Pulmonary failure in heart disease. Chronic pulmonary heart failure (cor pulmonale). Signs of pulmonary failure

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

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

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

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

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

Manifests itself as cardiogenic shock, suffocation (cardiac asthma), pulmonary edema. The patient takes a forced position - sitting with his arms resting in order to somehow ensure air flow.

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

Symptoms of acute heart failure

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

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

Swelling and pallor may appear quite quickly. The patient becomes very scared (and for good reason).

Acute cardiopulmonary failure may not have any special acoustic manifestations. Sometimes, using a phonendoscope, you can hear fine bubbly wheezing in lower sections lungs (edema). With advanced edema, moist rales appear over the entire surface of the lungs.

Symptoms of acute heart failure in the photo

Pressure in acute heart failure may be increased or decreased - this is not a diagnostic criterion. Due to severe stress in this condition, the heart rate increases. If the patient has had episodes of arrhythmia in the past, it may happen again.

First aid for acute cardiopulmonary failure

Call an ambulance immediately. If the patient cannot figure out how to breathe easier, we sit him on a chair (“on horseback” position) with his legs down. Your elbows should rest on the back of the chair.

Pulmonary edema is one of the most dangerous conditions in medicine, no traditional methods, the power of self-hypnosis and reflexology does not save you from it.

Regardless of your assumptions about the nature of the condition, the patient needs to put a nitroglycerin tablet under the tongue.

If the leading mechanism of failure 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 the overall prognosis.

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

It is quite effective to apply a tight tourniquet to both legs - this will significantly relieve the load on the heart, because will reduce the volume of circulating fluid. This manipulation can save the patient’s life, however, with prolonged tourniquet, the patient dies from intoxication after decompression of the legs.

If you are afraid that the patient will not last until the ambulance arrives (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 heart attack department or to the intensive care unit at the cardiology clinic or department. If the process is accompanied by arrhythmia, go to the cardiology hospital where there are arrhythmologists.

In the hospital, pulmonary edema will be removed hormonal drugs, the patient is given narcotic analgesics. If the problem was thrombosis coronary arteries- thrombolytics are prescribed: Actelise, Metalyse, Streptokinase, Urokinase, etc.

Thrombolytics are quite expensive, but they help save the patient in the first hours after thrombosis. In fact, when the blood clot breaks down, the situation resolves without serious consequences for the patient. Don't skimp on 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's heart failure is accompanied by arrhythmia (atrial fibrillation, atrial fibrillation), antithrombotic therapy is prescribed.

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

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

Chronic cardiopulmonary failure

Denoted 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 coronary arteries due to atherosclerosis. The heart is gradually “cut off” from nutrition, as a result of which the heart muscle first enlarges and then collapses, which leads to failure.

The second consequence of atherosclerosis is increased 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 physical activity and an increase in total body weight. Both bodybuilders and people simply prone to obesity increase the overall resistance in the vascular bed (more mass - more vessels). Simply put, there are more pipes, but the motor is the same. For some time the heart works at increased speed - the muscle tries to produce normal pressure. Then the heart muscle is destroyed and failure occurs.

It is believed that stress and smoking are also factors that provoke 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 toxic effect ethyl alcohol on the heart muscle is periodically observed, and alcoholic myocarditis sometimes causes the development of an acute form of heart failure. Moderate alcohol consumption is indeed a factor in the prevention of atherosclerosis (and, therefore, CHF), however, due to the lack of moderation among the population in this matter, this topic is not considered by doctors.

Symptoms of heart failure and classes of CHF

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

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

1st class CHF. It is considered the most soft shape illness - when going up to the 3rd floor or higher, shortness of breath appears. Otherwise, the person feels normal, activity is normal;
2nd class is already quite easy to detect even in rural areas— when going up to the first floor, shortness of breath begins, as with fast walking. 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 during any physical activity;
4th grade - shortness of breath at rest, the condition constantly worsens (even to death).

The chronic form is characterized by blue discoloration of the fingers and toes (cyanosis), hemoptysis, dry wheezing, swelling of the extremities (class 1-2 - 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 failure

Treatment should be lifelong under periodic medical supervision

Psychological phenomenon - no one wants to undergo long-term treatment (consciousness rejects an incurable disease). As a rule, patients take medications 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. Canceling a doctor’s prescription quickly leads to a transition to the next functional class of CHF.

