Cardiopulmonary insufficiency. Symptoms and treatment of cardiopulmonary insufficiency Chronic cardiopulmonary insufficiency

Pulmonary insufficiency is a condition characterized by the inability of the pulmonary system to maintain a normal blood gas composition, or it is stabilized due to a strong overvoltage of the compensatory mechanisms of the external respiration apparatus. The basis of this pathological process is a violation of gas exchange in the pulmonary system. Because of this, the required amount of oxygen does not enter the human body, and the level of carbon dioxide is constantly increasing. All this becomes the cause of oxygen starvation of organs.

With pulmonary insufficiency, the partial tension of oxygen in the blood decreases below 60 mm Hg. Art. At the same time, an increase in the partial tension of carbon dioxide is observed. Its performance exceeds 45 mm Hg. Art. This pathological syndrome can begin to progress in people from different age categories. He is not gendered.

Etiology

The main reason for the progression of pulmonary insufficiency in humans is damage to the external respiratory apparatus at its various levels:

• neuromuscular system. The causes of the progression of pulmonary insufficiency can be various infectious or neurological ailments that have a damaging effect on the central nervous system and disrupt the physiological mechanisms of transmission of impulses from the brain to the muscles of the respiratory apparatus. Such pathologies include, and so on;
• respiratory center and CNS. In this case, the causes of the progression of pulmonary insufficiency can be brain damage of varying severity, the use of potent drugs, impaired blood circulation in the brain, and so on;
• rib cage. The accumulation of excess exudate in the pleural cavity can also lead to pulmonary insufficiency;
• damage to the airways: laryngeal edema, embolus in the bronchi,;
• alveoli. Pulmonary insufficiency is often manifested by the main symptom, as well as ailments characterized by the growth of connective tissue in the lungs.

Varieties

According to the mechanism of progression:

• hypoxemic. In this case, there is a decrease in the concentration of oxygen in the blood (hypoxemia). It is difficult to normalize partial pressure even with oxygen therapy. This form of pathology is more typical for ailments that directly affect the respiratory system, as well as for those diseases, the basis of which is the rapid replacement of lung tissues with connective tissue;
• hypercapnic. Too much carbon dioxide accumulates in the blood. It is worth noting that in this form, oxygen deficiency is also observed, but it can be corrected with oxygen therapy. Hypercapnic pulmonary insufficiency progresses due to the weakness of the muscular structures of the respiratory system, chronic obstructive pulmonary disease, obesity, and so on.

Development speed:

• acute pulmonary insufficiency. This form of pathology progresses very quickly. Symptoms of the acute form may appear within a couple of minutes, several hours or days. Since this period is very short, the body does not have time to turn on its compensatory capabilities. That is why acute insufficiency is a very dangerous condition that threatens not only the health, but also the life of the patient. To stop it, you need to resort to intensive therapy. Treatment of an acute form of pathology is usually carried out in intensive care;
• chronic pulmonary insufficiency. A characteristic feature of the chronic form is slow development. The pathological condition progresses over several months or even years. This enables the human body to maximize its compensatory capabilities, thereby maintaining a full-fledged blood gas composition. The chronic form is safer, since in most clinical situations it is detected and treated in a timely manner. Lethal outcome is extremely rare.

Based on severity:

1 degree– partial oxygen tension (PNA) in the blood is in the range of 60–79 mm Hg. Art. Blood oxygen saturation at this degree ranges from 90 to 94%;

2 degree. PNK decreases to 40–59 mm Hg. Art., and blood oxygen saturation up to 75-89%;

3 degree. PNA in the blood decreases to critical levels - below 40 mm Hg. Art., and blood oxygen saturation is less than 75%.

Based on the severity of the symptoms manifested (only for chronic pulmonary insufficiency), the following are distinguished:

LN 1 degree. A sick person develops shortness of breath with moderate or significant physical. loads;

2 degrees. Shortness of breath occurs even with light exertion. While a person is at complete rest, it can be noted that compensatory mechanisms have activated;

3 degrees. Shortness of breath and acrocyanosis are manifested even in a state of complete rest.

Symptoms

With pulmonary insufficiency, the following symptoms appear:

• shortness of breath of varying degrees of intensity;
• in the morning, a sick person may experience headaches;
• insomnia;
• pulse rate increases;
• nausea and vomiting;
• the skin becomes bluish;
• auxiliary muscle structures are involved in the respiratory act;
• memory impairment;
• decrease in blood pressure;
• the frequency and depth of breathing changes;
• disturbance of consciousness.

Diagnostics

The standard diagnostic plan for suspected pulmonary insufficiency includes:

• collection of patient complaints;
• inspection;
• assessment of the gas composition of the blood;
• assessment of the acid-base state of the blood;
• x-ray;
• spirometry.

Therapeutic measures

Treatment of a pathological condition is carried out in a hospital, so that doctors have the opportunity to monitor the patient's condition. Therapy should be only complex, only then it will be possible to achieve positive dynamics:

• treatment of the underlying ailment that provoked the pathology. In this case, they carry out therapy for heart failure, respiratory diseases, etc.;
• oxygen therapy. It must be included in the treatment plan in order to maintain the gas composition of the blood at the required level;
• postural drainage;
• vibration massage of the sternum - a method of treatment that allows you to ensure the normal patency of the bronchi;
• the appointment of pharmaceuticals that thin the sputum;
• IVL. This method of treatment is indicated for 2 degrees of insufficiency;
• tracheal intubation. Conducted if there is no positive dynamics, but there is a high threat of suffocation.

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Diseases with similar symptoms:

As you know, the respiratory function of the body is one of the main functions of the normal life of the body. The syndrome, in which the balance of blood components is disturbed, and to be more precise, the concentration of carbon dioxide greatly increases and the volume of oxygen decreases, is called "acute respiratory failure", it can also become chronic. How does the patient feel in this case, what symptoms may bother him, what signs and causes of this syndrome - read below. Also from our article you will learn about diagnostic methods and the most modern methods of treating this disease.

Heart failure is a condition of the heart in which it “insufficiently” copes with its function, i.e. blood supply to organs and tissues with blood occurs with some difficulties.

