The heart muscle is the main organ in the human body. She is responsible for supplying blood to the soft tissues. In the event of a malfunction, the body quickly dies due to a lack of oxygen and nutrients. One of the worst cardiological disorders is considered to be cardiac asthma.
It is characterized by stagnation of blood in a small circle, as a result of which the lungs begin to experience a lack of useful substances. On the other hand, against the background of accumulation of blood in the capillaries of the respiratory organs, their edema occurs. As a result, a person suffers from attacks of suffocation. In this situation, immediate medical attention is required.
Medical certificate
Cardiac asthma is a pathology accompanied by attacks of shortness of breath and suffocation of varying degrees of intensity. Its development is preceded by stagnant processes in the pulmonary circulation. Due to the influence of provoking factors and against the background of deterioration of the heart, there is insufficient functioning of the left parts of the heart muscle. In this case, the activity of the right departments is fully preserved.
Due to the resulting dissonance in the left atrium, pressure increases. The same indicator increases in the vessels of the small circle. In this case, the pressure rises in the capillaries, arteries and veins of the lung tissue. With a further increase in these parameters, the compensatory mechanism, the so-called Kitaev’s reflex, is activated. This condition is characterized by a spasm of the vessels of the pulmonary system as a response to an increase in pressure in the left heart. There is a kind of vicious circle.
Subsequently, sweating and transudation of blood cells is first observed, first into the interstitial space, and then into the cavity of the alveoli. This stage is alveolar edema. The sweating substance contains plasma, an increased amount of protein and red blood cells. Air flows are mixed with transudate in the cavity of the alveoli, which is accompanied by the release of foamy sputum of a pinkish tint. The progression of the pathological process inevitably leads to hypoxemia and hypoxia.
Main reasons
The main cause of cardiac asthma is acute heart failure, affecting the left parts of the main muscle of the body. This disease, in turn, can develop against the background of the following reasons:
- diffuse cardiosclerosis;
- myocarditis;
- aneurysms of the left ventricle and atrium;
- Ischemic heart disease;
- previous myocardial infarction;
- acquired heart valve defects (e.g., stenosis);
- the presence of large blood clots in the muscle.
The following factors increase the risk of cardiac asthma: unbalanced diet, smoking, alcohol abuse and frequent stress. Modern man experiences their impact daily.
Clinical picture
Manifestations of bronchial asthma and cardiac asthma are much similar. The most characteristic symptom is increasing dyspnea. It can appear suddenly or after intense physical activity. Among the provoking factors should also include nervous strain.
About 2-3 days before the upcoming attack, the so-called precursors arise. These include the following disorders: coughing after a change in body position, shortness of breath, discomfort in the chest area.
The attack of cardiac asthma usually happens at night, when the whole body is resting, and the elements of the pulmonary circulation are filled to the maximum. During the day it can provoke physical or emotional overstrain. A sudden feeling of lack of oxygen and shortness of breath appearing at the same time make him wake up. A person cannot lie and intuitively takes a comfortable pose in which he feels better.
It’s hard for the patient to speak, he is forced to breathe only with his mouth. The following symptoms of cardiac asthma are sometimes added to the above symptoms:
- Feeling of fear and fear of dying.
- Change in skin color of the nasolabial triangle to cyanotic.
- Tachycardia.
- Increased blood pressure.
- Fine bubbling wheezing in the lungs.
The appearance of such symptoms of cardiac asthma requires immediate medical attention. If the patient will always postpone the visit to the doctor, the clinical picture may worsen. Usually it is supplemented by a deterioration in general condition, a drop in blood pressure, a change in skin color. In this case, each time the attack increases in duration. The appearance of foamy sputum with impurities of blood indicates the transition of the disease into pulmonary edema.
Cardiac and bronchial asthma: differences
Many, due to insufficient medical knowledge, often confuse bronchial asthma with cardiac asthma. Such errors are due to a similar clinical picture. In both cases, the patient experiences shortness of breath and asthma attacks. However, the main difference is the cause of shortness of breath. In the first case, bronchospasm and pulmonary edema play the role of factors provoking the disorder. Cardiac asthma is a consequence of the failure of the pumping function of the heart. For the bronchial variant, direct contact with irritating elements, the presence of a history of allergic ailments is necessary. This is an independent disease. Cardiac pathology is always one of the manifestations of heart failure.
