​the sinoatrial node with the same interval. Symptoms do not always appear, due to the absence of failures in the sequence of the cardiac cycle. That is, blood delivery to all systems occurs as usual, so the body receives oxygen in a normal volume.

With arrhythmic tachycardia, a rhythm disturbance is noted. In such a situation, not only heart contractions become more frequent, but their sequence also goes astray. Very often there is an imbalance between the parts of the heart, which causes dysfunction of the valves and the loss of the ability to fill the chambers with blood.

The clinical types of tachycardia include fibrillation and flutter of the atria or ventricles. They can occur for such reasons: alcoholism, severe pneumonia, acute myocarditis, serious electric shock, heart attack, overdose of certain drugs (diuretics, glucocorticoids).

Even in medical practice, there are cases of bradycardia-tachycardia syndrome, which is a form of sinus node weakness. This may be due to atrial fibrillation or atrial flutter.

Symptoms and signs

The clinical picture depends solely on the severity of tachycardia, the duration and nature of the causative disease. Symptoms may be absent or manifest as follows:

The severity of symptoms is determined by the causative disease and the level of susceptibility of the nervous system. Some pathologies of the heart, along with an increase in heart rate, can initiate angina attacks, aggravate the course of heart failure.

Diagnostics

To identify the cause of tachycardia, the patient is sent for a series of diagnostic measures, including:

• Donating blood. It is required to determine the number of red blood cells, check the level of hemoglobin, analyze the hormonal background.
• Electrocardiogram. When using this method, electrical impulses that occur during the work of the heart are recorded. In some cases, a Holter ECG is prescribed, which involves checking cardiac activity during the day.
• Ultrasound of the heart. Thanks to this study, it is possible to evaluate the work of the heart, valves, detect pathologies, and consider signs of chronic diseases.

After receiving all the results, the doctor makes a diagnosis and selects the tactics of treating tachycardia. Of great importance is the age of the patient, his well-being, the presence of concomitant ailments. Self-medication in this case is not the best solution.

Treatment

When it comes to physiological tachycardia, treatment consists only in observing a special diet and eliminating bad habits. The pathological form requires a more serious approach in terms of therapy. Usually her treatment occurs on an outpatient basis. But it does not do without situations when urgent hospitalization of the patient is carried out. This decision is made by the attending physician after determining the diagnosis.

Medical

To prevent the development of serious complications, the patient is recommended to take antiarrhythmic drugs. They restrain cardiac activity and minimize the risks inherent in tachycardia. The most popular tools are included in the following list:

Treatment is not complete without combined drugs, which include Persen, Novo-Passit and Corvalol. Heart failure caused by frequent attacks of tachycardia is recommended to be treated with diuretics and drugs designed to supply the body with oxygen. Perfectly relieves morning attacks "Anaprilin". But it is worth noting that it is able to lower blood pressure, so it must be taken with extreme caution.

Folk remedies

The decision regarding the use of traditional medicine prescriptions should be agreed with the cardiologist. Otherwise, the likelihood of a deterioration in well-being against the background of the development of complications of the disease is high. You can not be treated with folk remedies at home without determining the cause of tachycardia.

In order to get rid of the attack, you can use the following methods:

• Herbal infusion of calendula. For cooking, take 5 small spoons of the inflorescences of this plant and pour a liter of boiling water. After an hour of infusion, the remedy should be drunk in half a glass three times a day.
• Decoction of adonis. It is necessary to take one small spoonful of grass, pour boiling water over it and send it to the fire for 5 minutes. The resulting broth still needs to stand for a couple of hours, after which it is taken one tablespoon three times a day.

It is not necessary to combine the intake of antiarrhythmic drugs with non-traditional methods of treatment. Some plants contain chemicals that can enhance or weaken the effect of medical drugs.

Surgical

If medical correction does not help relieve seizures and does not bring the desired effect, tachycardia is treated surgically. Its essence lies in the introduction of small electrodes into the affected parts of the heart, capable of generating bioelectric impulses, thereby stabilizing the rhythm. The device is installed in a minimally invasive way through large blood vessels.

Another common treatment option is heart ablation. To do this, a catheter is inserted through an opening in the patient's inguinal or femoral vein into the heart. After the detection of the pathological zone, treatment with radiofrequency waves (radiofrequency ablation) or freezing of the affected tissue (cryoablation) is carried out. This allows you to reduce cell activity, as well as permanently eliminate the cause of arrhythmia.

