heart muscle is known, serves as a kind of pump in our body.If this device for any reason can not cope with their immediate work, we have to be heart failure.Every year this pathology only younger, and in recent times it is fatal.
Acute heart failure.What it is?
Acute heart failure - is suddenly appeared decrease the contractile function of the heart, causes its overload and pulmonary circulatory disorders.The disease can appear as background on existing cardiac abnormalities, and with no previous cardiac ailments.Most often, it is diagnosed myocardial infarction, when cell death occurs due to a sharp deterioration in circulation in this area.
Depending on overload departments main muscles of the human body, there are two main course of the disease: right ventricular and left ventricular failure.On the latter we describe in more detail in this article.
pathogenesis of the disease
One of the major pathogenetic moments of left ventricular failure is a buildup of hydrostatic pressure in the capillary and venous parts of the pulmonary circulation.In pulmonary interstitium gradually accumulated liquid in excess, which leads to a decrease of elasticity.Lungs become more "hard", there are restrictive disorder.Then edematous fluid gets into the alveoli, so that they cease to participate in gas exchange.
is further dissemination along serous lung and bronchial trunks.There has been infiltration of serous fluid and perivascular peribronchial spaces that affect their immediate resistance, deteriorating terms of trade.
left atrial blood from non-ventilated alveoli mixes with oxygen-rich substance.This entails a decrease in total arterial oxygen tension, the development of hypoxemia.In the initial stage of the latter wears circulatory nature.
Left ventricular failure is usually due to severe overload or failure of relevant parts of the heart.This disease leads to poor circulation.It requires not only a timely diagnosis, and treatment literacy.When combined pathology with right heart failure increases the probability of death of the patient.
main causes of the disease
- Cardiomyopathy.
- CHD.
- Myocardial infarction.
- cardiogenic pulmonary edema.
- Symptomatic hypertension.
- Mitral stenosis.
- extensive surgery.
- Brain Injury.
- Diseases infectious nature.
- toxic effects on the myocardium (medication, alcohol use).
acute left ventricular failure and myocardial infarction
The disease often develops in the presence of myocardial infarction.Usually it is caused by diastolic dysfunction, and can occur with a normal ejection fraction.Important role in the development of heart failure, in this case given to mitral regurgitation.It is due to ischemia of the papillary muscles or loss of a significant myocardial mass.
disease in the early hours in patients with myocardial infarction is characterized by a sharp decrease in blood volume, changes in cardiac output and a minimum sodium retention in the body.
clinical picture
It is known that almost all diseases have a common nature of cardiac symptoms, ie the pain expressed in the heart.It can give to his elbow, neck or shoulder.This phenomenon is usually observed in this disease as left ventricular failure.Symptoms are complemented by a fever, shortness of breath, sudden increases of pressure and temperature violation.
The nature and intensity of the disease symptoms directly depend on what portion of the heart muscle is damaged.For left ventricular shape, in addition to core symptoms, characterized by the appearance of syncope, arrhythmia, dizziness, swelling of the extremities, increased jugular veins.
Gradually signs of left ventricular failure worse, manifesting itself now not only at the stage of the activity, but also at rest.If you do not respond to this problem in a timely manner, can not be ruled death.
form of the disease pathology may occur in several types.
- with congestive type of hemodynamics.It manifested in the form of cardiac asthma (asthma) and pulmonary edema.
- With hypokinetic hemodynamics:
- arrhythmic shock.Developed in response to the violation of the heart rate.
- Reflex shock.It appears as a response to pain.
- true cardiogenic shock.Occurs when significant amounts of damage (over 50% left ventricular mass).
- sharp deterioration in already diagnosed with heart failure (the muscle system does not provide the needs of an adequate blood supply).
Diagnostics
Many cardiac disease characterized by rapid progression of nature, and acute left ventricular failure in this regard is no exception.Doctor if you suspect this diagnosis is the first thing is to examine the patient.However, the physical examination is not sufficient to assess the full clinical picture.Therefore, the patient is prescribed a number of diagnostic procedures including EKG, heart ultrasound, x-ray of the sternum, radionuclide ventriculography, and PET.