Drugs that lower blood pressure are prescribed - sartans (Losartan), ACE inhibitors (enalapril, lisinopril), diuretics (hydrochlorothiazide, etc.). In addition to diuretics, patients are advised to strictly limit their fluid intake. To control heart rate, beta blockers (carvedilol, metaprolol, etc.) are recommended.

To prevent 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 methods of treatment

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 (tonsils can be cut out, sinusitis can be sanitized, etc.);
atherosclerosis of the coronary arteries is successfully treated with bypass and ballooning. At the same time, the narrowed vessel is expanded, and the person returns to active social and physical life;
Mitral valve stenosis can also be operated on quite successfully.

Attention to loved ones and timely contact with a cardiologist can extend life by decades. Even with chronic failure the process can be stopped in the early stages and significantly slowed down in the later stages. The key point medicinal method treatment is permanent daily intake medications prescribed by the doctor.

Fedorov Leonid Grigorievich

Cardiopulmonary failure is a failure of two vital systems for humans - the heart and the lung. Such stagnation in the pulmonary circulation leads to serious problems and even death. When the process of filling the blood with oxygen is disrupted, the myocardium works more intensely, which thickens it. What does this mean?

Features of the pathology

Cardiopulmonary failure is most often a malfunction of the left ventricle, which causes stagnation of blood in the lungs. This may be caused by a change in the activity of the heart muscle after infectious pathology or electrical discharge, coronary blood clots and any other vascular accident.

Manifests itself in cardiogenic shock, suffocation, and pulmonary edema. The latter swell due to excess pressure in them, which leads to the filling of blood vessels in the intercellular space with fluid, disrupting natural process gas exchange. For acute cardiopulmonary failure a person painfully tries to take a breath, and if he is not helped, death will occur. The attack develops suddenly at any age.

Reasons for development

Pulmonary heart failure does not occur out of nowhere. Usually this is a combination of pathologies that provoked such a condition. The causes of cardiopulmonary failure are divided into groups:

Vascular, including changes provoked by:

atherosclerosis;
compression of the heart by an aneurysm;
blood clots in the arteries of the lungs.

Bronchopulmonary, consisting of:

extensive pneumonia;
tuberculosis;
chronic bronchitis;

Thoradiaphragmatic, associated with obvious deformation of the chest, provoked by:

kyphoscoliosis;
polio;
ankylosing spondylitis;
abnormal structure of the diaphragm.

Classification

Pathology is classified according to the type of course:

Acute, which is often decompensated. Often this is a consequence of massive thromboembolism of the pulmonary artery, valvular pneumothorax, mediastinal emphysema or status asthmaticus. It occurs suddenly due to an increase in pressure in the artery, which provokes an expansion of the cavity of the right ventricle, making its walls thin.
Subacute, occurring with and without it. This is a consequence of any of the above reasons in combination. Develops from a month to several years, provoking severe.
Chronic is similar to subacute, but has a less pronounced course and can develop over years.

Acute, subacute and chronic pulmonary heart failure may have the following clinical types:

respiratory with a predominance of w, episodic suffocation, cough, wheezing and cyanosis;
cerebral, giving symptoms of encephalopathy from aggressiveness and psychosis to apathy;
anginal provokes severe chest pain and suffocation;
abdominal - nausea, vomiting, gastric ulcer and other signs of gastrointestinal hypoxia;
collaptoid is accompanied by hypotension, pallor, weakness, and cold sweat.

Symptoms

Each form of cardiopulmonary failure has its own symptoms:

Acute, in which the patient must be immediately taken to the hospital. because the risk of death is quite high, especially in a child. Provokes her pain shock and extensive swelling of the lungs. Symptoms:

sharp drop blood pressure indicators up to collapse;
the breathing process is difficult, superficial, it is difficult to take a breath;
neck veins are swollen;
the skin turns blue, especially the limbs;
chest pain varying degrees heaviness;
sticky sweat;
suffocation due to lack of oxygen.

Chronic is easier than acute and subacute forms. Symptoms largely depend on the underlying cause. Usually this:

The more severe the stage of the pathology, the brighter the symptoms. Often, at a later stage, individual symptoms are added that provoke irreversible changes in orgasm, such as:

shortness of breath at rest;
heartache;
when you inhale, the veins in the neck swell;
tachycardia in the background low blood pressure;
swelling that does not go away even after taking it special means;
pain in the liver area, etc.