Correction of lifestyle and physical activity

You can only be cured if you remove the factors that can affect the increase in heart rate. These include:

• caffeinated drinks;

• alcohol and nicotine;
• excessive physical activity;
• spicy food;
• chocolate;
• psycho-emotional overload.

It is also desirable for the patient to avoid high physical activity. As for physical therapy exercises, this issue should be discussed with the doctor. Prevention is also important, which will reduce the number of tachycardia attacks and cure the underlying disease faster.

Prevention is the foundation of health. First of all, you need to make adjustments to your diet. Also, do not consume large amounts of animal fats, as they lead to the development of atherosclerosis, increasing the risk of a heart attack at the time of a tachycardia attack.

Patients who are addicted to smoking should give up their habit. Nicotine worsens the performance of the heart and increases the risk of complications in the presence of cardiac pathologies.

In addition, the patient needs to ensure peace and tranquility, avoid excitement and prevent the occurrence of neurosis.

The prognosis for this diagnosis is mostly positive. It can be unfavorable if the tachycardia is a consequence of myocardial damage. There is a high probability of death in acute myocardial infarction, which is combined with hypotension and heart failure.

Despite modern scientific achievements in the field of medicine, pneumonia remains one of the most dangerous diseases. High mortality in this disease is observed in young children - up to two years old and in the elderly - over 65-70 years old. But it is necessary for every person to be able to raise the alarm in time, to know how to determine pneumonia, because the situation from moderate to severe can at any moment go into a critical stage, when the clock goes to the clock, and it will not be so easy to find an effective medicine.

Inflammation of the lungs, or pneumonia, is an inflammation of the lung tissues as a result of the penetration of pathogenic bacteria, strains of viruses into the cells of an organ. Less common are forms caused by protozoal infections - protozoa, mold spores.

A symptom complex characteristic of pneumonia becomes a reaction to the penetration of pathogens. It can be difficult for a person without medical education to distinguish the disease from pleurisy, bronchitis, so the final diagnosis should be made by an experienced specialist.

Causes of inflammation of the lungs

Every child and adult faces banal infections of the upper respiratory tract, almost every year. However, in the course of common colds lies the risk of complications. Inflammation of the lungs can develop for the following reasons.

1. Complication of acute respiratory viral infections. For whatever reason, the human immune system is unable to defeat the virus, and he "descends" down the respiratory tract. Often, the "chain" begins with a sore throat or rhinitis, then turns into pharyngitis, then comes the turn of bronchitis, and only after that the lung tissue becomes inflamed.
2. Infection with characteristic pathogens - most often these are bacteria from the genus Streptococcus pneumoniae. The disease can be transmitted by airborne droplets, household way.
3. Accession of a bacterial infection on the background of a viral one. In this case, pneumonia develops a few days after ARVI or tonsillitis. Secondary infection is especially dangerous for people with initially weakened immunity.
4. Congestive pneumonia. Typical for bedridden patients. A specific risk group is old people who have suffered a hip fracture, and other people who are forced to stay in one position for a long time. The lack of proper ventilation in the lungs contributes to the development of pathogenic microflora.
5. Hospital infections. This type of pneumonia is recognized as the most dangerous, since pathogens, as a rule, are superinfection and are difficult to treat with antibiotics.

It must be remembered that, regardless of the type, the disease is severe. The first signs may begin to appear already a few days after infection, and sometimes the disease develops over a longer time. To avoid serious consequences, you need to take measures and know the symptoms of pneumonia.

The classification of the types of disease is used by doctors in order to determine the source of the infection, the pathogen, the method of development and the degree of damage to the lung tissue. Important data are the nature of the course, associated complications. The severity of the disease affects the choice of treatment methods, the prognosis for a particular patient.

All together allows doctors to most effectively approach the treatment of each specific case of pneumonia.

Based on epidemiological data

This classification is necessary to determine the source of infection. These data are important from the point of view of the possible resistance of the pathogen to drugs. Classification based on epidemiological data indicates the following types of pneumonia.

1. Community-acquired infections - occur outside of the hospital. Doctors are recognized, as a rule, for relatively "light" cases.
2. Nosocomial infections. They are dangerous because the pathogen is almost always a superinfection. Such bacteria are not susceptible to common antibiotics because the strains develop protection against the main active ingredients. Modern areas of medical science suggest the use of bacteriophages.
3. Provoked by immunodeficiency states. In risk groups for the development of pneumonia in adults are bedridden patients, HIV-infected patients, patients with oncological diagnoses. Pneumonia in immunodeficiency always implies a cautious prognosis.
4. atypical pneumonia. They occur with an altered clinical picture, provoked by insufficiently studied pathogens.

