Often we hear the expression “cardiopulmonary insufficiency”, but few can definitely say what this pathology is. What kind of disease is it, what are its signs and causes - we will understand.
Cardiopulmonary failure - what is it?
In modern medicine, cardiopulmonary insufficiency is understood as a condition in which heart failure, that is, the inability of the heart to provide normal blood supply in the body, is combined with pulmonary, which occurs due to excessive blood pressure in the vessels of the lungs where gas exchange occurs. All this leads to a decrease in the level of oxygen in the blood.
In practice, pulmonary failure often develops first, and heart symptoms join in after a while. Strictly speaking, this symptom complex can be observed both in many diseases of the cardiovascular system, and in diseases of the lungs. In its course, the pathology can manifest itself in an acute form, when the symptoms increase in a short time period, and may have a chronic form, when the deterioration occurs within several years or even decades.
Causes of Acute Cardiopulmonary Failure
Acute pulmonary insufficiency is a complication that occurs in some conditions that threaten the patient's life. In this case, urgent medical intervention is necessary. As a rule, it can develop in the following conditions:
- as a result of thrombosis or spasm of the pulmonary artery;
- with thromboembolism;
- with pneumo- or hydrothorex;
- with exacerbation of bronchial asthma, asthmatic status.
However, the cause of increased pressure in the pulmonary artery may be heart disease. Most often, this occurs with a sudden occurrence of mitral valve insufficiency. Also, pulmonary valve insufficiency, acute heart attack, myocarditis, heart defects in the stage of decompensation, cardiomyopathy can become the cause of pulmonary failure. In this case, the cavity of the left ventricle expands, and the contraction of its wall is no longer able to push the entire volume of blood into the lumen of the vessel. Some part of it stagnates and increases pressure in the pulmonary veins. As the right ventricle continues to pump blood in full, pressure continues to increase, which can lead to pulmonary edema or cardiac asthma.
Causes of Chronic Heart Pulmonary Failure
Chronic pulmonary failure, in contrast to the acute form, grows slowly. The process of increasing pathological changes has been going on for several years. In this case, the development of hypertension in the pulmonary vessels occurs in connection with the following pathologies:
- hereditary idiopathic hypertension;
- atherosclerosis;
- insufficiency of the pulmonary artery, which can be caused by endarteritis or re-embolism of small branches;
- chronic lung diseases - emphysema, pleurisy, pneumosclerosis, obstructive bronchitis;
- slowly progressive congenital heart defects ;
- acquired valve disorders.
Pulmonary insufficiency: severity
Due to the fact that the chronic form of this disease is characterized by a slow and often almost imperceptible increase in pathological symptoms, four degrees of disease severity are determined:
- I degree - there are no signs of the disease, with the usual physical exertion, the manifestations of the disease are not observed, with an increase in the load, a small shortness of breath appears.
- II degree - at rest, symptoms do not appear, but with habitual physical exertion, shortness of breath and a frequent heartbeat appear.
- III degree - symptoms of insufficiency appear with minimal physical activity, but are absent at rest.
- IV degree - a person can not exercise minimal physical activity, signs of the disease appear at rest.
An acute attack of pulmonary failure can develop according to one of two options - right and left ventricular failure. Left ventricular failure may result in pulmonary edema or cardiac asthma.
Cardiac asthma
This is pulmonary failure, the symptoms of which increase gradually. In the early stages, it manifests itself as shortness of breath, which appears first after physical exertion, with time it intensifies, appearing even at rest. With shortness of breath, the act of inspiration (inspiratory nature) is difficult. In the future, it is replaced by asthma attacks, most often occurring during sleep. For this stage, the forced posture is indicative - a high headboard, during attacks, the patient is forced to sit down, lowering his legs from the bed and leaning on his hands, except for shortness of breath, palpitations, sweating, fear of death. Cough with cardiac asthma is dry, with sparingly separated sputum. The skin is pale, pronounced cyanosis of the nasolabial triangle, fingers. The pulse is irregular, weak, the pressure is reduced.
Consider the features of cardiac and bronchial asthma:
| Heart | Bronchial |
Breath | Noisy, bubbling, audible from a distance | Wheezing, dry |
Type of dyspnea | Inspiratory (difficulty breathing) | Expiratory (difficulty exhaling) |
Sputum | Scanty, with pulmonary edema - pink foam | A lot of transparent sputum, which is difficult to separate |
Auscultation | Wet wheezing | Dry, wheezing, weak breathing |
Action of drugs | The use of diuretics brings relief | With the introduction of diuretics, the condition worsens |
Pulmonary edema
Acute pulmonary failure can be complicated by the development of pulmonary edema. This is the exit of a significant amount of blood into the lung tissue. An attack develops suddenly, regardless of the time of day. The onset is characterized by a sharp suffocation, while there is a rapid deterioration in the patient's condition:
- shortness of breath intensifies, the patient does not have enough air, there is cyanosis of the skin of the face and limbs, cold sweat;
- consciousness is impaired - it can be either motor excitement or a stupor up to a complete loss of consciousness;
- breathing noisy, bubbling, pink foam stands out;
- if the attack occurred against a background of myocardial infarction or myocarditis, cardiogenic shock may develop.
Right ventricular failure
It can also occur as a complication of myocardial infarction or myocarditis. Its manifestations, except shortness of breath and increasing suffocation, are:
- cyanosis of the face and fingers;
- swollen cervical veins are clearly visible, especially on inhalation;
- swelling of the legs, face, abdominal wall up to ascites;
- enlarged liver, pulsation in the epigastrium is observed.
Chronic cardiopulmonary failure
Due to the fact that the chronic form of this pathology develops over many years, its clinical manifestations are less pronounced. Since the pathology of the respiratory system most often lies at the heart of the disease, it is manifested primarily by shortness of breath. The following symptoms may join it:
- chest pain
- arrhythmia;
- tachycardia;
- cyanosis;
- swelling on the legs;
- neck vein swelling;
- encephalopathy.
As the disease progresses, the symptoms begin to intensify, and if at first they appeared after certain loads, then at the final stages (in the stage of decompensation) this happens completely at rest.
Cardiopulmonary failure: treatment
The development of acute failure usually requires quick and professional intervention. As a rule, treatment is carried out in a hospital, and more often in an intensive care unit. If the attack has developed at home, you need to take the person to a medical facility as soon as possible. Therapy of the chronic form of the disease is an integrated approach to the treatment of the disease. This is not only a medical correction, but also an optimization of the level of physical activity, nutrition. Drug therapy for this pathology consists in the appointment of the following groups of drugs:
- beta blockers;
- diuretics
- cardiac glycosides.
The treatment regimen and dosage in each individual case is determined by the doctor. Self-medication in such cases is unacceptable. In case of failure of conservative treatment, the problem is solved surgically.