First aid for pulmonary edema

Acute cardiopulmonary failure, which must be treated immediately, is dangerous. During an attack, the patient needs help because he cannot help himself. That's why urgent Care should be based on the following manipulations:

Call an ambulance.
Place the person on a chair in the “horse” position with the elbows resting on the back.
Place a Nitroglycerin tablet under your tongue.
Open all windows, ensuring airflow fresh air.
If you have an oxygen mask, apply it to the patient.
Make tight bandages on both legs to slightly relieve the load on the heart and the amount of fluid circulating through it. Make sure that decompression of the lower extremities does not occur.

Cardiopulmonary failure is a pathology that provokes disturbances in the respiratory and cardiovascular systems. Appears due to the development of hypertension in the pulmonary circulation. This phenomenon provokes the release of blood into the pulmonary artery, which causes myocardial hypertrophy.

In the case of destruction of the heart muscle, its contractility decreases, which affects the total amount of blood pumped.

Malfunctions of the heart lead to the following pathologies:

Hypoxia of various organs due to a reduced amount of oxygen obtained from the blood.
Congestion in the lungs, which does not allow the patient to use their full volume when breathing.
Pathologies associated with stagnation of fluid in the lungs, which are combined with heart failure. The syndrome includes several dangerous disorders.

The following symptoms appear:

Dizziness that starts without visible reasons, even at rest.
Shortness of breath with little physical exertion.
Decreased performance, inability to perform habitual actions that did not seem difficult before the onset of the pathology.
Pallor skin in the area of the nasolabial triangle and fingers of the upper extremities.

Causes

Acute cardiopulmonary failure is considered a dangerous disease that requires prompt medical intervention to prescribe treatment. Reasons leading to this condition:

Asthma during exacerbation.
Constant spasms, thrombosis pulmonary artery.
Pneumonia.
Stagnation in chest due to the accumulation of a significant amount of liquid and air.
Trauma in the sternum area.

Factors influencing the occurrence of diseases of the cardiovascular system:

Vasculitis in the lungs.
Formations of a tumor nature in the mediastinum.
The development of aneurysms, which, as the pathological process increases, compresses the parts of the heart located on the right side.

Causes of bronchial disease:

Pneumonia, treatment.
Chronic infectious processes in the lungs: bronchitis, tuberculosis.
Emphysema in the lung area.
Bronchitis with an asthmatic component.

Symptoms

Sometimes cardiopulmonary failure appears without predisposing factors, while a clear clinical picture. If the disease occurs in acute form, first aid must be provided immediately. Usually the patient is transferred to intensive care. The disease is manifested by the following symptoms:

Pulmonary artery thrombosis.
Pneumonia.
Exacerbation of asthma.
Mitral valve dysfunction.
Malfunction of a previously transplanted artificial valve.
In the case of the development of many unfavorable factors, signs of severe circulatory failure are possible.

The following symptoms appear:

Breathing is accelerated, it is impossible to take a deep breath.
A sharp decrease in pressure. If timely assistance is not provided, there is a risk of collapse.
Dyspnea.
Decreased temperature of the extremities.
Blueish skin tone.
Profuse sweating.
Pain syndrome in the chest.

Signs of chronic cardiopulmonary failure appear as a result of hypertension in the pulmonary circulation. This process gradually intensifies, development occurs over a long period of time. Patients live without manifestations negative symptoms for several months, years.

From time to time, patients notice the following symptoms:

Shortness of breath, which worsens when playing sports.
At physical activity Fatigue sets in within a few hours after starting a work shift or attending an important event.
Frequent appearance of a bluish tint of the skin in the area of the fingertips and nasolabial triangle.
Increased heart rate.
If pulmonary heart failure is accompanied by decompensation, the negative manifestations gradually intensify, leading to dangerous processes in the organs. You may notice the following signs of the disease:
Shortness of breath does not leave a person even at rest. The attack may intensify if the patient moves to a horizontal position.
The pain syndrome increases as a result of the progression of ischemia.
Swelling of neck veins.
Decrease in blood pressure, development of tachycardia.
Blueish skin tone.
Liver enlargement discomfort in the right hypochondrium.
The swelling does not subside when using standard medicines, folk remedies.

If the condition worsens, the functions of the brain and kidneys may be depressed. The person becomes lethargic, apathetic, and signs of increased drowsiness are noticeable. The condition is dangerous due to decreased diuresis and other disorders in organs that are difficult to restore when used. medications. With hypoxia, the amount of hemoglobin and red blood cells in the blood increases.