By pathogen

Identification of the type of pathogen affects the choice of drugs. The following types of infections are distinguished:

• bacterial - the most common type;
• viral;
• fungal;
• protozoan;
• mixed.

According to the mechanism of development

The source of the appearance of the disease allows you to determine the treatment strategy. The following forms of development are identified:

• primary - an independent disease;
• secondary - appear against the background of other diseases;
• post-traumatic - caused by mechanical damage to the lung tissue and secondary infection;
• postoperative;
• pneumonia after a heart attack - develop due to a partial violation of the patency of the pulmonary veins.

According to the degree of involvement of the lung tissue

The level of tissue damage affects the strategy of intervention and the prognosis. There are degrees:

• unilateral inflammation;
• bilateral;
• total lesion - includes basal forms, croupous, segmental.

By the nature of the flow

Given the complications

According to the severity of the current

Symptoms of the disease

Inflammation of the lungs shows different symptoms, but together they add up to a certain clinical picture. Some of them are general, others depend on the specific course of the disease. The patient or his relative should pay attention to the following manifestations.

1. High temperature, which is poorly amenable to the action of antipyretics.
2. Sweating, shortness of breath even at rest. Weakness, sometimes confusion, this symptom indicates a severe bilateral or croupous lesion of the lungs.
3. Cough - may be dry or with phlegm. With focal pneumonia, the sputum is greenish in color, has the smell of pus. Lobar pneumonia is characterized by the discharge of blood-colored mucus, this is one of the important symptoms of a dangerous condition. Cough brings no relief.
4. Pain in the sternum when breathing, especially during physical exertion.
5. Croupous pneumonia is accompanied by severe intoxication, therefore, rashes are observed in the region of the nasolabial triangle.

Without special competent treatment, the patient's condition will worsen. Alternative methods are not effective in this serious disease, so you need to seek the help of a doctor. In severe conditions, it is recommended to call an ambulance.

Diagnostic methods

The correct diagnosis includes not only the identification of the pathological process occurring in the lungs, but also the clarification of additional details. The causative agent, severity and other data are taken into account that help determine the prescription of drugs and additional procedures.

Diagnostic methods include the following:

• visual primary examination, assessment of the patient's condition;
• taking sputum for analysis - reveals the causative agent of infection;
• general blood test - determines the degree of intoxication;
• radiography;
• Ultrasound of the pleural cavity.

A full range of diagnostic procedures is recommended to establish the most accurate diagnosis possible. Ultrasound is recommended to be performed several times - to identify the effectiveness of the treatment, timely detection of complications.

Treatment of pneumonia

The treatment of pneumonia implies the correct choice of drug therapy aimed at the destruction of pathogenic microflora, in combination with drugs that help restore lung tissue and maintain the patient's condition.

Home treatment of pneumonia is unacceptable, the patient is hospitalized in the pulmonology department for complex procedures.

The standard treatment regimen includes the following activities.

1. Prescribing antibiotic therapy. Doctors recommend starting it as early as possible, using new generation drugs, without wasting time identifying a specific pathogen. If necessary, the drugs are adjusted and combined in the course of treatment. The course of treatment lasts up to 14 days.
2. Providing the patient with bed rest in a warm, well-ventilated area. A special diet is recommended - light, but high-calorie, with a lot of vitamins.
3. Appointment of antipyretic, expectorant, antihistamines. These drugs help to relieve intoxication, improve the general condition of the patient, reduce the burden on the kidneys and heart.
4. With extensive lung damage and difficulty breathing, it is recommended to use oxygen masks.
5. After the acute phase of pneumonia is removed, physiotherapy (electrophoresis with potassium iodide), inhalations, physiotherapy exercises are added to restore the damaged lung focus.

With the right approach to treatment, the symptoms of pneumonia decrease after three to four days, and full recovery occurs in 15-21 days.

Prevention and prognosis

Inflammation of the lungs in adults occurs when the methods of preventing this disease are neglected. To prevent the disease, it is recommended to keep, stop smoking and drinking alcoholic beverages.

Hardening and strengthening immunity with the help of proper nutrition, rich in vitamins and useful microelements, is also a great way to “prevent” bacterial or viral infections from reaching the lower respiratory tract.

