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Heart failure

Heart failure

Heart failure is a complex disorder, the cause of which is associated, as a rule, mainly with a decrease in myocardial contractility.

Heart failure can be acute or chronic. As a rule, heart failure develops in a chronic form. In this case, heart failure develops gradually and is associated with a constant depletion of the body's compensatory capabilities. The heart with heart failure changes in size upward, the heart muscle becomes denser.

Among the symptoms of heart failure, the leading place belongs to shortness of breath, it is this symptom that is most pronounced in different classes of the disease. In addition to shortness of breath with heart failure, the following symptoms occur: cyanosis of the integuments of the body, decreased physical activity, and others.

In the treatment of heart failure, as in the treatment of many other diseases, the patient himself plays an important role, who must strictly follow all the doctor's recommendations. Treatment of heart failure is complex, an important step is the treatment of the underlying disease that caused the development of heart failure.

Among the drugs used in treatment are diuretics, cardiac glycosides, angiotensin-converting enzyme inhibitors, and other classes of drugs. The goal of the treatment is to improve the patient's quality of life and increase its duration.

Heart failure is a serious medical condition. As for the disease, heart failure is not actually such. However, this is precisely the opinion that is widespread among the people. What is heart failure? Heart failure is a combination of pathological signs that develop due to the fact that the heart is not able to cope with the amount of load that is imposed on it. These signs include, for example, shortness of breath, swelling of the legs, and others.

Typically, heart failure is chronic. Moreover, this form of heart failure is the most common complication of diseases of the cardiovascular system. It should be understood that any heart disease contributes to a decrease in its ability to provide the body with a normal amount of blood, thus cardiovascular diseases lead to a decrease in the pumping function of the heart.

Heart failure develops gradually. Indeed, this is a rather slow process, since the mechanism for the development of heart failure includes more than one stage. Simplifying the mechanism of development of heart failure, the following stages can be distinguished. As a result of existing heart diseases, the load on the left ventricle of the organ increases, in connection with this, myocardial hypertrophy (that is, an increase in the volume of the heart muscle) occurs. Under such conditions, for a certain period of time, the heart manages to maintain blood circulation at a normal level. However, after a while in the thickened and enlarged myocardium, there is a violation of oxygen delivery and nutrition. The reason for this is that the vascular system of the heart cannot adapt to such a significantly changed organ volume. Dysfunction of the myocardium is caused by a number of changes occurring in the heart, including due to sclerosis of muscle tissue. Dysfunction of the myocardium is manifested primarily in the violation of contractions and relaxation of the heart. The latter, in turn, contributes to the fact that the release of blood into the vessels becomes insufficient, and the nutrition of the organ also deteriorates significantly. Heart failure leads to changes in other organs (such as the lungs and kidneys). Thus, the human body tries to help the heart.

The compensatory capabilities of the body are constantly decreasing as heart failure develops. This leads to increased heart rate, the heart is not able to perform its pumping function in full, that is, to pump all the blood from the blood circulation (large and small). The fact that the heart does not have time to pump blood from the systemic circulation explains the fact that the left ventricle of the heart is significantly loaded. It is the left ventricle of the heart that suffers first. Then the classic symptoms of heart failure appear, in particular, shortness of breath. Dyspnea is especially troubling to the patient at night, when the patient is in the supine position. Shortness of breath is a direct consequence of the processes of blood congestion in the lungs, which also leads to the appearance of edema. The development of heart failure leads to an increase in the size of the liver and the appearance of pain in the area of ​​the right hypochondrium.

The acute form of heart failure is characterized by rapid development. Unlike the chronic form. Acute heart failure can develop over a period of hours to days. Acute heart failure, as a rule, manifests itself against the background of an exacerbation of the main disease. If the appropriate classification is carried out, then usually chronic and acute forms of heart failure are distinguished, but sometimes they speak of a stagnant phase. What does this mean? In general, the stagnant phase occurs in acute heart failure and is associated with the following processes. Retention of fluid in the tissues of the human body occurs due to a slowdown in blood flow, which can cause the appearance of such a symptom as pulmonary edema. Pulmonary edema is life threatening.