Treatment

If cardiopulmonary failure appears in an acute form, the patient is transferred to the intensive care unit. They use technology to maintain artificial respiration by introducing an oxygen mixture through a mask or using a nasal catheter. Thanks to this event, the vital functions of important organs are supported.

Treatment for cardiopulmonary failure includes intravenous administration the following substances:

Thrombolysis is required to reduce the symptoms of pulmonary embolism. After its implementation, the dissolution of the blood clot and normalization of blood flow are observed.
Atropine acts as a muscle relaxant and relaxes the muscles of the bronchi. The result is the ability to breathe independently.
Papaverine is necessary for excessively strong vascular tone. The effect of this substance is to expand the vascular walls and normalize pressure.
Anticoagulants prevent thrombosis and protect the heart from risks associated with blood diseases.
Eufillin restores normal work myocardium, reduces the severity of breathing disorders.

Providing first aid for pulmonary edema

If pathological process increases by the minute, it is necessary not only to call “ Ambulance", but also independently carry out important activities:

Move the patient to a sitting position.
Make sure the area is well ventilated.
To reduce blood pressure you will need a nitroglycerin tablet. It must be absorbed under the tongue to ensure an almost instant effect. Before deciding to use the drug, you should make sure that the patient does not currently have low blood pressure. Also cannot be used medications independently if the patient is unconscious.
If the process is mild or moderately severe, a diuretic can be given. This is how swelling is quickly relieved, thereby getting rid of excess fluid.
If the pressure increases excessively, it is necessary to ensure that blood is drained away from the lungs to avoid its accumulation. To do this at home, you can take a basin and pour heated water. Ask the patient to put their feet in it.
Soak the gauze in alcohol and give it to the patient. Inhaled vapors will help slightly reduce negative symptoms.

In order not to harm a person, it is advisable, when calling an ambulance, to consult with a specialist about what measures can be taken for the patient’s specific conditions.

Consequences

In case of relief of the acute stage of cardiopulmonary failure, with the onset of remission of the chronic form of the disease, the risk of complications remains:

Infection. If a patient has pulmonary edema, inflammation and bronchitis may develop. When functions decrease immune system Treatment of these diseases is complicated.
Chronic hypoxia of organs. Oxygen starvation manifests itself in life important organs, in particular, the brain and heart. It is necessary to start taking it in a timely manner medical supplies to prevent irreversible damage.
Ischemic tissue damage due to insufficient quick removal symptoms of hypoxia.
Atherosclerosis of the lungs. The formation of an area whose functioning is impaired due to exposure to liquid.

To cure cardiopulmonary failure, it is necessary to diagnose this disease in a timely manner. Constant monitoring of the patient, conducting regular courses therapy will help avoid dangerous complications, reduce the likelihood of the formation of irreversible disorders, which has a positive effect on the prognosis and helps to increase life expectancy.

Cardiopulmonary failure is primarily defined as a violation of the functionality of the cardiac and pulmonary systems. Simply put, this is stagnation in the pulmonary circulation. It is responsible for filling the blood with oxygen. Violation this process contributes to the fact that the right ventricle begins to work at an increased rhythm, which leads to thickening of the myocardial walls.

Forms of manifestation of the disease

The myocardium thickens due to constant intense work. Speaking in simple language, just like during intense training a person builds up muscle mass, the heart also increases it due to constant intense workload. The load is caused by poor oxygen supply to the blood. Because of this, the heart automatically starts working faster to compensate for the lack of oxygen received by the body. In fact, this does not cause any complications separately, but, on the other hand, it can lead to a more rapid development of cardiovascular diseases in adulthood simply due to the fact that the heart wears out faster due to constantly increased load and too intense work.

Thickening of the myocardial walls

Reasons for the development of pathology

Pulmonary heart failure itself does not develop without any significant cause. Most often it's not even separate disease, but rather even a manifestation of other more serious problems.

Sometimes such manifestations can take an acute form and develop into complications that can lead to death.

Provoking factors that can lead to pulmonary heart failure are usually divided into main groups:

Also, pulmonary heart failure can be provoked by various neoplasms, both malignant and benign. In this case, stagnation of the pulmonary circulation occurs due to compression of the pulmonary artery and other vessels supplying the lungs with blood. Also, a similar phenomenon can occur due to blockage of blood vessels by various blood clots.