The prognosis for healthy adults is favorable. In 80% of cases, with proper treatment, an absolute restoration of lung tissue is observed within two to three months. Sometimes there may be a partial degeneration of the affected focus - carnification, then additional measures will be required to recover from the disease.

Doubtful and unfavorable prognosis in severe cases in people with HIV infection suffering from oncological diseases.

Conclusion

Inflammation of the lungs is a disease that should not be underestimated. Remember that before the invention of antibiotics, every third sick person died from it. The achievements of modern medicine have made pneumonia not so dangerous, but qualified treatment is possible only with the help of professionals, in a hospital setting. Non-traditional and folk methods can be an addition to the main therapy, but not the basis of treatment.

Pneumonia in adults (pneumonia) is an inflammation of the lower respiratory tract of various etiologies, occurring with intraalveolar exudation and accompanied by characteristic clinical and radiological signs. The main cause of the development of the disease is a pulmonary infection that affects all structures of the lungs. There are many types of pneumonia, ranging in severity from mild to severe, or even those that can be fatal.

What is pneumonia?

Pneumonia (pneumonia) is a predominantly acute pathological condition caused by an infectious and inflammatory lesion of the pulmonary parenchyma. In this disease, the lower respiratory tract (bronchi, bronchioles, alveoli) is involved in the process.

This is a fairly common disease, diagnosed in about 12-14 adults out of 1000, and in older people whose age has exceeded 50-55 years, the ratio is 17:1000. In terms of the frequency of deaths, pneumonia ranks first among all infectious diseases.

• ICD-10 code: J12, J13, J14, J15, J16, J17, J18, P23

The duration of the disease depends on the effectiveness of the prescribed treatment and the reactivity of the organism. Before the advent of antibiotics, the high temperature dropped by 7-9 days.

The degree of contagiousness directly depends on the form and type of pneumonia. But one thing is for sure - yes, almost all types of pneumonia are contagious. Most often, the disease is transmitted by airborne droplets. Thus, being in poorly ventilated rooms with a carrier of the pneumonia virus (collective), a person is easily susceptible to infection.

Causes

Treatment of pneumonia

How to treat pneumonia in adults? General practitioners, pediatricians, family physicians, and general practitioners can treat uncomplicated forms of pneumonia.

For non-severe pneumonia in adults, inpatient treatment is performed. It consists of the following measures:

1. taking drugs that dilate the bronchi for sputum discharge;
2. taking antibiotics, antiviral drugs to combat the causative agent of pneumonia;
3. undergoing a course of physiotherapy;
4. performance of physiotherapy exercises;
5. diet, drinking plenty of water.

Moderate and severe course requires hospitalization in a therapeutic or pulmonological department. Uncomplicated mild pneumonia can be treated on an outpatient basis under the supervision of a local therapist or a pulmonologist visiting the patient at home.

It is preferable to treat in a hospital in the following situations:

• patient over 60 years of age;
• the presence of chronic lung disease, diabetes, malignant tumors, severe heart or kidney failure, low body weight, alcoholism or drug addiction;
• failure of initial antibiotic therapy;
• pregnancy;
• desire of the patient or his relatives.

Antibiotics

In pneumonia of the lungs, it is advisable to use antibiotics in adults after the disease has been confirmed by at least one diagnostic method.

• With a mild course, preference is given to protected penicillins, macrolides, cephalosporins.
• Severe forms require a combination of several antibiotics: macrolides, fluoroquinolones, cephalosporins.
• Efficiency is evaluated after 2-3 days. If the condition has not improved, this is a direct indication to change the group of drugs.

Other drugs

In addition to antibiotic therapy, antipyretic therapy is also prescribed. Antipyretics are prescribed when the temperature rises from 38.5 degrees:

• ibuprofen;
• Paracetamol;
• Ibuklin;
• Aspirin.

Mucolytics are used to thin sputum:

• Ambrohexal;
• Lazolvan;
• Ambrobene;
• Fluimucil;
• Fluditec.

Physiotherapy treatment of pneumonia in adults

There are a number of procedures that are used in the treatment of pathology, the most effective are:

• ultrasonic aerosol inhalation using mucolytics and antibiotics;
• electrophoresis with the use of antibiotics and expectorants;
• decimeter wave treatment of lungs;
• UHF therapy;
• magnetophoresis;
• UV radiation;
• chest massage.

Therapeutic measures are carried out until the patient's recovery, which is confirmed by objective methods - auscultation, normalization of laboratory and X-ray studies.