Differential diagnosis of both ailments is extremely important for the appointment of competent treatment. The patient’s history, the study of his complaints, and ECG data play a primary role in this matter.
First aid
In cardiac asthma, emergency care should be given to the patient immediately. First of all, it is recommended to call a team of medical workers, and secondly, to carry out a number of specific actions to alleviate the human condition.
- The patient must be seated on the bed so that his legs are lowered down.
- Open a window for airing the room.
- It is recommended to remove all squeezing clothes, loosen the tie, unfasten the belt. In this way, normal blood flow can be restored.
- Extremities should be bandaged or plaited on them. This will fill the venous bed, reduce the load on the heart muscle.
- It is important to measure the pressure. If blood pressure indicators are normal or slightly exceed this mark, the patient should be given a tablet of Nitroglycerin or Validol. At low pressure, a combination of these drugs is prohibited. In this case, only Validol is permitted. After 10 minutes, re-measure the pressure. If the indicators do not return to normal, you need to repeat the treatment. However, taking drugs is allowed no more than three times.
- After the patient sits in this position for about 10-15 minutes, it is recommended to lower the legs into a basin with warm water.
- In order to avoid the development of pulmonary edema and only with full access to fresh air, you can let the victim breathe ethyl alcohol vapor. To this end, a small piece of cotton cloth or a regular cotton pad is moistened in solution and the nasal passages are covered.
- With excessive overstrain and anxiety, sedatives help to cope well. They can be found in any person’s medicine cabinet.
Help with cardiac asthma usually continues to be provided to the patient during his transportation to a medical facility. When the excitation of the respiratory center with rapid breathing is diagnosed, narcotic analgesics are used. Among the drugs from this group, Omnopon and Morphine can be noted. However, these medications are strictly contraindicated during pregnancy, cerebral edema, and airway obstruction.
In case of severe psychomotor overexcitation, the above drugs are used in combination with antipsychotics (Haloperidol, Droperidol). Medical emergency care is usually supplemented with the introduction of a solution of "Diphenhydramine".
After stopping the attack, further treatment is carried out in a hospital setting. Therapy is aimed at reducing the excitability of the respiratory center, reducing the load on the pulmonary circulation. All drugs for this purpose, their dosage and duration of administration are selected individually.
Medical examination
Diagnosing cardiac asthma is usually straightforward. First, the doctor conducts a patient survey, during which he can ask a number of clarifying questions. It is important for him to know when the initial symptoms of malaise occurred, what factors preceded them, how long each attack lasts. Then the specialist proceeds to a physical examination. In this case, he should pay attention to the color of the skin, respiration, body position and general condition.
After that, the doctor proceeds to auscultatory diagnostic methods. Through a phonendoscope, he evaluates the functioning of the lungs, the functioning of the respiratory tract and heart muscle.
Obvious signs of cardiac asthma from the respiratory system are wheezing during breathing and coughing. This may be accompanied by sputum with blood. During auscultation of the heart, muffling of its tones is often observed, which is typical for disruption of the myocardium, noise may appear. Also, pathology is always accompanied by:
- severe tachycardia, in which the heart rate is 110-150 strokes;
- inspiratory dyspnea;
- tachypnea (rapid breathing).
If there is a suspicion of cardiac pathology, the patient must be prescribed an ECG. This examination allows you to determine the state of acute myocardial infarction or previous pathology. In addition, it helps to identify hypertrophy of various parts of the heart, impaired processes of impulse transmission.
Additionally, chest x-ray, echocardiography with a Doppler effect may be required. The listed diagnostic methods help to evaluate the clinical picture of the pathology, the work of the heart muscle, and find out the cause of the underlying disease.
Treatment features
Night attacks of shortness of breath and suffocation in the initial stages can pass on their own. However, this fact does not allow the patient to ignore the symptoms of pathology. Due to the high likelihood of developing pulmonary edema and the occurrence of a threat to life during an attack of cardiac asthma, emergency care is simply necessary for the patient.