Main manifestations

Considering in more detail the symptoms and treatment of pulmonary heart failure, first of all, it is worth immediately stipulating that in medicine it is customary to distinguish acute and chronic forms of the development of pathology. Based on this, the treatment method chosen for each specific case will directly depend.

Acute form of failure.
This form always occurs spontaneously and develops quite acutely. The symptoms are pronounced, the patient's condition is rapidly deteriorating. If such a person is not delivered in a timely manner to intensive care unit hospital, then most likely it will end fatal. Death often occurs due to thromboembolism, when pain shock rapidly develops, as well as extensive pulmonary edema.
Most often, this problem can be caused by:
- the inflammatory process affects too much lung volume;
- thrombosis of the pulmonary trunk. This most often occurs due to the formation of a blood clot;
- failure of the prosthetic valve;
- pneumothorax;
- rapid deterioration of the condition in the presence of a diagnosis of “bronchial asthma”;
- serious chest injuries;
- interruptions in the functioning of the mitral valve.
This form of pulmonary heart failure usually has sufficient severe symptoms, which makes it easy to diagnose such a patient:
- a rapid decrease in blood pressure to critical values. Very often, collapse can occur quickly;
- rapid shallow breathing, often quite difficult;
- an increase in the size of the veins in the neck;
- breathing is predominantly complicated during inspiration;
- blue discoloration of the skin. Blueness of the extremities and cyanosis are especially pronounced;
- cold hands and feet;
- chest pain of varying intensity;
- sticky sweat on the body;
- difficulty breathing up to the point of suffocation.
If a person does not get help in a timely manner, then he can die quickly enough from pulmonary edema or simply from suffocation. First aid in this case should primarily consist of ensuring normal free access of oxygen to the lungs. If necessary, the patient should artificial respiration before the ambulance arrives. This condition is especially dangerous because it almost always develops suddenly. Sometimes even without any apparent reason (for example, a person may experience blockage of the pulmonary trunk with a blood clot, the presence of which the person does not even suspect). But at the same time, the patient’s condition deteriorates too quickly and therefore sometimes the person may die even before the ambulance arrives.
Chronic form.
This form often has a fairly easy flow pattern on early stage development. Very often it can develop very slowly (for years a person may not even suspect that he has such a disease, attributing the main symptoms to age-related changes in the body or on others accompanying illnesses). Most often, the main symptomatology in this case is the manifestation of the root cause. Simply put, usually a person pays attention rather to the symptoms of the pathology that led to the development of this problem. At the same time, they may not pay attention to the deficiency. It often has the following symptoms:
- the skin, especially the limbs and nasolabial triangle, acquire a bluish tint;
- severe dizziness;
- cardiopalmus;
- fatigue, weakness.
Moreover, the intensity of the development of symptoms directly depends on the stage at which the disease is located. For example, fatigue and shortness of breath will be more severe in late stages development of chronic
But at the same time, in later stages, additional forms of manifestation may also be added to these symptoms. This is primarily due to the fact that irreversible processes are already beginning to occur in the organs and tissues of the body due to a severe form of failure. The main manifestations of this stage:
- intense shortness of breath at rest, while lying down the situation only worsens;
- pain in the heart area;
- when inhaling, severe swelling of the veins in the neck;
- tachycardia, constantly low blood pressure;
- swelling that does not respond to treatment methods;
- heaviness in the right hypochondrium, discomfort in the liver area. At this stage, they may develop severe complications in the functioning of the brain. Kidney function is also impaired, which very often leads to a complete cessation of urine output.

The most effective therapy

If cardiopulmonary failure is diagnosed, treatment should be started as quickly as possible. The sooner the main therapy is started, the greater the chances that after its favorable completion no irreversible processes that have already occurred in the patient’s body will be detected.

Atropine

In addition, if we are talking about an acute form of the disease, then timely initiation of therapy will determine whether the patient will live. In this case, the difference between the two forms will lie primarily in the fact that in the acute phase it is necessary first of all to restore the normal supply of oxygen, while in the chronic form it is necessary to begin complex treatment the illness that caused the deficiency. In the acute form, the root cause will also need to be treated, but such therapy is prescribed later, when there is no fear for the patient’s life.

In acute form of deficiency, treatment consists of the following basic actions:

administration of thrombolysis drugs. They are especially effective if the failure is due to blockage of the pulmonary trunk by a thrombus;
papaverine. Helps relax the walls of blood vessels and thereby improve blood flow;
anticoagulants. Prevents the formation of blood clots and blood stagnation due to dilution;
atropine. Relaxes the muscles of the bronchi and thus facilitates respiratory function.