The prognosis for pneumonia in an adult directly depends on the degree of virulence and pathogenicity of the pathogen, the presence of a background disease, as well as the normal functioning of the human immune apparatus. In most situations, pneumonia proceeds favorably and ends with a complete clinical and laboratory recovery of the patient.

Compliance with the regime

1. During the entire period of illness, the patient must comply with bed rest.
2. You need a nutritious diet rich in vitamins. If there are no signs of heart failure, it is useful to drink plenty of fluids up to 3 liters per day.
3. The room should have fresh air, light, temperature +18C. When cleaning the room, you should exclude products containing chlorine, do not use heaters with an open coil, as they dry the air a lot.

During the period of resorption of the inflammatory focus, physiotherapy is prescribed:

• inductothermy;
• microwave therapy;
• electrophoresis of lidase, heparin, calcium chloride;
• thermal procedures (paraffin compresses).

Diet and nutrition

Diet for pneumonia during an exacerbation:

• lean meat, chicken, meat and chicken broth;
• lean fish;
• milk and dairy products;
• vegetables (cabbage, carrots, potatoes, herbs, onions, garlic);
• fresh fruits (apples, pears, citrus fruits, grapes, watermelon), dried fruits (raisins, dried apricots);
• fruit, berry and vegetable juices, fruit drinks;
• cereals and pasta;
• tea, rosehip broth;
• honey, jam.

Avoid foods such as: alcohol, smoked foods, fried, spicy and fatty foods, sausages, marinades, canned food, store-bought sweets, foods with carcinogens.

Recovery and rehabilitation

After pneumonia, a very important point is rehabilitation, which is aimed at bringing all the functions and systems of the body back to normal. Rehabilitation after pneumonia also has a beneficial effect on overall health in the future, which minimizes the risk of developing and recurring not only pneumonia, but also other diseases.

Recovery implies taking medications, physiotherapy, diet, tempering procedures. This stage can last up to 3-6 months, depending on the severity of the disease.

Prevention

The best prevention is to lead a rational lifestyle:

1. Proper nutrition (fruits, vegetables, juices), outdoor walks, avoiding stress.
2. In winter and spring, to avoid a decrease in immunity, you can take a multivitamin complex, for example, Vitrum.
3. To give up smoking.
4. Treatment of chronic diseases, moderate alcohol consumption.

Pneumonia is a dangerous and unpleasant disease of the respiratory tract, which is accompanied by the manifestation of specific symptoms. It is worth paying attention to these symptoms in order to maintain good health and maintain the health of the body.

This is all about pneumonia in adults: about the medical history, symptoms and first signs, and treatment features. Be healthy!

Modern doctors are faced with a variety of forms of the course of pneumonia: from mild flowing subclinical forms to severe, life-threatening manifestations. The difference in the types of inflammatory processes is explained by the variety of causative agents of pneumonia, as well as the individual local and general immune response of the whole organism to the invasion of these pathogens.

Based on the characteristics of the etiology, on the severity and duration of the disease, on X-ray morphological differences, there are several classifications of pneumonia.

The division of pneumonia according to the form of infection and the conditions for the development of the disease has become widespread throughout the world. This principle of classification dictates a separate approach to the treatment of each type of pneumonia.

Classification of pneumonia according to the form of infection and the conditions for the development of the disease

1. Community-acquired pneumonia - most often occurring at home as a complication of SARS. This is the most typical type of pneumonia.
2. Nosocomial (nosocomial, hospital) pneumonia - developing during the patient's stay in the hospital or 2 days after discharge from it. This type of pneumonia is usually caused by strains that are resistant to common antibiotics and require a special approach to treatment.
3. Aspiration pneumonia - develop when microorganisms enter the respiratory tract from the oropharynx and stomach. As a rule, this happens with vomiting in patients with diseases of the gastrointestinal tract, with alcoholism and drug addiction, in patients after anesthesia, as well as in newborns as a result of aspiration of amniotic fluid during childbirth.
4. Pneumonia in immunodeficiency states is the fate of cancer patients receiving immunosuppressant treatment, patients with immunodeficiency states.

Classification of pneumonia according to clinical and morphological characteristics

1. Parenchymal (croupous, focal, segmental)

Croupous pneumonia(usually pneumococcal) is characterized by a pronounced clinically hyperergic lobar inflammation, covering, as a rule, an entire lobe of the lung, often extending to the pleura.

