Heart failure is a pathological or acute condition that manifests itself against the background of a weakening of the contractile ability of the myocardium. Patients suffering from the disorder face congestion in the small or large circulatory system, shortness of breath in the absence of physical exertion and increased fatigue. Against the background of acute insufficiency, pulmonary edema or cardiogenic shock may develop. The chronic form of the disorder often leads to hypoxia of organs and a decrease in human performance.
Causes of heart failure
A decrease in the contractility of the myocardium is not considered by cardiologists as an independent disease. This condition is typical for patients who have had a heart attack and suffer from coronary heart disease (CHD). In people over 60 years of age, heart failure manifests itself against the background of hypertension and type II diabetes mellitus, complicated by arterial hypertension.
The risk of developing heart failure increases significantly when the body is exposed to adverse external and internal factors. These include:
increased physical and psycho-emotional stress
arrhythmias, hypertensive crises, progressive coronary
artery disease, pneumonia, ARVI, anemia, kidney failure
taking medications with cardiotoxic effect
rapid weight gain
systematic alcohol consumption.
Persons suffering from chronic heart failure may face symptoms of an acute form of pathology if the recommendations of a cardiologist are not followed.
Symptoms of heart failure
The acute form of pathology leads to alveolar pulmonary edema and cardiac asthma. An asthmatic attack develops against the background of physical or psychoemotional stress. At night, suffocation occurs, provoking the patient to wake up due to a feeling of lack of air, increased heartbeat, coughing with copious sputum, an attack of weakness and profuse sweating.
The chronic form of pathology provokes the development of vascular and gas changes in the lungs. Patients suffer from shortness of breath, cyanosis, palpitations, cough with hemoptysis, fatigue. Prolonged stagnation of blood in the veins leads to their sclerosis. The pressure in the pulmonary artery increases, which causes excessive congestion of the right ventricle of the heart.
Diagnosis of pathology
The diagnosis is made by a cardiologist or therapist. The doctor records the patient’s complaints and conducts a physical examination. During it, individual symptoms indicating heart failure are detected: hypertension, swelling of the shins, ascites, palpitations, low-amplitude pulse.
The next stage of diagnosis is the determination of the electrolyte and gas composition of the blood, the assessment of its acid-base balance, the detection of the concentration of urea, creatinine, cardiospecific enzymes and other parameters.
During the ECG, doctors will detect signs of arrhythmia, hypertrophy and insufficient blood supply to the myocardium. Electrocardiography is often combined with stress testing on an exercise bike or treadmill. The use of these devices allows cardiologists to assess the reserve potential of the patient’s heart muscle.
Ultrasound echocardiography is used to assess the surface function of the myocardium and identify the causes that provoked the development of heart failure. Magnetic resonance imaging allows you to confirm the presence of coronary heart disease, congenital or acquired heart defects in a patient. Radiography is used to visualize stagnant processes in the small circle of blood circulation.
Treatment of heart failure
Therapeutic measures are designed to eliminate the primary cause of heart failure. In the acute course of pathology, bed rest, moderate consumption of liquids and salt, dietary nutrition (based on plant products) is indicated. Drug therapy is based on drugs of several groups:
glycosides that increase myocardial contractility
vasodilators that reduce vascular tone and dilate the lumen of the arteries
nitrates that provide blood filling of the ventricles of the heart
diuretics that help to remove excess fluid from the body
anticoagulants that exclude the possibility of blood clots.
Additionally, drugs that improve myocardial metabolism are prescribed — B vitamins, ascorbic acid, inosine.
Pulmonary edema becomes an indication for hospitalization and emergency therapy. With ascites, puncture removal of fluid accumulated in the abdominal cavity is performed. To do this, drugs that increase heart tone are introduced. The length of stay in the hospital depends on the dynamics of treatment, the average duration of hospitalization is 10 days.
Questions and answers
Which doctor treats heart failure?
The therapeutic course is developed by a cardiologist. Some patients may need to consult a nutritionist, endocrinologist, neurologist, therapist or narcologist.
Is there an effective set of measures to prevent heart failure?
Patients at risk should follow the recommendations of doctors: minimize physical activity, avoid stress, give up bad habits, follow a balanced diet, undergo routine cardiological examinations.
What is the prognosis formed by doctors for patients with the pathology in question?
Detection of an acute condition in the early stages allows cardiologists to form a favorable prognosis.Drug therapy can completely compensate for the decrease in myocardial contractile function. Deterioration of the prognosis is possible with the advanced course of chronic heart failure.