Cardiopulmonary insufficiency is a form of the disease when, due to increased pressure in the small (pulmonary) circulation, symptoms of congestion in the lungs are added.

Most often, the chronic form of the disease develops in women, since men with a pathology of the cardiovascular system, as a rule, die before the development of chronic heart failure from heart attacks or strokes. This situation has developed due to the positive effect of female hormones on the vascular wall (estrogen prevents the development of vascular accidents in the female).

Doctors call this condition acute left ventricular failure, because it is left ventricular dysfunction that most often leads to stagnation of blood in the lungs.

Deficiency is associated with a sharp change in the activity of the heart muscle, due to an infectious disease or an electrical discharge that hit the heart muscle, thrombosis of the coronary (supplying the heart itself with blood) arteries, muscle rupture and other vascular accidents.

It manifests itself as cardiogenic shock, suffocation (cardiac asthma), pulmonary edema. The patient takes a forced position - sitting with the emphasis of the hands, in order to somehow ensure the flow of air.

The mechanism of pulmonary edema in heart failure: due to the extremely high blood pressure in the lungs, fluid effusion from the vessels into the intercellular space begins, which disrupts normal gas exchange in the lung tissues. As a result, suffocation occurs. Acute cardiopulmonary failure can develop almost instantly; within a few minutes.

Symptoms of acute heart failure

The patient begins shortness of breath, gradually turning into a painful suffocation. The patient assumes a forced position

Due to the effusion of fluid in the lungs, sputum may be coughed up, which does not bring the patient any relief. In severe cases, pink, frothy sputum is separated from the mouth and nose.

Edema and pallor may appear quite quickly. The patient becomes very scared (and not unreasonably).

Acute cardiopulmonary failure may not have specific acoustic manifestations. Sometimes with the help of a phonendoscope, small bubbling rales can be heard in the lower parts of the lungs (edema). With expanded edema, moist rales appear over the entire surface of the lungs.

Symptoms of acute heart failure in the photo

The pressure in acute heart failure may be elevated, may be reduced - this is not a diagnostic criterion. Due to severe stress in this condition, an increase in the heart rate is observed. If the patient has had episodes of arrhythmia in the past, it may happen again.

First aid for acute cardiopulmonary failure

We immediately call an ambulance. If the patient cannot figure out for himself how it is easier for him to breathe, we seat him on a chair (posture “on a horse”) with his legs down. elbows should rest on the back of the chair.

Pulmonary edema is one of the most dangerous conditions in medicine, no folk methods, the power of self-hypnosis and reflexology can save you from it.

Regardless of your assumptions about the nature of the condition, a nitroglycerin tablet should be placed under the tongue of the patient.

If the leading mechanism of insufficiency is myocardial infarction, then timely prescribed nitroglycerin significantly reduces the area of ​​tissue damage, i.e. reduces the risk of rupture (transmural infarction) of the heart muscle and improves overall prognosis.

We open the windows in the room - the air must be saturated with oxygen. If there is oxygen in the room (in the tank), let the patient breathe.

It is enough to effectively apply a tight tourniquet on both legs - this will significantly unload the heart, because. reduce the volume of circulating fluid. This manipulation can save the life of the patient, however, with prolonged burning, the patient dies from intoxication after decompression of the legs.

If you are afraid that the patient will not make it to the arrival of the ambulance (foamy sputum from the mouth, the patient turns blue) - you can burn the lower limbs.

Treatment of acute left ventricular heart failure in a hospital

Such patients are taken either to the infarction department, or to the intensive care unit at the cardiological dispensary or department. If the process is accompanied by arrhythmia - to the cardiological hospital where there are arrhythmologists.

In the hospital, pulmonary edema will be removed with hormonal drugs, the patient is given narcotic analgesics. If the problem was in thrombosis of the coronary arteries, thrombolytics are prescribed: Actelize, Metalise, Streptokinase, Urokinase, etc.

Thrombolytics are quite expensive, but they can save the patient in the first hours after thrombosis. In fact, when a blood clot splits, the situation is resolved without serious consequences for the patient. Do not save at this stage - if the clinic has run out of a tender thrombolytic - buy it.

In addition, doctors prescribe drugs that reduce the activity of the respiratory center, sedatives and stimulants of metabolism in the heart muscle (metabolic therapy).

If a patient has heart failure accompanied by arrhythmia (atrial fibrillation, atrial fibrillation), antithrombotic therapy is prescribed.

Cardiac arrhythmia caused by left ventricular heart failure is itself a factor provoking thrombosis. To prevent this common complication, Xarelto, Clexane and other fractionated heparins are prescribed.

After emergency care, the patient is transferred to a regular ward, prescribed drugs that lower blood pressure (ACE inhibitors, diuretics) and drugs to normalize the heart rhythm.

Chronic cardiopulmonary insufficiency

It is designated by the abbreviation CHF - this is a very common pathology associated with gradual decompensation (overload) of the left ventricle. It is this part of the heart that is responsible for the blood supply to the entire body, i.e. produces systolic ejection of blood.

As a rule, the cause of heart failure in this case is associated with a gradual narrowing of the lumen of the coronary arteries due to atherosclerosis. The heart is gradually “cut off” from nutrition, as a result of which the heart muscle first increases and then collapses, which leads to insufficiency.

The second consequence of atherosclerosis is high blood pressure, which aggravates the process of destruction of the vascular system.

Causes of CHF in the photo

Another common cause of CHF is excessive exercise and an increase in overall body weight. Both bodybuilders and people who are simply inclined to be overweight increase the overall resistance in the vascular bed (more mass - more blood vessels). Simply put, there are more pipes, but the motor is the same. For a while, the heart works at high speeds - the muscle tries to give out normal pressure. Then - the destruction of the heart muscle occurs and insufficiency occurs.

It is believed that stress and smoking are also factors provoking CHF, since constant vasoconstriction enhances the effect of atherosclerotic changes.

Factors provoking the development of CHF

Alcohol is not a direct risk factor for CHF, however, the toxic effect of ethyl alcohol on the heart muscle is periodically observed, and alcoholic myocarditis is sometimes the cause of the development of an acute form of heart failure. Moderate alcohol consumption is indeed a factor in the prevention of atherosclerosis (and, consequently, CHF), however, due to the lack of moderation among the population in this matter, this topic is not considered by doctors.