Focal pneumonia characterized by inflammation of the lung tissue, in which exudate accumulates in the lumen of the alveoli. The foci of inflammation are infiltrates 0.5-1 cm in size, which are located in one or more segments of one or less often both lungs. In some cases, such foci merge, forming a single focus, often occupying an entire lobe of the lung.

Segmental pneumonia characterized by inflammation of the entire segment, the airiness of which is reduced due to the collapse of the alveoli (atelectasis). Such pneumonias tend to have a protracted course, leading to fibrosis of the lung tissue and deformation of the bronchi.

2. Interstitial pneumonia

Interstitial pneumonia is most often caused by viruses, mycoplasmas, or fungi. The diagnosis of interstitial pneumonia must be approached with great responsibility. Such caution is due to the fact that interstitial inflammation can be a manifestation of a wide variety of pathological processes both in the lungs and outside them.

Severity of pneumonia

1. Mild severity is characterized by mild signs of intoxication (fever up to 38, consciousness is clear, blood pressure is normal), lack of shortness of breath at rest. Slight shortness of breath on exertion. X-ray revealed small foci of inflammation in the lung tissue.
2. Moderate severity is manifested by moderately severe intoxication (body temperature above 38, tachycardia up to 100 beats per minute, mild euphoria, sweating, some decrease in blood pressure), shortness of breath at rest. On the radiograph, there is a pronounced infiltration of the lung tissue.
3. A severe degree proceeds with pronounced signs of intoxication (temperature above 39, tachycardia - more than 100 beats per minute, clouded consciousness, delirium, lowering blood pressure up to collapse). Signs of respiratory insufficiency are sharply expressed. On the roentgenogram: extensive infiltration. Complications may develop.

With the flow allocate acute, prolonged and chronic pneumonia, each of which can be complicated or uncomplicated.

Changes in the cardiovascular system in pneumonia.

Although the main function of the circulatory system is transport, its participation in physiological and pathological processes in the body is very diverse. Therefore, evaluating the role of this system in the inflammatory processes of the respiratory organs, it is necessary to consider the ongoing changes at all levels: organismal, organ (primarily in the bronchi and lungs), cellular, subcellular and molecular.

It should be noted that clinical, functional and morphological changes occurring in cardiovascular system(CVS) in inflammation, as a rule, represent a complex chain of causal and closely related manifestations of pathology. Therefore, pathological changes that can be objectively assessed are usually the result of the simultaneous influence of many factors: hypoxemia, hypercapnia, bronchial obstruction and associated ventilation disorders, intoxication with products of altered tissue metabolism, pathological effects of biologically active substances (BAS), violations of the rheological properties of blood, etc.

expressiveness changes in the cardiovascular system and, accordingly, its clinical manifestations depend on the prevalence of lesions of the bronchi and lungs, the nature of the inflammation (acute or chronic), the form (the most pronounced in the exudative form, the least in the alterative and proliferative), as well as the phase of the process.

At the level of the whole organism changes in the circulatory system in connection with acute broncho-pulmonary inflammation quite typically presented in patients with pneumonia.

Indicators of central hemodynamics in acute inflammation in the lungs undergo a number of characteristic shifts. According to V.P. Silvestrov et al. examined 70 patients with pneumonia, the minute volume of blood circulation (MOV) and the volume of circulating blood (CBV) against the background of an active inflammatory process clearly increase. In young patients, the increase in IOC often occurs due to an increase in the stroke volume of the heart (SV). In lobar pneumonia, cardiac output sometimes reaches very high values ​​(UV up to 216.3 ml with an IOC of 15.5 liters), but this increase is usually associated with an increase in heart rate.

M.I. Butomo et al. focus on addiction changes IOC from the phase of the process: an increase in the acute phase of inflammation and a return to normal upon recovery.

With croupous pneumonia marked acceleration of blood flow in the systemic and pulmonary circulation. Thus, the transit time of the radioactive drug in the area "right ventricle - left atrium" in some patients decreased to 2.2-3.7 seconds, which, in all likelihood, was due to "shunting" of blood through the affected areas of the lungs.

Systemic arterial pressure(BP) in uncomplicated pneumonia usually remains normal or decreases slightly towards the end of the febrile period and in the first days after the temperature drops. In severe pneumonia, blood pressure can drop rapidly and significantly both during the febrile period and during the crisis (during and after the crisis). With lobar inflammation of the lungs, after a drop in body temperature, vascular collapse may develop: a drop in blood pressure, very frequent, small filling or thready pulse, cyanosis.