In the case of a chronic form of deficiency, treatment should always be comprehensive and consist of the following main points:

treatment of the main provoking disease;
taking anti-inflammatory drugs;
blood thinners;
relaxing muscles and promoting the expansion of bronchi;
various hormonal drugs.

To summarize, it is worth noting once again that to improve the quality of life of patients and ensure a more favorable prognosis, it is very important to diagnose in a timely manner this pathology and begin treatment as quickly as possible not only for the main symptoms, but also for the root cause. Without eliminating provoking factors, it will not be possible to achieve high-quality and long-lasting results. The sooner treatment is started, the greater the chances of getting rid of the disease and the longer the life of patients with this pathology can be.

But even if the therapy gave positive results, then in any case it will be necessary to undergo regular examinations, as well as to apply maintenance therapy.

Video

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

The disease can be acute or chronic form. In both cases, the patient’s quality of life 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 development of the disease is due to high blood pressure in the pulmonary circulation, which is responsible for the supply of oxygen to the blood.

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

Causes

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.

This period is called compensated; complications do not develop during it. If the pathology progresses, compensatory mechanisms are disrupted, which leads to irreversible changes in the heart: stages of decompensation.

There are several groups of factors that cause the disease:

Bronchopulmonary factors include:

chronic bronchitis, bronchiolitis obliterans;
pulmonary enphysema;
extensive pneumonia;
sclerosis of lung tissue;
bronchial asthma;
chronic suppurative processes in pathologically altered bronchi.

The disease can develop with tuberculosis and pulmonary sarcoidosis.

Vascular factors include:

pulmonary artery atherosclerosis;
tumor in the middle parts of the chest cavity;
compression of the “right heart” by an aneurysm;
pulmonary arteritis;
pulmonary artery thrombosis.

The disease can cause deformities of the diaphragm and chest:

curvature of the spine in the lateral and anteroposterior direction (kyphoscoliosis);
polio;
ankylosing spondylitis;
impaired innervation of the diaphragm.

Under the influence of vascular factors, the arteries narrow. This occurs due to blockage by a blood clot 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, and the lumens are fused with connective tissue. As a result of such processes, body tissues experience a lack of oxygen.

IN medical practice The disease most often develops against the background of:

pneumosclerosis;
pulmonary vasculitis;
emphysema;
thromboembolism;
pulmonary edema;
pulmonary artery stenosis.

The disease has pronounced symptoms, which rarely go unnoticed.

Symptoms of the disease may appear suddenly. In this case, they are distinguished by rapid development and a vivid clinical picture. In case of acute form of the disease, emergency health care and admission to the intensive care unit.

Acute cardiopulmonary failure occurs:

with sudden spasms or thrombosis of the pulmonary trunk;
extensive pneumonia;
asthmatic status;
accumulation in pleural cavity air or liquid;
severe form of incompetence of the bicuspid heart valve;
chest injuries;
impaired operation of the prosthetic valve.

Under the complex influence of unfavorable factors, hemodynamics are sharply disrupted. This manifests itself in the form of insufficient blood circulation of the “right heart”.

The disorder is accompanied by the following symptoms:

rapid breathing;
decreased blood pressure; in the acute form, collapse may occur;
shortness of breath, difficulty breathing;
enlarged veins in the neck;
lack of air, suffocation;
cold extremities;
bluish coloration of the skin;
cold sweat;
chest pain.

The acute form of the disease may be accompanied by pulsation in the epigastric region of the dilated right ventricle. The x-ray shows an increase in the mediastinum to the right and upward; the electrocardiogram shows overload of the “right heart”.

When listening to the heart, the “gallop” rhythm and muffled tones are clearly revealed. In case of acute blockage of the pulmonary artery by a thrombus, pulmonary edema and pain shock rapidly develop, which can lead to rapid death.

Symptoms depend on the stage of the disease. In the compensated form of the pathology, symptoms characteristic of high pressure in the pulmonary circulation are revealed. Chronic pulmonary heart failure can develop over several years. It appears as:

fatigue;
pulsations in the epigastrium;
bluish tint of fingertips and nasolabial area;
dizziness;
rapid heartbeat.