Heart failure symptoms and CHF classes

Shortness of breath is one of the most important signs of heart failure.

Traditionally, the severity of CHF is determined by analyzing the distance that a person can overcome without shortness of breath and other symptoms. The classic test is climbing stairs.

• 1st class CHF. It is considered the mildest form of the disease - when climbing to the 3rd floor and above, shortness of breath appears. Otherwise, the person feels normal, activity is normal;
• The 2nd class is already quite easy to detect even in the countryside - when climbing to the first floor, shortness of breath begins, as well as when walking fast. Morning swelling appears. The heart is enlarged, which becomes noticeable even on a chest x-ray;
• 3rd class - a serious condition in which shortness of breath occurs with any physical exertion;
• Grade 4 - shortness of breath at rest, the condition is constantly worsening (up to death).

The chronic form is characterized by blue fingers and toes (cyanosis), hemoptysis, dry rales, swelling of the extremities (1st-2nd class - only in the morning).

The diagnosis is made by a cardiologist. As a rule, an examination, an ECG and a plain radiograph are sufficient for this.

Treatment of chronic cardiopulmonary insufficiency

Treatment should be lifelong under periodic medical supervision

Psychological phenomenon - no one wants to be treated for a long time (consciousness rejects an incurable disease). As a rule, patients take drugs only 2-3 months after visiting a cardiologist. This is the main reason for the relatively rapid death from heart failure.
Treatment of chronic heart failure is prescribed for life. Cancellation of doctor's appointments quickly enough leads to the transition to the next functional class of CHF.

Pressure-reducing drugs are prescribed - sartans (Losartan), ACE inhibitors (enalapril, lisinopril), diuretics (hydrochlorothiazide, etc.). In addition to diuretics, patients are advised to strictly limit the fluid they drink. Beta-blockers (carvedilol, metaprolol, etc.) are recommended for heart rate control.

For the prevention of thrombosis, patients must be prescribed acetylsalicylic acid (aspirin). Sometimes it is combined with warfarin and other anticoagulants and antiplatelet agents.

Video: treatment of chronic heart failure

Surgical treatments

Some of the problems leading to the development of CHF can be solved surgically:

• bacterial myocarditis can be cured with antibiotics, and the primary focus can be removed (cut out tonsils, sanitize sinusitis, etc.);
• atherosclerosis of the coronary arteries is successfully treated by bypass and ballooning. At the same time, the narrowed vessel is expanded, and the person returns to an active social and physical life;
• mitral valve stenosis is also operated quite successfully.

Attention to loved ones and a timely appeal to a cardiologist can prolong life for decades. Even with chronic insufficiency, the process can be stopped in the early stages and significantly slowed down in the later stages. The key point of the medicinal method of treatment is the constant daily intake of drugs prescribed by the doctor.

The development of cardiopulmonary insufficiency is directly related to the disruption of such body systems as respiratory and vascular. A pathological process develops due to an increase in blood pressure. Pathological disorders occur in the pulmonary circulation. They lead to the fact that the right ventricle of the heart has an excessive load. Gradually, this is accompanied by thickening of the myocardium.

With decompensation of cardiopulmonary insufficiency, conditions dangerous to human health and life develop. What causes such disorders in the body, and what to do when the primary symptoms of such disorders appear?

Why does the disease develop?

Hypertension of the pulmonary valve is fraught with violations of oxygen saturation of internal organs and tissues. Because of this, there is an increase in cardiac activity. The body activates such processes in order to prevent the development of hypoxia.

If the pathological process in the right parts of the heart proceeds for a long time, then it provokes an increase in muscle mass, which occurs due to constant overloads. Such a period experts call compensated. It does not cause the development of any disorders. If no therapeutic measures are taken at this stage of pathological disorders, then a violation occurs on the part of the compensatory mechanism, which is fraught with the occurrence of irreversible processes in the region of the heart - the stage of decompensation.

The main causes of cardiopulmonary insufficiency:

• On the part of the bronchi, pathological changes are accompanied by compression of the vascular structures. This is fraught with violations of muscle tone.
• On the part of the vascular structures, deviations are accompanied by narrowing of the arteries, which occurs due to thrombosis or the development of malignant or benign formations that thicken the walls.
• Due to the deformation of the sternum, compression occurs, which occurs under the influence of this factor. Such a process causes the infection of the lumen, which contributes to an increase in pressure and aggravation of hypoxia throughout the body.

The development of a chronic form of pulmonary heart failure occurs rather slowly. Pathological disorders develop gradually. This may take several years. This occurs against the background of pathologies such as idiopathic hypertension, atherosclerosis, heart disease and pulmonary artery insufficiency. Pulmonary valve insufficiency, as a rule, occurs against the background of chronic pathological processes in the lungs, slowly progressive heart disease and acquired valvular disorders.

What are the degrees of the disease?

Violations of blood vessels, heart and respiration are classified according to the severity of the pathological process.

• In the first stage (preclinical), a transient form of pulmonary hypertension is observed. This condition is characterized by symptoms of a load on the right ventricle of the heart.
• In the second stage, signs of hypertrophy appear. The right ventricle of the heart increases in size. Pulmonary hypertension becomes permanent. Circulatory failure at this stage does not yet occur.
• At the third stage of disease progression, decompensation of cardiopulmonary insufficiency occurs. This occurs against the background of right ventricular failure.

Specialists identified 4 degrees of pulmonary insufficiency, which also affects the right ventricle, which is accompanied by its overload. In this case, there is a supersaturation of the blood with oxygen, which leads to insufficiency of circulatory processes. At the very beginning of progression, pulmonary valve insufficiency is accompanied by a decrease in lung volume. The heart enlargement that has occurred is not traceable on the ECG, but can be determined using echocardiography. Circulatory failure develops at stages 2 and 3 of the progression of pathological changes.