P.I. Fedotov during the examination of 416 young patients with croupous pneumonia in the first 1-2 days of illness, he found a decrease in systolic blood pressure by 5-10 mm Hg. and diastolic - by 15-20 mm Hg. in 44.3% of patients. Of these, 4 patients were admitted in a state of collapse, and in 13, due to severe hypotension, fainting was observed. With focal pneumonia, arterial hypotension is usually noted in 1/3 of patients. Fluctuations in blood pressure are usually explained by changes in vascular tone, including due to a violation of its central regulation.

Croupous pneumonia with severe intoxication may also be accompanied by a decrease in venous pressure.

During the period of active inflammatory process in the lungs, a decrease in peripheral vascular resistance a large circle, which is considered as the result of an adaptive reaction of the vascular bed to a significant increase in the IOC or the impact of toxic-infectious factors on the walls of blood vessels. After the elimination of inflammation, normalization of hemodynamic parameters is observed.

Long dynamic observation of patients with different variants of the course of pneumonia suggested that the hyperkinetic type of hemodynamics detected in the acute period of the disease is an indicator of an adequate response of the cardiovascular system to the inflammatory process in the lungs. Eukinetic or hypokinetic type of hemodynamics in asymptomatic pneumonia often accompanies a protracted course of the disease and may indicate a weakening of the contractile function of the heart.

Myocardial damage and such clinical signs of it as tachycardia, expansion of the right ventricle and right atrium, increased second tone over the pulmonary artery, muffling of the first tone at the apex of the heart, are most often evidence of severe pneumonia (croupous pneumonia, confluent focal pneumonia).

On the ECG appear characteristic for such patients with low voltage. negative T waves in the second, third, or all standard leads, shift of the ST interval, conduction and rhythm disturbances, and with sudden congestion in the lungs, high, pointed P waves.

An increase in heart rate is observed in half patients with focal pneumonia with severe toxicity. Tachycardia above 120 beats per minute without severe fever almost always indicates toxic myocardial damage, and an increase in frequency above 130 beats per minute is an unfavorable prognostic sign.

Lobar pneumococcal pneumonia

Lobar pneumonia is characterized by suddenness(occurrence among full health) with a short tremendous chill, but not more than 1-3 hours (in 80% of patients); having a headache. Later in 85% of cases appear fever(38-39 ° C) of a constant type (but in old people and malnourished patients, body temperature is often normal); pleural pain in the chest, on the affected side, associated with the development of parapneumonic pleurisy on the first day of illness (in 80%); cough at first dry, then productive with viscous sputum, mucopurulent (more often) or "rusty" (in 35%); dyspnea. moreover, with volumetric lesions of the lungs or the presence of cardiac pathology - and at rest (in 60%); herpetic eruptions on the lips, near the nose on the 2nd-4th day bo-II (in 25%); varying degrees of cyanosis and symptoms intoxication- headache, general severe weakness (in 60%).

Elderly and debilitated persons, alcoholics are often brought to the hospital with impaired consciousness(acute impairment of brain activity), and alcoholics may even develop psychosis of somatogenic origin. All this complicates the diagnosis of pneumonia.

Availability "rusty" sputum and herpes labialis are recorded quite rarely and cannot be considered as a pathognomonic sign of lobar pneumococcal pneumonia. If the clinical picture of this pneumonia is dominated by damage not to the lungs, but to other organs, it is necessary to look for another pathology or complications. In severe forms of this pneumonia, icteric staining of the skin, sclera of the eyes and mucous membranes may appear due to an increase in the level of total bilirubin (up to 25-30 mg / l). In patients with chronic diseases of the lungs or heart, this pneumonia can be complicated by acute respiratory failure, heart failure, or manifest as a severe septicemic disease.

At objective examination a patient with lobar pneumococcal pneumonia is diagnosed with tachycardia and tachypnea; infiltration phenomena - increased voice trembling and bronchophony (in 60-90%), which can be several hours ahead of the appearance of percussion dullness (in 70-100% of cases). Dullness of lung sound may not be determined if the focus of compaction is deeper than 4 cm.

On the 2-3rd day begin to be auscultated (in 65-90% of patients) crepitus(which occurs in the alveoli and is heard at the maximum inhalation, does not disappear and does not change its character when coughing) and pleural rub(in 30-60%). The latter occurs in both phases of breathing, and crepitus occurs only at the end of inspiration. When simulating breathing (chest movements), crepitus is not audible. Even later, bronchial breathing is heard (in 30-40% of cases) over the entire affected area. Bronchial breathing due to the filling of the alveoli with exudate (air does not penetrate into them), better conductivity of the denser tissue of the air through the bronchi. Sometimes breathing can be hard (in a third of patients) or weakened vesicular (in 30-60% of patients). Above the affected area, breathing is usually weakened, wet, often deaf (less often sonorous) fine bubbling rales are heard.