Based on these results the doctor can confirm the diagnosis and competent treatment.
acute left ventricular failure: acute care
During the attack the patient is very important to provide expert assistance in a timely manner before the arrival of the medical team.First of all it should be put to bed (to lie strictly prohibited) to provide air flow, start oxygen therapy.
The patient should be given "Nitroglycerin" under the tongue, enter sc 1% "Morphine".With the development of pulmonary edema as a result of the strong reduction of blood pressure is introduced "Prednisolone" intravenously (3-5 ml).
In the absence of essential drugs the patient should apply a tourniquet to the hips and shoulders to sharply limit the amount of circulating blood.Also intravenously can enter a special blend.For this purpose, a 10 ml syringe should dial 3 ml of 96% ethanol, and after adding water for injection.It is important that the entire volume has been filled.This solution has a defoaming effect.The patient should be cause cardiac medical team.After the elimination of pulmonary edema, all patients with a diagnosis of "acute left ventricular heart failure," subject to mandatory hospitalization.Transportation is usually carried out on a stretcher in a sitting position.
Basic principles of treatment
This pathology is threatening the patient's life, and always requires emergency treatment.
- If the cause of the disease is a change in the heart rate, to stabilize the hemodynamic status of the patient and the need to restore the heart rate.
- If the cause is a prior myocardial infarction, to combat the disease must be as soon as possible to normalize the coronary blood flow.In the context of pre-hospital assistance as possible through systemic thrombolysis, ie intravenous special drugs to dissolve blood clots.
- If left ventricular failure is the result of previous violations evolved intracardiac hemodynamics of myocardial rupture or injury, shows immediate hospitalization.
Drug therapy
treatment of diseases in general, implies an integrated approach (complete tranquility, the absence of serious physical activities, adherence to medical diet).However, it's more preventative measures, sometimes can not even arrest the pain that accompanies the disease is acute left ventricular failure.Treatment with drugs just in this case, comes to the rescue.
following are the main objectives of drug therapy:
- normalization of myocardial contractility.
- eliminate the symptoms of sinus tachycardia.
- prevent the formation of blood clots and blockage of blood vessels.
- normalization process of removing fluid from the body.
- Extending remission.
First of all, without exception, all patients prescribed oxygen therapy.To fight with excess fluid in the body recommend taking diuretics ("Furosemide", "Uregei") and a sharp restriction of drinking regime.To reduce vascular resistance and also improve circulation, prescribe vasodilators and disaggregants ("tiklid", "Plavix").To enhance myocardial contractility and cardiac glycosides appoint cardiotonic.
All drugs the doctor prescribes an individual basis for each patient.It is therefore important to understand that the surface self-therapy can only aggravate the clinical picture and did not bring the desired result.
When you need surgery?
If medication does not alleviate the patient's condition, left ventricular heart failure only strengthened in its manifestations, recommend surgery.Currently in clinical practice are two types of operations: cardiomyoplasty and implantation of a special device to improve blood circulation.Both options are dangerous to life, so to help them resorted to only in extreme cases.Moreover, postoperative noticeable effect only after 3-4 months after a long recovery period.Before you go to such an operation, it is necessary to consult a physician and to compare all of its advantages and possible disadvantages.
Complications
If the patient is diagnosed with "left ventricular failure," he neglects his own health and delay treatment, likely early death.
Preventive measures If you have diseases of the cardiovascular system chronic nature shows regularly monitored by a cardiologist, and strict adherence to all its provisions.It is essential to minimize its impact on the whole body.These include addictions (smoking, alcohol and drugs), psycho-emotional overload and frequent stress and overweight.
as preventing such diseases as acute left ventricular failure, the causes of which are often hiding in inactivity, it is recommended dosage exercise.This can be swimming, walking outdoors, skiing, playing in the gym or yoga.It should constantly monitor blood pressure.Particular attention should be paid to nutrition.The diet should be as well-balanced, high-fiber foods.It is better to give up fatty and fried foods, as well as excessively sharp products.
These simple preventive measures can not only prevent the development of such a disease dangerous to health, but also improve the quality of life in general.
Conclusion In this article, we talked about what is a disease called left ventricular failure.The causes of this disease may be very different, starting with myocardial infarction and ending a toxic effect on the body of drugs.Timely diagnosis and competent treatment minimize the risk of complications, the most dangerous of which is fatal.Be healthy!