The therapeutic measures prescribed by doctors pursue several goals at once: to reduce the load on the pulmonary circulation, restore the patient's emotional background, and reduce the excitation of the respiratory center. Therapy for patients with severe shortness of breath and severe pain involves the use of narcotic analgesics ("Morphine", "Pantopon"). If there is a pronounced tachycardia, these funds are taken simultaneously with Suprastin or Pipolfen. In case of bronchospasm, cerebral edema, or respiratory depression, they are replaced with Droperidolum.
Treatment of cardiac asthma with venous congestion and arterial hypertension includes a bloodletting procedure in a volume of 300-500 ml. In the absence of serious contraindications to the patient, tourniquets are applied to the limbs, compressing the veins and artificially creating venous stasis. The maximum duration of the entire procedure is 30 minutes. In this case, the doctor must constantly monitor the pulse. In case of urgent need or worsening of the patient's condition, the procedure is immediately stopped.
In addition to these measures, blood pressure is always corrected using antihypertensive and diuretic drugs. In almost every case of an attack, it is considered advisable to administer cardiac glycosides (Digoxin, Strofantin). The use of such a popular drug as “Eufillin” is most effective for mixed pathology, when the patient is diagnosed with bronchial and cardiac asthma. In the clinic, a patient with cardiac arrhythmias can be given defibrillation.
After stopping the symptoms of an attack, treatment of the underlying disease is usually started, which is to prevent its reappearance in the future.
The need to change the diet
After discharge from the hospital, the patient must adhere to the prescriptions of doctors in order to prevent repeated attacks. The focus is on eliminating factors that can cause shortness of breath and coughing. First of all, it is recommended to eradicate all addictions, adhere to a diet and a certain diet. It is extremely important to normalize the time of rest and wakefulness, to avoid psycho-emotional shocks.
Food is usually based on the following rules:
- The number of meals per day should be 5-6 times. Many worry that with this regimen you can quickly recover. This is actually not the case. You should eat often, but in small portions.
- Food should be high in calories, but digest well.
- From the diet you need to exclude baking and sweets, coffee, spicy and fatty dishes, smoked meats and semi-finished products.
- It is best to cook in a double boiler or oven. Light foods should be preferred: lean meats and fish, cereals. Be sure to have fresh vegetables and fruits in the diet. Black tea must be noticed on green or use herbal infusions, fruit drinks.
- It is important to pay attention to the drinking regimen. Up to two liters of still water are recommended to be consumed per day. But it is better to refuse a large amount of salt and spices.
The doctor selects the diet and drug treatment of cardiac asthma taking into account the general health of the patient, the presence of concomitant ailments.
Some patients prefer treatment with folk remedies. The most popular decoctions based on coltsfoot, wild rose, leaves of wild strawberry. All of them are prepared according to a single principle. A tablespoon of dry grass requires a glass of boiling water. The resulting infusion must be left for 30 minutes, filtered. Take it in small sips throughout the day. It is worth noting that treatment with non-traditional means is permissible only in the inactive period of the disease and after consulting a doctor.
Possible consequences
The development of heart failure, asthma on its background is accompanied by unpleasant symptoms. In most cases, they indicate serious damage to the heart muscle. Therefore, you can not do without appropriate treatment. Patients with such a diagnosis are shown inpatient therapy. After discharge, they need to be constantly monitored by a cardiologist.
If all the recommendations of the attending physician are observed after recovery, a satisfactory condition can be maintained. However, in this case, the patient will have to radically change his usual lifestyle. As a rule, it is necessary to abandon addictions and intense sports, follow a diet, regularly undergo preventive examinations.
Prevention Methods
In order to prevent the occurrence of cardiac asthma with subsequent pulmonary edema, prevention is necessary. It implies the timely treatment of all cardiac diseases. In addition, you must completely review the pace of life, try to relax more.
It is important to completely eradicate addictions, normalize nutrition, and sharply limit the excessive consumption of salt and foods with animal fats. Do not overeat or exceed the permissible amount of fluid consumed, especially in the evening. The last meal, according to doctors, should take place about 4-5 hours before bedtime.
On the one hand, intense physical activity is not recommended, and on the other, a sedentary lifestyle. They approximately equally worsen hemodynamic indices. After therapeutic measures in a hospital, respiratory gymnastics, exercise therapy and walking must be used with a gradual increase in duration and pace.