Decompensated form

It is accompanied by increasing symptoms and leads to irreversible consequences in all tissues and organs. Signs of a progressive disease include:

shortness of breath at rest, worsening when lying down;
ischemic pain in the heart area;
enlargement of the veins in the neck, which persists when inhaling;
decreased blood pressure, tachycardia;
bluish skin tone;
enlarged liver, heaviness on the right side;
swelling that cannot be treated.

With increasing death of all tissues (terminal state), serious damage to the brain and kidneys develops. These processes are expressed in the form of lethargy, apathy, impaired mental functions, and cessation of urine output. In the blood, due to a lack of oxygen, the concentration of hemoglobin and red blood cells increases.

Severity

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

Diagnostics

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

The disease can be determined using instrumental diagnostic methods:

X-ray of the heart and lungs	X-ray reflects changes in the shape and size of the shadow of the heart and its ventricles. The disease is characterized by a number of characteristic radiological signs. One of the important criteria for this type of examination is the accumulation of fluid in the pleura and modification of the shadow of the pulmonary veins. Their expansion indicates swelling.
Echocardiography	Echocardiography is an important ultrasound technique examination of all parts of the heart, valve mechanisms, contractile function of the heart muscle, speed and volume of blood ejected from the atria. Clear parameters have been established indicating the presence or absence of right or left ventricular heart failure.
Electrocardiography	Electrocardiography displays electric fields, which are formed during the work of the heart. Failures in the functioning of one of the departments, ischemia, disturbed rhythm, hypertrophy and other pathologies are easily determined by the results of the ECG. In some cases, long-term techniques are used ECG examination(Holter monitoring or exercise testing - bicycle ergometry). Disturbed heartbeat often causes the development of cardiopulmonary failure.
Electrokymography	This research method determines possible malfunctions in the cardiovascular system.
Catheterization of the heart cavities	Catheterization of the pulmonary artery, right ventricle and right atrium determines blood pressure in these areas and thus identifies possible pathology.

Treatment

The main areas of treatment for cardiopulmonary failure include:

Taking diuretics	Taking diuretics allows you to remove excess fluid from the body that accumulates as a result of decreased contraction of the heart muscle. Hydrochlorothiazide is inexpensive and effective drug. It helps normalize blood pressure and relieves swelling. Furosemide – more effective drug fast action. Taken in the morning on an empty stomach, it is necessary to monitor the electrolyte-salt balance, since microelements are excreted along with the liquid. The medicine lasts for six hours. It is prescribed even in cases of impaired renal function. Furosemide quickly removes fluid and reduces swelling. Among the diuretics, ethacrynic acid is also used - another effective remedy, quickly relieving swelling.
Taking beta blockers	Therapy using beta blockers is aimed at relieving edema, normalizing blood circulation and improving left ventricular function. The most effective beta blockers are propranolol and timolol. They have an adrenergic-selective effect and relieve almost all symptoms of the disease. Therapy with metoprolol is effective. This drug has high cardioselectivity and eliminates all signs of the disease.
Surgical therapy	Radical treatment is prescribed in cases where the disease becomes severe. Typically, atrial septostomy, thromboendarterectomy, or organ transplantation are performed. Atrial septomy reduces pressure in the right atrium and pulmonary trunk. Thrombendarterectomy is used to remove blood clots from the lungs. A transplant is carried out only if treatment with other methods has not given the desired result.
Bloodletting	Therapy involves pumping out a certain amount of blood from the bloodstream. Up to 400 ml of blood is removed from the body. This technique helps reduce pressure, remove excess fluid and relieve swelling.
	Digoskin is recognized as the most effective glycoside. Glycosides are positive inotropic drugs that improve the quality of life of people diagnosed with the disease. Glycosides are taken in small doses. The use of cardiac glycosides reduces the likelihood of hospitalization.
Traditional methods	Cardiopulmonary failure is a very serious and dangerous disease, therefore traditional methods of treatment can be used only after medical examination and specialist consultations. Wormwood is often used to cure illness. The plant reduces pain, normalizes blood circulation and removes excess fluid. A decoction is made from wormwood, which is taken ¾ cup before meals. Another effective remedy– a decoction of nettles, which is used to make hand baths. The procedure should be carried out every day for ten minutes. Pumpkin juice helps well in treating the disease. It is important to remember that folk remedies alone will not be enough to treat cardiopulmonary failure. In addition, some medications are incompatible with medicinal plants due to the possibility of increased adverse reactions.