Heart failure as a combination of disorders associated with the deterioration of the contractile functions of the heart muscle is a dangerous pathology for humans. The result of this condition is a deficiency in the supply of nutrients and oxygen to the myocardium, which affects the work of all internal organs and systems, human well-being. Heart failure of varying degrees occurs in both men and women. The disease can lead to irreversible complications, including the death of the patient due to ineffective or belated medical care.
Ignoring the symptoms of heart failure is a guarantee of imminent ill health. That is why, when the first alarming "bells" of this life-threatening disease appear, it is necessary to rush to an appointment with a cardiologist. Only a specialist will be able to make an accurate diagnosis, establish the cause and draw up competent therapy. In addition, the doctor will give the necessary recommendations and instructions on how to stop a heart attack at home.
Acute form of pathology
The first symptoms of heart failure often indicate a complication of a severe form of arrhythmia, among the common types of which it is worth noting paroxysmal tachycardia, ventricular fibrillation. An acute form of the disease can also occur as a result of myocarditis or heart attack. As the ability of the heart muscle to contract normally decreases, the volume of blood entering the arterial system for every minute becomes smaller.
Acute heart failure is often caused by a decrease in the pumping function of one or both ventricles, the left atrium. Again, the chances of developing an ailment are increased by myocardial infarction, the presence of aortic defect, and frequent hypertensive crises. A decrease in the contractile functions of the atrium or at least one of the ventricles leads to an increase in blood pressure and an increase in the permeability of the vascular walls. This phenomenon, in turn, becomes a provoking factor in pulmonary edema. Symptomatic acute heart failure is almost identical in symptoms to the manifestations of acute vascular insufficiency, this condition is called a collapse by doctors.
Description of the chronic course of the disease
Unlike the acute variety, the chronic one develops gradually, which is associated with the compensatory capabilities of the body. The disease begins with an increase in the rhythm of heart beats and an increase in their intensity. Against the background of arrhythmic manifestations, arterioles and capillaries expand. This in turn contributes to the problem-free emptying of the chambers and the improvement of perfusion of muscle tissue.
As the disease progresses and the compensatory mechanisms are exhausted, the volume of cardiac output is steadily decreasing. The ventricles are no longer able to empty completely and during the diastole period remain overflowing with blood. Myocardium in chronic heart failure is trying to somehow promote stagnant ventricular blood into the arterial circulatory system. However, this does not give the desired result, and therefore it becomes a favorable condition for the formation of compensatory hypertrophy of the heart muscle. In the future, the myocardium will only become weaker due to the dystrophic and sclerotic processes occurring in it. Their cause is a lack of blood supply and oxygen, nutrients and energy entering the tissues.
The next stage in the development of chronic heart failure is the decompensation stage. To maintain the level of normal hemodynamics, the body turns to the neurohumoral mechanisms of the sympathetic-adrenal system. A relatively stable level of blood pressure is provided precisely due to their activation, despite significantly reduced volumes of cardiac output. Typically, this process is accompanied by a spasm of the vessels of the kidneys, which leads to organ ischemia and the development of their dysfunction with a delay in interstitial fluids.
Further, the pituitary gland production of antidiuretic hormone, which affects the mechanism of water retention in the body, is enhanced. As a result, an increase in the volume of circulating blood, an increase in blood pressure, and sweating of fluid into the interstitial space.
Chronic heart failure occurs on average in 2% of the population. In old age, the likelihood of developing a disease increases, and among 70-year-olds, one in ten is diagnosed with an ailment. In fact, heart failure is a serious medical and social problem, since pathology often leads to death or disability.
Heart disease as the main cause
It is impossible to unequivocally answer the question of what leads to the development of heart failure. First of all, the risk increases the presence of heart and vascular diseases, in particular:
- congenital heart disease;
- arterial hypertension;
- myocardial infarction;
- atrial fibrillation;
- expansion of the heart cavities;
- inflammation of the heart muscle;
- cardiopathy;
- coronary artery disease;
- myocardiopathy with alcohol withdrawal.
Inflammatory and Infectious Diseases
Heart failure often occurs as a result of transferred infectious ailments, accompanied by a dangerous inflammatory process in the body. By the way, this reason is the most common in childhood. Heart failure may result from:
- flu
- poliomyelitis;
- pneumonia;
- scarlet fever;
- diphtheria;
- sore throats.
As a rule, this ailment of the heart, proceeding in a chronic form, has a long path of development, however, it is important to know that it can occur at any time with an acute attack. Each person with impaired functioning of the heart and blood vessels should have information on how to stop it.
How to understand that a person has heart disease
The specific signs of heart failure include specific clinical manifestations. The most common ones are:
- Dyspnea, worse even with minimal physical exertion. In the later stages of the development of the disease, it occurs not only with stress, but also at rest and even during sleep.
- Constant weakness and overwork. This inevitably affects labor productivity, reduced efficiency.
- Chronic cough and tachycardia.
- Swelling. The mechanism of fluid accumulation in tissues has been described above. This symptom is manifested due to a lack of oxygen, which the heart muscle is trying to make up due to its intense contraction, and, consequently, the increase in heart rate.