Lung valve insufficiency leads to a decrease in oxygen in the blood, which is fraught with the development of a serious degree of hypoxia. The volume of the lungs in this case is reduced by 40%. At rest, the patient has shortness of breath. Pulmonary valve insufficiency is accompanied by disorders such as the lack of ability to close the valves. This process is characterized by a reverse flow of blood. This is due to right ventricular diastole.

Pulmonary valve insufficiency at the 4th degree of progression is accompanied by a decrease in blood oxygen saturation by 50%. Dilatation is added to the increase in the right ventricle of the heart. At this stage of progression, the insufficiency of the circulatory process reaches stage 2B.

Clinical picture

Acute cardiopulmonary failure is accompanied by a number of symptoms that depend on the area and degree of damage to the body. An experienced specialist can already determine the degree of damage to internal organs by the symptoms.

Symptoms of heart disorders

In acute heart failure, the following symptoms appear:

• Shortness of breath, turning into suffocation.
• Fluid effusion in the lungs gives sputum, after discharge, which is not relieved.
• In severe cases, frothy pink sputum may come out of the nose and mouth.
• Swelling quickly appears, and the skin in the face area becomes pale.
• The patient experiences fear and anxiety.

Cardiac lesions may not present with acoustic symptoms. Already at the 1st degree of development of the disease, pronounced cyanosis of the lips occurs. The reason for this is hypoxia, which is characterized by a lack of oxygen in the blood.

Symptoms of disorders in the lungs

Acute respiratory failure is accompanied by stagnation of blood in the lungs. This is due to myocardial insufficiency. The cause may be an infectious disease, arterial thrombosis, muscle rupture and electric current.

Acute respiratory failure is accompanied by the following symptoms:

• Instant development of cardiogenic shock.
• The occurrence of cardiac asthma (suffocation).
• The appearance of severe pulmonary edema, which can cause death.

Acute respiratory failure develops gradually due to increased blood pressure in the lungs. This leads to the release of fluid (effusion) into the region of the intercellular space, which is fraught with disruption of normal gas exchange.

Decompensated processes of cardiopulmonary insufficiency lead to the progression of irreversible processes in the body. With the development of pathology, breathing is disturbed - shortness of breath appears even when a person is at rest. Ischemic pains appear in the region of the heart, and pressure decreases. Plus, persistent swelling occurs, and the skin becomes bluish.

First aid

With cardiopulmonary insufficiency, treatment should be started immediately. The sooner the patient starts taking medication, the less likely it is to develop complications.

In an acute attack of cardiopulmonary insufficiency, the patient should be given emergency care. The first step is to call an ambulance. If it is difficult for the patient to find a comfortable position of the body, then he should be helped in this. It must be seated in a position in which it will be easiest to breathe. Most often, the “on horseback” pose helps: the patient sits on a chair facing the back, leaning on it with his elbows.

Please note that pulmonary edema is the most dangerous condition that requires immediate medical attention. Before the arrival of the doctor, it is necessary to give the patient a nitroglycerin tablet, which should be placed under the tongue and slowly dissolved. This is necessary to reduce tissue damage and reduce the risk of rupture of the heart muscle. Timely assistance can improve the prognosis of the heart and lungs.

Symptoms and treatment of cardiopulmonary insufficiency are closely related.

Diagnostic Measures

Before starting the treatment of acute cardiopulmonary insufficiency, there is a need for a comprehensive diagnosis:

• X-ray of the sternum. The procedure is carried out in order to identify extensions from the mediastinum and changes that have occurred in the lung structures. The diagnostic measure defines pulmonary valve insufficiency.
• CT scan. The diagnostic procedure is carried out for an in-depth study of pathological disorders in the heart and lungs.
• Echocardiography. The research measure makes it possible to determine dysfunctions in the area of ​​the valvular apparatus even at the initial stages of development. This procedure determines changes in cardiac output and makes it possible to identify the contractility of the heart muscle.
• Electrocardiography. An additional diagnostic technique makes it possible to detect violations of the heart rhythm.
• Angiography. The procedure is carried out in order to visualize the shape and lumen of the vessels, and also makes it possible to identify blood clots.
• catheterization. This technique is indispensable for measuring pressure indicators in the region of the heart cavities and large vessels of the lungs.
• Spirometry. A diagnostic study is carried out to determine the degree of respiratory failure.

Medical measures

Acute cardiopulmonary failure requires assistance in intensive care. With the development of a serious condition, there is a danger to the life of the patient. Without fail, specialists use an oxygen mask or install a nasal catheter. This measure is necessary in order to eliminate oxygen starvation and mitigate hypoxia. If these measures are not effective enough, then the patient is transferred to artificial lung ventilation.

Drug correction of cardiopulmonary insufficiency involves intravenous administration of the following agents:

• "Aktilis", "Streptokinase". These drugs are designed to restore blood flow and dissolve blood clots.
• "Atropine". The effectiveness of the drug is aimed at relaxing the smooth muscle muscles of the bronchi, which improves the functioning of the lungs.
• "Heparin", "Warfarin". Anticoagulants prevent blood clots and thin the blood.
• "Papaverine". The drug is intended to reduce the tone in the area of ​​vascular structures, expand their lumen, normalize pressure in the area of ​​the pulmonary circulation.
• Eufillin. The drug is intended to reduce the myocardium and restore respiratory functions.

Children and adults receive similar drug treatment. Dosages are prescribed individually for each patient, depending on the degree of damage to the heart and lungs.

The child and adult suffering from cardiopulmonary insufficiency should be treated as early as possible. Otherwise, there are high risks of developing serious health complications that endanger the life of the patient.

How to recognize heart failure?

When heart failure develops, the symptoms increase gradually, sometimes the process of developing the disease takes more than 10 years. In many, the disease is detected already when, due to the inability of the heart to provide a full blood supply to the organs, various complications arise in people. But complications can be avoided if the treatment of the disease is started in a timely manner. But how to recognize the first symptoms?

How does pathology develop?

Before answering the question: “How to recognize heart failure?”, It is worth considering the mechanism of the development of the disease.