Heart failure is a serious complication of cardiovascular disease. This is because heart failure most often develops incrementally. In this regard, over time, the manifestations of heart failure become more serious than the manifestations of the underlying disease, which caused the development of heart failure itself. Often the cause of death of a patient is precisely heart failure. American researchers argue that manifestations of heart failure sharply reduce the patient's quality of life and, in this regard, they call the figure - 81%.

Shortness of breath is the main symptom of heart failure. In severe cases, shortness of breath can occur even at rest. However, shortness of breath is not the only sign of advanced heart failure. These also include increased body fatigue, increased heart rate, and the appearance of edema. The latter is caused by fluid retention in the human body. With heart failure, there is a limitation in a person's physical activity.

With heart failure, the cyanosis of the integument of the body appears. The reason for this is obvious - insufficient blood supply. As a result of this insufficiency, the nasolabial triangle and nails turn blue, and it occurs at normal room temperature. Heart failure leads to abnormalities in blood circulation. These deviations can either be noticed directly by the patient himself, or they can be detected by the attending cardiologist.

There are several methods by which a cardiologist can diagnose heart failure. When a specialist listens to the heart, he notes the presence of not two of its tones, but a track, by the way, this phenomenon is called "gallop rhythm". An electrocardiogram shows the presence of signs of an underlying disease that caused the development of chronic heart failure. There is an increase in the size of the heart and, sometimes, pulmonary edema. An echocardiogram is performed to determine the extent to which the heart is malfunctioning.

There are several classes of chronic heart failure. This statement can be made based on one of the classifications given by the New York Heart Association. Let's consider them.

The first class is characterized by the following features. The group of patients belonging to the first class is not limited in physical activity, although the onset of shortness of breath is observed when climbing stairs above the third floor.

The second class can be characterized by the following features. Firstly, here it is already possible to identify a decrease in physical activity in patients, albeit to an insignificant extent, however, signs of insufficiency can manifest themselves even with the usual daily stress. Secondly, in the matter related to shortness of breath, its appearance should be noted already when climbing to the first floor or when walking fast.

The third class is characterized by the following features. With regard to physical activity, then, in comparison with the previous two cases, it is much more limited. In order for the signs of existing heart failure to manifest themselves, enough little physical exertion. They may appear even with normal walking, but usually disappear at rest.

The fourth grade can be characterized as follows. Signs of heart failure are very disturbing to the patient, even when he is at rest. With the slightest physical exertion, the manifestations of heart failure become much stronger.

The main goal in the treatment of heart failure is to improve the patient's quality of life and increase its duration. Great importance is attached to the treatment of the disease that caused heart failure. Often there is a need to use surgical methods. It is important to think about ways to reduce the load on the heart, in connection with which the patient should think about limiting himself in physical activity, providing sufficient time for rest. In terms of a certain diet, the patient should try to reduce the intake of salt and fatty foods and not forget about the importance of a healthy lifestyle.

Cardiac glycosides are the mainstay of treatment for heart failure. This was certainly the case in the past. However, even at the present stage of development, this class of drugs continues to play an important role in the treatment of heart failure, although they are used much less frequently than in the last century, and mainly at the initial stages of the development of heart failure. This type of drugs has an effect on enhancing the work of the myocardium, and also help to improve the patient's tolerance to physical activity. A great lack of cardiac glycosides consists in their accumulation in the patient's body, in more scientific terms - cumulation, as a result of which, in the case of accumulation of a large amount of glycosides, poisoning by them may occur. The latter has characteristic features. This is, first of all, a slowdown in the pulse, nausea and loss of appetite. Sometimes poisoning with cardiac glycosides leads to interruptions in the heart, which is the reason for urgent medical attention.

Diuretics are a second class of medications used for heart failure. Diuretics are diuretic drugs. In cases of heart failure, diuretics are prescribed if there is fluid retention in the body. Which leads to the appearance of edema and weight gain. Diuretic drugs include, for example, veroshpiron, furosemide, diacarb, and others.