- Arterial hypotension.
- Visceral obesity (subcutaneous fat accumulates mainly in the peritoneum).
- Ascites is the concentration of excess fluid in the stomach.
- Cyanosis is a pathological condition that is manifested by cyanosis and pallor of the skin.
In addition, with heart failure of the first degree, the appearance of angina pectoris is possible - acute pain in the sternum. It is practically impossible to recover from this disease forever, but the doctor and patient can eliminate the symptoms that impede a full life. Achieving persistent remission will be possible with complex therapy.
Stages of the development of the disease
Doctors classify the considered pathology of the heart mainly according to the severity of the manifestation and reaction of the patient's body to physical activity. You can understand what it is, heart failure of the 1st degree, by minor shortness of breath that occurs during the ascent of the stairs. Meanwhile, physical activity of a different kind does not affect the patient’s well-being. The prognosis for heart failure of the 1st degree is the most favorable. The main thing is to monitor your health and prevent the progression of the disease. As such, treatment for heart failure of the 1st degree is not required.
The second degree of heart failure affects working activity. At this stage of the development of pathology, fast fatigue appears, the pulse quickens, breathing is difficult. Symptoms disappear without a trace at rest. The third and fourth degrees of severity of the disease occur with symptoms that can be traced even with minimal patient motor activity and remain in a calm position.
Conservative therapy, list of drugs
Doctors, as a rule, do not resort to drug treatment of heart failure of the 1st degree. The recommendations of specialists for such patients come down to a review of lifestyle and daily routine. In order to prevent the development of the disease, the patient should avoid stress, heavy physical exertion, eat a balanced diet, have a good rest and, of course, completely abandon bad habits. If necessary, sedatives and antidepressants are prescribed.
The second degree of heart failure is an indication for taking medications that support the work of weakened muscles. Conservative therapy involves taking a range of drugs:
- Cardiac glycosides ("Digitoxin", "Methyldigoxin", "Digoxin", "Strofantin K"). They are prescribed to the patient to improve myocardial contractile function.
- Nitrates ("Nitroglycerin"). Stop pain attacks in the chest, expand the veins.
- ACE inhibitors (Captopril, Captopress, Lisinopril, Fosinopril). Medicines in this group reduce blood pressure, dilate blood vessels, reducing the risk of cardiac arrest.
- Beta-blockers (Metoprolol, Atenolol). They are indicated for arrhythmias and tachycardia, slow the heartbeat and lower blood pressure.
- Calcium antagonists (Verapamil, Cinnarizine, Diltiazem, Amlodipine, Nitrendipin). Necessary for the expansion of blood vessels, elimination of arrhythmia.
- Diuretics ("Spironol", "Urakton", "Furosemide", "Aldactone"). Medicines of this group accelerate the elimination of excess fluid from the body, preventing the formation of edema. Diuretics increase the effectiveness of drugs that lower blood pressure.
Heart surgery
With congenital cardiovascular insufficiency, the use of drugs, unfortunately, is insufficient to stop the progression of the disease. As a rule, drugs help only temporarily stop the manifestations of the disease, but do not eliminate the provoking factor. In fact, the symptoms of heart failure are only evidence of its effects.
In severe cases, the cardiologist may decide on the need for surgery. The type of surgical treatment will depend on the type of cardiovascular failure:
- With defects in heart valves, prostheses are installed.
- Stenosis is a direct indication for stenting arteries, during which a special dilating framework is placed inside the vessel.
- With an open arterial duct, an occluder is installed.
- Catheter ablation of the pathways is carried out with WPW and LGL syndrome.
Organ transplant
Indications for heart surgery are severe symptoms of heart failure and a serious, life-threatening condition of the patient. In such cases, the disease is not always treatable, which means that transplantation may be necessary because of structural changes in the organ. A successful transplant of a healthy heart will allow a person to live a full life, but we must not forget about the high mortality rate. On average, about 10% of patients die during the operation and during the first month after it. The main reason is rejection of the donor heart due to the body's immune response.
Recommendations to patients
Any sign of heart failure out of the above is an alarm that indicates that your lifestyle needs urgent adjustment. First of all, it is necessary to abandon bad habits, if any. The prognosis of life in heart failure of the 1st degree leaves hope for a happy future, however, in order for the disease not to develop further, you will have to reconsider your diet.
Fresh vegetables and fruits (especially apricots and persimmons), sour-milk drinks and cottage cheese, low-fat varieties of meat and fish, boiled potatoes, buckwheat, oatmeal should predominate in the diet of a person with heart disease. While salty, fried and pickled dishes are better to completely exclude. Strong tea and coffee, spicy spices, smoked meats and chocolate will not benefit. Alcohol is completely contraindicated in heart failure.
To minimize edema and reduce the burden on the kidneys, it is better to reduce the daily amount of fluid consumed (no more than 1 liter). Self-medication for heart disease is not the best solution. Do not delay a visit to the doctor. Remember that the prognosis of the disease largely depends on the quality and timeliness of medical care.