The pathogenesis of heart failure can be described as follows:

• under the influence of adverse factors, the volume of cardiac output decreases;
• to compensate for insufficient emission, compensatory reactions of the body are connected (there is a thickening of the myocardium, an increase in heart rate);
• for some time, compensation processes make it possible to ensure a full blood supply to organs and tissues due to the work of the organ with an increased load;
• but the myocardium, which has increased in size, requires a larger volume of blood for full-fledged work, and the coronary vessels can only transport the same volume of blood and cease to cope with providing the muscle with nutrients;
• insufficient blood supply leads to ischemia of certain parts of the heart and in the myocardium, due to a lack of oxygen and nutrients, contractile function decreases;
• as the contractile function decreases, the value of cardiac output decreases again, the blood supply to the organs worsens, and signs of heart failure increase (the pathology becomes incurable, you can only slow down the progression of the disease).

Symptoms of heart failure may develop:

• Slowly. Chronic heart failure (CHF) progresses over the years and often occurs as a complication of heart or vascular disease. In most cases, CHF detected in a timely manner at an early stage is reversible.
• Fast. Acute heart failure occurs suddenly, all symptoms grow rapidly and compensatory mechanisms often do not have time to stabilize blood flow. If the acute violations that have arisen are not eliminated in a timely manner, they will end in death.

Having understood what heart failure is, you can consider how it manifests itself.

Symptoms of the disease

Manifestations of heart failure will depend on the degree of the compensatory mechanism and on which part of the heart is more disturbed. Types of heart failure are distinguished:

• left ventricular;
• right ventricular;
• mixed.

Left ventricular

It is characterized by stagnation in the pulmonary circulation and a decrease in the supply of oxygen to the blood. Chronic heart failure with damage to the left ventricle will manifest itself:

• shortness of breath;
• constant feeling of fatigue, drowsiness and impaired concentration may occur;
• sleep disturbance;
• pallor and cyanosis of the skin;
• the cough is initially dry, but as the disease progresses, scanty sputum appears.

With the development of the disease, a person begins to suffocate while lying on his back, such patients prefer to sleep in a semi-sitting position, putting several pillows under their backs.

If the treatment of heart failure was not started in a timely manner, then the person develops cardiac asthma, and in severe cases, pulmonary edema may occur.

Right ventricular

Symptoms of chronic heart failure with impaired functioning of the right ventricle will manifest themselves taking into account the tissues or organs in which congestion has occurred. But the general symptoms will be:

• feeling of chronic fatigue;
• feeling of pulsation of the veins in the neck;
• the appearance of edema, first on the legs, and then on the internal organs;
• rapid pulse;
• shortness of breath occurs first with exertion and then at rest, but cardiac asthma or pulmonary edema rarely develop;
• there are signs of general intoxication.

Compared to left ventricular failure, right ventricular failure progresses much faster. This is due to the fact that most of the important organs suffer during its development.

mixed

It is characterized by dysfunction of both ventricles. Syndrome of chronic heart failure mixed type occurs when the failure of another joins the dysfunction of one of the ventricles. Almost always, the mixed appearance is accompanied by atrial hypertrophy. The heart in this case increases significantly in size and cannot fully perform its function of pumping blood.

Effect of age on symptom severity

The age of the patient also affects the symptoms of the disease. By age group, there are:

• newborns;
• children of preschool and early school age;
• teenagers;
• young and middle age;
• elderly people.

newborns

Heart failure in newborns occurs due to a violation of intrauterine development of the heart or blood vessels. Newborns are always diagnosed with acute heart failure, which is characterized by a rapid increase in clinical symptoms.

In newborns, pathology manifests itself:

• severe shortness of breath;
• increased heart rate;
• cardiomegaly;
• enlargement of the spleen and liver;
• sluggish sucking or complete refusal to eat;
• cyanosis of the skin.

Such children are immediately sent to the intensive care unit.

Children of preschool and primary school age

At this age, chronic heart failure often develops, and its first signs will be a decrease in concentration and lethargy.

Such children try to move less, avoid outdoor games, and it is difficult for them to concentrate on a specific task. Schoolchildren's performance is declining.

Parents should remember that the occurrence of problems with school performance can be associated with heart disease. If treatment is not started in a timely manner, then the symptoms will increase and complications of heart failure may occur, which will negatively affect children's development.

Teenagers

Due to the hormonal maturation of CHF in adolescents, it is difficult to diagnose without examination. This is due to the fact that during hormonal changes in adolescents, hypersensitivity of the nervous system occurs, which means that symptoms such as fatigue, palpitations or shortness of breath can be temporary, transient.

But the manifestation of symptoms in adolescents associated with breathing or heart is dangerous to ignore, because the consequences of heart failure can be serious, and complications will cause disruption of vital organs.

If CHF is suspected, it is necessary to conduct a complete examination of a teenager in order to timely identify the pathology.

If a person does not have chronic diseases that give similar symptoms, for example, shortness of breath with asthma and COPD or swelling of the legs with varicose veins, then in most cases the symptoms are pronounced and suggest the presence of a pathology.

Elderly people

In older people, the body's defenses are weakened and the symptoms become pronounced already with the onset of severe heart failure, which means that it becomes much more difficult to treat it. This is due to the fact that a person associates a gradual deterioration in well-being with the gradual effort of the body, and not with the development of the disease.

How are manifestations of pathology classified?

In cardiologists, the classification of chronic heart failure is adopted according to:

• stages of development of the compensatory mechanism;
• phases of contractile dysfunction.

Stages of compensation

From how the body's defenses compensate for pathological disorders in the work of the heart, the following degrees of cardiac pathology are distinguished:

1. Compensated or degree 1. It is quite difficult to diagnose the disease in this period, the first signs may not appear in any way or occur only after significant physical exertion. If changes in the myocardium are detected at the initial stage, then in most cases it is possible to cure heart failure by eliminating the provoking factor and conducting a course of maintenance therapy. But at the first degree, the disease is detected only by chance, during a routine medical examination.
2. Decompensated. First, moderate heart failure appears with shortness of breath on exertion and a feeling of increased fatigue. Gradually, the symptoms increase, shortness of breath appears at rest, the skin becomes pale cyanotic, edema of various localization appears, and a rapid pulse can last for a long time. What is the danger of chronic heart failure not treated in a timely manner? The fact that with the development of congestive phenomena of blood circulation, irreversible ischemic disorders occur in the vital systems of the body. Heart failure of the decompensation stage is not completely cured, the treatment process is aimed at relieving symptoms and slowing down the progression of pathological processes.
3. Terminal. Medicines at this stage are ineffective, the patient has undergone dystrophic changes in all vital organs, and the water-salt metabolism has been disturbed. Such patients are in the hospital and the nursing process for chronic heart failure in the terminal stage is aimed at alleviating the pain of the patient and providing full care.