In general, physical data correspond spread of pulmonary infiltrate and involvement in the process of the pleura. With early prescription of antibiotics, the appearance of clinical and radiological symptoms in the hot stage is ephemeral, a thorough physical search is necessary. In cases of fatal pneumonia, severe acute respiratory failure and circulatory collapse appear. When listening to the heart, tachycardia (more than 120 per minute), deafness of heart sounds (in 20-40%) are noted, there may be an accent of the 2nd tone over the pulmonary artery.

Depending on the characteristics of the clinical picture, one can distinguish:

results x-ray examination depend on the time of the examination. At the beginning of the disease, they are minimal: increased lung pattern in the affected area, non-structural root on the side of the lesion. Then (on the 4th-6th day) in 3/4 patients homogeneous segmental foci of infiltration are detected on the periphery of the lung fields. In severe pneumonia, there may be a rapid increase in lung tissue compaction despite antibiotic treatment. The upper lobe of the right lung is most often affected (in 16-32% of cases) and the lower lobe of the left lung (12-24%). In 1/3 of patients, parapneumonic pleurisy is detected, although with a targeted search it is found in half of the cases. With adequate and early treatment in 1/3 of adult patients, the resorption of infiltration occurs on the 7-8th day, and with delayed antibiotic treatment, against the background of chronic obstructive diseases, it slows down (up to 30-40 days). Regular timing X-ray normalization of the lung pattern are 20-30 days. Protracted resolution of lobar pneumonia occurs in 30-50% of patients.

in peripheral blood leukocytosis 15-25 x10 9 /l is noted in 95% of cases) with a shift of the formula to the left, toxic granularity of neutrophils, hyperfibrinogenemia, increased ESR. In very severe cases of pneumonia, leukocytosis may not be present, leukopenia is detected (less than 3×10 9 /l).

Equity pneumococcal pneumonia can worsen abscess formation, small parapneumonic pleurisy, less often - meningitis, endocarditis with damage to the aortic valve. Elderly, debilitated patients may develop shock, heart and respiratory failure, delirium.

Forecast of this pneumonia, without the presence of complications, is good in young, treated individuals. But there is a high risk of mortality (15-20%) in a number of elderly patients with a large lesion of the lung tissue, severe concomitant diseases (chronic obstructive pulmonary disease, cardiac pathology, liver cirrhosis, oncological diseases) against the background of low or high leukocytosis (less than 4 × 10 9 /l and more than 20 × 10 9 /l leukocytes, respectively) and the appearance of a bacteremic form of this pneumonia with the development of extrapulmonary lesions (meningitis, endocarditis).

high sensitivity of pneumococcus to penicillins and cephalosporins allows the use of these antibiotics as a diagnostic tool. Their appointment in 2/3 cases of pneumococcal pneumonia leads to normalization of body temperature within 3 days, a sharp decrease in intoxication and leukocytosis in the peripheral blood. In 1/3 of patients, such treatment is ineffective, normalization of body temperature occurs only after 6-7 necks. This is usually observed when more than one lobe of the lung is affected, or in people suffering from alcoholism or concomitant diseases (CHD, chronic obstructive pulmonary disease, hepatitis).

Quite often (up to 50% of cases), lobar pneumonia is not recognized during life or patients are hospitalized late (up to 60%). Generally characteristic of lobar pneumococcal pneumonia :

• development against a background of various pathologies (chronic obstructive pulmonary disease, coronary artery disease, diabetes mellitus, tuberculosis, chronic alcoholism, oncological diseases) and a decrease in the overall reactivity of the macroorganism;
• high fever (88%);
• drug crisis (good, “breaking” effect) with rapid normalization of temperature within two days from the start of treatment with penicillin, cephalosporins (in 75% of cases);
• lung compaction symptoms (60%);
• crepitus (65%);
• pleural friction noise (30-60%).

In modern conditions, the clinical picture of this pneumonia can still be varied, blurry and do not fit into the above classical description. This is determined not only by the pathogen, but also by the reactivity of the patient.

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You are reading a manual on pneumonia. written by Professor BSMU A. E. Makarevich.