Other classes of drugs are used in the treatment of heart failure (except for cardiac glycosides and diuretics). In modern medicine, angiotensin-converting enzyme inhibitors are widely used in the treatment of manifestations of heart failure. These include, for example, berlipril, enalapril, lisinopril. Angiotensin-converting enzyme inhibitors contribute to the expansion of arteries, restoration of the functionality of the vessel walls (the inner lining, first of all), which naturally leads to the promotion of the work of the heart associated with the pushing of blood through the vessels. These drugs are usually prescribed for every patient with heart failure. For some patients, cardiologists prescribe beta blockers, which help to reduce the rate of contraction of the heart muscle. Thus, the oxygen deprivation of the myocardium decreases and the pressure decreases. Beta blockers include carvedilol, metoprolol, concor, and other drugs. Several other classes of drugs are often used in the treatment of heart failure.

The patient plays a significant role in the treatment of heart failure. He is obliged to follow all the recommendations of a specialist (and there are usually a lot of these recommendations). The cardiologist, firstly, prescribes a certain diet to the patient. A diet that does not include excessive amounts of liquid and table salt is recommended. Secondly, the cardiologist usually advises patients on the following: moderate physical activity (which is often supervised by a specialist), as well as ensuring a calm environment both at work and at home. From the point of view of the direct treatment that is prescribed to a patient with heart failure, then it should mainly be directed to the treatment of the underlying disease that led to the development of heart failure. It can be coronary heart disease, myocardial infarction, valvular heart disease, arterial hypertension, or some other disease. Preventive measures are important in the treatment of heart failure.

Prevention of heart failure is the best medicine for it. This is an indisputable fact. As shown above, this syndrome develops against the background of other diseases of the cardiovascular system - as a complication. In this regard, prevention of cardiovascular diseases is of great importance in the prevention of heart failure. It includes regular visits to a cardiologist, timely and rational treatment of arterial hypertension, avoiding unnecessary stress on the heart. As for the latter, it is very important to maintain body weight at a normal level - after all, its increase leads to a direct increase in the load on the heart. Unfortunately, people only start to think about it when shortness of breath begins to seriously bother them. Probably, everyone has heard more than once about the importance of a healthy lifestyle - giving up bad habits, healthy eating, an active lifestyle, etc. But how many people perceive such information rationally? But a healthy lifestyle is the prevention of absolutely all diseases and the guarantee of health for many years.

Limiting salt intake to prevent heart failure is an important step. It is common table salt that loads the heart and blood vessels, if its amount is defined as an excess. The most correct option in terms of preventing cardiovascular diseases and, as their complications, heart failure is to limit salt intake. It is worth accustoming yourself to eating slightly salted food. In general, it is not necessary to give up salt, although there are such people.Limiting salt intake is much easier than maintaining a strict diet when heart failure has already developed.

Coffee and tea are enemies of the cardiovascular system. They put quite strong stress on her. Of course, we are talking about excessive consumption of coffee and tea. Of course, one cup of coffee during breakfast and three cups of tea during the rest of the day is not only healthy, but beneficial. However, drinking coffee cup after cup and thus fighting fatigue is harmful. In this regard, it is necessary to carefully think about whether it is worth drinking the fourth or fifth (even third) cup of coffee while sitting at the computer at night (and at any other time).

Alcoholic drinks are the key to the development of heart failure. Lovers of this kind of drinks are able to argue and argue the French scientists. These scientists have proven that red wine has a good effect on the heart and blood vessels. However, one should not delude ourselves about this. Firstly, scientists have proven the beneficial effect of natural dry grape wine, and not all other alcoholic beverages. Secondly, French scientists talked about small daily doses, and not about Russian feasts. Even such amendments cannot be made about smoking, since it is harmful in any case.

Physical activity also puts stress on the heart. So say a sedentary person who spends hour after hour at the computer. However, he has something to object. Firstly, there are loads that are beneficial to the heart (physical activity is just such), and there are those that have a detrimental effect (alcohol abuse, smoking, etc.). You should know that, so to speak, "idle" heart work will not lead to anything good either. While physical activity helps to strengthen the myocardium - the heart muscle. Thus, physical activity on the body is useful, they are an excellent prevention of myocardial infarction and, of course, heart failure too.


Watch the video: Heart Failure Treatment (December 2021).