Phases of violation

Depending on the phase in which the violation of the contractile function occurred, there are:

• systolic (gastric wall contracts too quickly or too slowly);
• diastolic (the ventricles cannot fully relax and the volume of blood flowing into the ventricular chamber decreases);
• mixed (completely impaired contractile function).

But what are the causes of chronic heart failure? Why is the work of the heart disturbed?

Causes of chronic disease development

The reasons why heart failure occurs may be different, but chronic heart failure is always a complication of another pathological process in the body.

CHF can become a complication:

• cardiomyopathy;
• cardiosclerosis;
• chronic cor pulmonale;
• hypertension;
• anemia;
• endocrine diseases (more often with impaired thyroid function);
• toxic infections;
• oncological processes.

The etiology of the onset of the disease affects the choice of tactics, how to treat heart failure and the reversibility of the process that has arisen. In some cases, for example, with infections, it is enough to eliminate the provoking factor and the full functioning of the heart can be restored.

Acute form of pathology

Acute heart failure occurs suddenly when the heart fails and is a life-threatening condition.

The causes of acute heart failure are varied. It could be:

• cardiac tamponade;
• malfunction of valves;
• heart attack;
• pericardial thromboembolism;
• ciliated ventricular arrhythmias;
• blood loss;
• left chest injury.

The diagnosis of acute heart failure is established quickly:

• the pulse increases sharply, but the pulse wave becomes weak, sometimes it can only be determined on the cervical artery;
• breathing becomes shallow and frequent;
• the skin becomes sharply pale and acquires a bluish tint;
• consciousness is confused or disappears.

The sooner treatment of acute heart failure is started, the more favorable the prognosis for the patient. If there is a suspicion of acute heart failure syndrome, then you should immediately call an ambulance. While waiting for the medical team, the patient must be laid down with his head and back elevated, and care must be taken that the person can breathe freely.

No drugs can be given to the victim, but you can wet a napkin with cold water and put it on the head of the sick person.

Seeking medical help cannot be neglected; for the treatment of acute heart failure, the help of a cardiologist is necessary. Even if it seems that the patient has become better, this does not mean that the victim is recovering full-fledged work of the myocardium: when acute heart failure has developed, the symptoms may subside before death. This is due to the fact that the body's defenses are completely exhausted and will fail at some point.

Diagnostic measures

The main methods for diagnosing heart failure are:

• initial examination of the patient (the pulse is checked, the skin is examined, the work of the heart is heard through the phonendoscope);
• taking an ECG.

ECG is the most reliable diagnostic method for clarifying pathological changes in the work of the heart: the pulse and the main signs of ventricular dysfunction can be seen on the electrocardiogram. During an external examination and on an ECG, the attending physician

The etiology of the disease is clarified with the help of additional examinations:

1. CT scan. The most accurate method: how to determine the degree of circulatory disorders and tissue areas with impaired trophism.
2. Ultrasound and dopplerography. This hardware examination allows you to identify the uniformity of the blood flow and how fully the blood supply to the organs occurs. Doppler ultrasound can check cardiac blood flow and determine the degree of myocardial ischemia.
3. Biochemistry of blood. Violation of the biochemical formula will indicate which organs have already suffered from impaired blood supply.

Diagnosis and treatment of chronic insufficiency, if it is first detected, is carried out only in a hospital, where the attending physician individually selects medications and their regimen. When heart failure has already been established, treatment can be carried out at home, taking the drugs prescribed by the doctor.

Features of the treatment process

But drugs to stop the symptoms and treatment brought relief to well-being, not the most important thing in the treatment process. Of course, so that the symptoms characteristic of heart failure do not progress further, treatment with pills and injections is necessary. But, in order to reduce the risk of complications, lifestyle in heart failure should exclude all provoking factors:

• timely treatment of acute and chronic diseases;
• getting rid of bad habits;
• compliance with the regime of work and rest;
• exclusion from the diet of harmful products (smoked meats, canned food, pickles);
• ensuring adequate physical activity (walks, dosed physical exercises).

In order not to aggravate heart failure, prevention by changing lifestyle and diet is no less important than the drugs that must be taken to maintain the full functioning of the myocardium.

It is necessary to perceive cardiac insufficiency as a serious pathological deviation of the work of the myocardium and, at the first suspicion of its development, make an ECG. This procedure takes only a few minutes and will allow you to identify the disease at an early stage of development. A timely identified cardiac abnormalities are easily treatable.

Symptoms and treatment of heart failure

Signs of the disease indicate obvious deviations in the condition and, with proper diagnosis, allow you to quickly identify the disease. If a person is diagnosed with heart failure, the causes of it in most cases lie in damage to the heart. The disease can be caused by negative deviations in the process of pumping the required volume of blood by the body, which passes through the vessels.

The reasons

The main causes of heart failure in humans are expressed in:

• ischemic heart disease;
• any of the heart defects;
• hypertension, when blood pressure is elevated.

In the fairer sex, the most common cause that provokes the development of the disease is hypertension. Among male patients, ischemic heart disease often causes the problem.

The reasons are related to the diseases already existing in a person, which were not treated in a timely manner or ineffective therapy was carried out. Affects the state of the cardiovascular system and the wrong way of life. Main annoying factors:

1. Arrhythmia - failures in the heart rhythm.
2. Cardiomyopathy.
3. Diabetes.
4. Myocarditis.
5. Excessive consumption of alcoholic beverages, smoking.

Patients should remember that some causes of heart failure, such as cardiosclerosis, myocardial infarction, are likely to provoke cardiac asthma. This is a dangerous pathological phenomenon, which is accompanied by moments of suffocation, while noisy breaths are observed. If such a pathology appears, you should immediately seek medical help, since cardiac asthma greatly threatens the health and life of a person.

Symptoms

Symptoms of heart failure can vary. It depends on the presence of negative abnormalities in a certain cardiac section, which cause blood stagnation. With left ventricular failure, blood stasis can be detected in a small circle of blood circulation, in the lungs.

Symptoms of the disease at the beginning of its development can make themselves felt only with great physical exertion. The patient has shortness of breath, he can breathe very often, deeply, which is not typical for physical exercise and cannot be provoked by work of an average level of severity. Symptoms of the disease may include a cough, which in some cases passes with blood impurities. This is due to an increase in pressure in the vessels located in the respiratory system.

Other signs: frequent heartbeat, severe and rapid fatigue, weakness. Such manifestations occur in people who have eaten a lot, played sports or activities related to physical labor. After some time, there is an increase in symptoms, which begins to be observed even in a state of complete rest of the body.

For many patients who suffer from this disease, a decrease in the amount of urine is characteristic. People start going to the toilet most often at night. Symptoms of heart failure are the appearance of swelling in the legs at the end of the working day. Initially, swelling is observed only at the very bottom, then they can be seen not only on the feet. The skin on the feet, upper limbs, earlobes, nose becomes blue. The disease can be accompanied by blood stasis (the liver suffers, as violations occur in the vessels of this organ), as evidenced by the appearance of pain and a feeling of heaviness in the patient under the ribs on the right side.

After some time, the disease causes negative transformations in a person that occur in the brain and are associated with blood circulation. Signs of heart failure are manifested in the form of causeless severe irritability of the patient, fatigue after mental activity. A person's sleep is disturbed, while in the daytime the patient constantly wants to sleep. Often, patients develop depression.

Varieties

There are certain types of heart failure, which depend on the characteristics of the disease. The first form of the disease is myocardial heart failure. It is characterized by certain disorders in the activity of the cardiovascular system. They occur as a result of damage to the heart walls.

With this form, there are violations of the metabolic function, which is associated with the energy type of metabolism through the heart muscle. The myocardial type of heart failure is dangerous due to the occurrence of a number of disorders in systole (contraction of the heart muscle) and diastole (relaxation).

Heart failure in children and adults can manifest itself in the form of congestion. This type of disease appears most often due to the large volume of loads that the functional system cannot cope with. Overload type of heart failure occurs due to the presence of heart disease. The combined type of illness is a unifying form. It includes myocardial damage, as well as high loads on the heart muscle.

Details about the stages

There are different stages of heart failure. In total there are 4 stages of the disease. At stage 1, the patient feels the appearance of shortness of breath. This symptomatic manifestation most often occurs when a person climbs stairs. Moreover, this manifestation is especially noticeable at the level of the 3rd floor and above. At this stage, there is no mention of a severe form of the disease, since the patient has a normal state during the implementation of physical actions.

The second stage is characterized by a fairly strong shortness of breath. It appears in the following cases: when climbing stairs even to the 2nd floor and when walking at a fast pace. The patient has a slight decrease in the ability to perform physical activities. Even a small load leads to the appearance of symptomatic signs associated with heart failure.

At stage 3 of the disease, characteristic symptoms appear with minor physical exertion. Weakness and other manifestations are observed even during slow walking.

Severe heart failure is typical for stage 4. Absolutely all symptomatic manifestations occur at rest. If the load increases (even to a slight extent), then the patient has serious disorders, which are manifested by the defective work of the cardiovascular system.

Diagnostics

Diagnosis and treatment should be carried out by a specialist. In the process of identifying the disease, one should be guided by the symptoms and the results of the medical examination. As part of the diagnosis, it is important to establish the factors that caused the appearance of pathology. For these purposes, an electrocardiogram can be used. An ECG for heart failure is often done at rest, but may need to be done during exercise. The patient will need:

• take blood tests;
• take a chest x-ray;
• undergo an echocardiogram.

When identifying factors that provoke pathology, a cardiovisor can help. A person who has felt a deterioration in the state of the body can use a special service. So, quickly do an EKG. A computer program provides data on the functioning of the heart, guided by the information received, while the information is supported by a medical report.
Thanks to the same service, you can send the results of examinations to the attending physician as soon as possible. It is important that a person has access to the Internet. This is convenient, life with heart failure will not become unbearable, since the right therapy can be quickly started.

Therapeutic course

If a person is diagnosed with heart failure, treatment should be comprehensive. The therapeutic effect on the body with the help of medicines helps prevent overloading of the heart muscle. Due to beta-blockers, blood pressure is lowered, the frequency at which the heart contracts is normalized.

Effective drugs can eliminate the symptoms of the disease. Severe deficiencies are treated with glycosides given intravenously for rapid relief. It is possible to treat heart failure with Korglikon, Digoxin (if the disease is chronic in children and adults), however, before starting any medication, it is important to consider the contraindications to it.

Patients may use diuretics, especially if congestive heart failure is diagnosed. They give good results, as they help to remove excess fluid from the body. Treatment of heart failure with drugs can sometimes be ineffective. Usually, atrial fibrillation is diagnosed with the same symptoms.

Prevention of heart failure is a series of measures that are aimed at preventing the occurrence of the disease in question. In addition, a number of procedures can prevent the further development of the disease.

Preventive measures include:

1. Food in accordance with the rules.
2. Moderate activity when performing certain physical tasks.
3. Quitting smoking and drinking alcoholic beverages.

At the same time, attention is focused on the effectiveness of the fight against the disease, if all diagnostic and therapeutic measures are carried out in time.

Heart failure syndrome is an unfavorable manifestation that must be dealt with. All therapeutic measures must be implemented as prescribed by the attending physician. Otherwise, there will be irreversible consequences. With any alarming symptoms, a person should be alert and seek help from a medical institution. Sometimes the disease can be diagnosed early, and then the negative consequences will be less.

Cardiopulmonary failure (ICD-10 code I27) is a disease characterized by a decrease in contractions of the heart muscle and the inability of the respiratory system to send the required amount of oxygen to the vessels.

The disease can take an acute or chronic form. In both cases, the quality of life of the patient is significantly reduced.

The causes of the pathology may be associated with individual or systemic disorders in the functioning of the lungs and heart. The mechanism of the development of the disease is due to increased pressure in the pulmonary circulation, which is responsible for the supply of oxygen to the blood.

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When blood is ejected into the pulmonary artery, the load on the right ventricle increases, resulting in hypertrophy (thickening of the myocardium).

The reasons

Pulmonary hypertension leads to a violation of the enrichment of blood in the alveoli with oxygen. As a result, the myocardium of the right ventricle increases cardiac output in order to reduce tissue hypoxia (lack of oxygen). Over time, due to excessive stress, the muscles of the right side of the heart grow.

Such a period is called compensated, with it complications do not develop. If the pathology progresses, compensatory mechanisms break down, which leads to irreversible changes in the heart: the stage of decompensation.

There are several groups of factors that are the causes of the disease:

Under the influence of vascular factors, the arteries narrow. This is due to blockage by a thrombus or thickening of the vascular walls due to the inflammatory process.

In the presence of deforming and bronchopulmonary factors, the vessels are compressed, the tone of their walls is disturbed, the gaps are fused with connective tissue. As a result of such processes, the tissues of the body experience a lack of oxygen.

In medical practice, the disease most often develops against the background of:

• pneumosclerosis;
• pulmonary vasculitis;
• emphysema;
• thromboembolism;
• pulmonary edema;
• stenosis of the pulmonary artery.

Severity

The chronic form of the disease is characterized by a slow and subtle increase in symptoms. Based on this, four degrees of severity of the disease are distinguished:

Diagnostics

To diagnose cardiopulmonary insufficiency and prescribe effective therapy, it is necessary to conduct a comprehensive examination.

The disease can be determined by instrumental diagnostic methods:

Treatment

The main directions of treatment of cardiopulmonary insufficiency include:

Today, specialists quite often diagnose a disease such as cardiopulmonary insufficiency (SLN). This is a pathology in which the heart is not able to provide stable blood circulation in the body, which first of all adversely affects the state of the respiratory system, which causes excessively high pressure in the vessels of the lungs.

As a result of these processes, the amount of oxygen in the bloodstream is reduced, and the load on the heart, in particular on the right ventricle, also increases, which subsequently causes thickening of some parts of the myocardium.

Cardiopulmonary failure can occur both spontaneously, in an acute form, and develop gradually over a long period of time. This pathology is extremely dangerous in the case of an acute manifestation, when the patient can die from pulmonary edema or from suffocation.

The whole danger of pathology lies in suddenness, and, accordingly, the patient himself cannot protect himself in any way. In this case, the life of the patient directly depends on the first aid provided to him.

There are frequent cases when, due to blockage of a vessel by a thrombus, a person's condition deteriorates so quickly that death occurs even before the ambulance arrives.

In the case of chronic pathology, many patients may not even notice the presence of this disease. As a rule, many symptoms of pathology are perceived by them as age-related changes, thus the initial stage of insufficiency can worsen and smoothly flow into a severe form.

Classification

Depending on how the pathology manifests itself, there are several forms of the disease:

Also, pathology is classified depending on the severity:

• First. In the preclinical stage, there is an increased load on the right side of the heart. The patient himself may not feel any signs other than shortness of breath.
• Second. In this case, there is a significant increase in the right ventricle. At this stage, the patient may experience severe shortness of breath, as well as increased heart rate with minimal physical exertion.
• Third. At this stage, the patient does not feel discomfort only at rest.
• Fourth. Specialists also distinguish a fourth, critical stage. In this case, the patient feels discomfort, even while at rest.

In order to stop the pathology in time, you should carefully study the causes of the disease.

Causes and provoking factors

The development of this pathology is based on pulmonary hypertension, which at some point can cause a breakdown of compensatory mechanisms. As a result, the right ventricle may not be able to cope with the pumping of venous blood, which continuously flows in increased volumes. Both acute and chronic SLN have different causes.

As a rule, the following violations should be attributed to the causes of the appearance of acute pathology:

• thrombosis in the arteries of the respiratory system;
• thromboembolism;
• viral diseases;
• pneumothorax;
• a sharp exacerbation of bronchial diseases.

In addition, pathology can also occur against the background of dysfunction of the heart. One of the most common causes of the acute form of this disease is heart defects, as well as pulmonary valve insufficiency. In this case, the left ventricle inflates and, accordingly, cannot cope with the expulsion of the entire volume of blood, due to which some of the remaining blood causes an increase in pressure in the veins of the lungs.

At the same time, the right ventricle does not stop pumping blood in full, because of which the pressure rises rapidly, and this is fraught with the occurrence of edema of the respiratory organs or cardiac asthma.

Chronic pathology has other causes:

The chronic form develops rather slowly. Changes in the operation of systems occur over several years.

Symptoms

This pathology has clear symptoms that are hard to miss. In order to diagnose the disease in time, you should carefully consider the occurrence of the following problems:

Similar symptoms may also indicate a number of other diseases, and therefore it is important to contact a specialist who will prescribe a number of necessary studies to accurately determine the diagnosis.

Diagnostics

To determine the exact diagnosis, specialists can use several types of special studies:

Each of the above diagnostic methods can accurately determine the disease in the early stages.

Therapeutic measures

Treatment of this pathology can be carried out in several ways: drug therapy, surgery and bloodletting.

In addition, the choice of method depends on the nature of the pathology:
In an acute condition, emergency funds are prescribed to save a person's life:

• thrombolysis (Heparin, Fibrinolysin, Urokinase);
• the introduction of Papaverine, to relieve vascular spasm;
• the introduction of Atropine to relax the pulmonary muscles and normalize breathing.

With chronicity of the pathology, the main principle of therapy is the treatment of the pathology that caused SLN. In addition to special means, specialists can prescribe the following medications:

In addition to drug treatment, there are also other methods of treating SLE:

Cardiopulmonary insufficiency is a severe pathology that most often develops instantly and poses a danger to the life of the patient.

It is quite possible to avoid the appearance of this disease by adhering to certain preventive measures: maintaining a healthy lifestyle, proper nutrition, playing sports, and most importantly, timely treatment of any disorders in the functioning of the heart and lungs.