🎻 🐶 ✉️ Pulmonary heart: causes, signs, treatment, diagnosis ⛄️ 🤟🏻 🎅🏽

Pulmonary heart disease is a pathological condition that is accompanied by hypertrophy with subsequent expansion of the right side of the heart. Similar disturbances develop against the background of increased pressure in the pulmonary circulation. The lack of therapy for this disease leads to dangerous complications up to myocardial infarction.

Of course, many people are looking for more information about pathology. Why does the disease develop? How does pulmonary heart develop? What symptoms should alert a sick person? Are there effective treatments? What predictions can patients expect? Answers to these questions will be useful to many readers.

Brief description of the disease

Pulmonary heart disease is a very common disease, which is accompanied by the expansion and enlargement of the right heart. The mechanism of development of pathology has been studied well.

As you know, the muscle layer of the right heart is not so developed, as it is only responsible for pumping blood through the pulmonary circulation (in the vessels of the lungs, the blood is saturated with oxygen and returns). Sometimes, for one reason or another, the pressure in the vessels rises, as a result of which the right ventricle and atrium are forced to cope with increased loads.

If we are talking about a subacute or chronic form (when blood pressure rises gradually), then myocardial tissue slowly changes - the number of muscle fibers increases in order to cope with additional loads. Unfortunately, these parts of the heart are not intended for hard work and the number of coronary vessels that feed the myocardium is less. Such an organ violates tissue trophism. The muscles of the heart suffer from oxygen and nutrient deficiencies.

The main causes of the development of pathology

In fact, this condition is not an independent pathology - it develops against the background of a number of other diseases. The causes of pulmonary heart disease are extremely important to determine during diagnosis, since the success of treatment depends on this in many respects. It is worth considering the most common risk factors:

Thromboembolism of the pulmonary artery of the heart is a dangerous condition, which is accompanied by a blockage of the lumen of the blood clot. Such a pathology can be the result of injuries, fractures, diabetes mellitus, and an increase in blood viscosity. Acute pulmonary heart often develops precisely against the background of thromboembolism.
Pneumothorax is a violation of the integrity of the pleural cavity, which may be associated with chest injuries, medical procedures, etc.
Exudative pleurisy is an ailment characterized by inflammation of the outer membrane of the lung with the release and subsequent accumulation of exudate in the pleural cavity.
The acute form of the pulmonary heart may be associated with a severe attack of bronchial asthma.
The causes include tuberculosis.
Pneumoconiosis is fibrosis of the lung tissue, which is associated with prolonged inhalation of dust, metals, talc and other substances.
Fibrosing alveolitis is an ailment that is accompanied by damage to the walls of the alveoli with subsequent replacement of the functional tissues with connective tissue. Of course, the processes of respiration and blood flow are disturbed.
Congenital lung pathologies are also considered risk factors. Pulmonary heart sometimes develops against the background of polycystic, cystic fibrosis, lung hypoplasia.
Sarcoidosis is a disease against the background of which large granulomas form in the lungs, which press on neighboring tissues, compress bronchioles and small pulmonary vessels.
The chronic form of the pulmonary heart often develops against a background of bronchitis (chronic).
The list of causes includes bronchiectasis, which are pathologically altered bronchi.
Emphysema is a disease that is accompanied by an increase in lung volume against the background of expansion of the bronchi. Of course, the destruction of the walls of the small bronchi leads to disruption of gas exchange and blood circulation.
A list of possible causes include vascular diseases, in particular, pathologies that affect the walls of the pulmonary artery, small pulmonary capillaries.
Neuromuscular diseases, for example, muscular dystrophies, poliomyelitis, myasthenia gravis, myopathies, are accompanied by weakness of the respiratory muscles, which leads to disruption of the processes of ventilation of the lungs.
Very rarely, the pulmonary heart develops against the background of disorders of the respiratory center, which is located in the medulla oblongata. This is sometimes observed after a stroke and head injuries, against the background of meningitis, increased intracranial pressure, with poisoning by some substances.
The list of causes can also include chest deformities, in which ventilation of the lungs is significantly impaired.

Classification scheme

Of course, there are many classification schemes for such a pathology. If you pay attention to the speed of development of the disease, then allocate:

acute form, which develops quickly, sometimes in a few hours (may be associated with vascular thrombosis);
subacute, in which the pathological process develops within a few weeks or months;
chronic pulmonary heart is a form of pathology that develops against the background of a gradual, prolonged increase in blood pressure in the vessels (the disease can be the result of chronic respiratory failure).

Stages of the development of pathology

How does the disease develop? The pulmonary heart progresses in several stages.

The preclinical stage proceeds without any symptoms, so the disease can be diagnosed only during an instrumental examination. Transient pulmonary hypertension is observed.
Compensated stage - persistent hypertension already takes place. For this stage, already expressed hypertrophy of the right ventricle is characteristic.
The decompensation stage is accompanied by the onset of symptoms of right ventricular failure.

The clinical picture: the main symptoms

It is worth noting that the symptoms of the pulmonary heart largely depend on the form and stage of development of the disease. The list of possible signs is quite impressive:

Often, patients note a rapid heartbeat, which indicates tachycardia. The heart begins to contract faster in order to compensate for circulatory failure. This is the most common sign of chronic pulmonary heart disease.
Pathology is often accompanied by arrhythmias.
Pain in the heart area also develops against the background of a similar pathology, in particular, its chronic form, because the heart is forced to work intensely in conditions of oxygen starvation. Pain is usually exacerbated during physical activity.
Acute pulmonary heart (as well as a chronic form of the disease) is accompanied by severe shortness of breath
The list of symptoms can also include frequent dizziness, episodes of which often end in loss of consciousness.
Cough is another symptom of a pulmonary heart, although it is associated with stagnation of blood in the pulmonary circulation. Coughing may increase during physical exertion.
Many patients complain of increased fatigue, constant weakness, and fatigue.
If there is right-sided heart failure, then the list of symptoms can be supplemented with edema that appears against the background of stagnation of blood. As a rule, excess fluid accumulates in the soft tissues of the lower extremities.
Cyanosis of the skin is associated with overflow of vessels with venous blood and a decrease in the level of oxygen in arterial blood.
Examination of the patient reveals swelling of the cervical veins.
Against the background of chronic pulmonary heart, the fingers of patients often change, taking the form of “drum sticks”. By the way, this is a common symptom testifying to various protracted diseases of the lungs and heart.
Pain in the right hypochondrium is associated with an increase in the liver, which occurs against a background of increased pressure and stagnation of blood in the inferior genital vein.
At a later stage of chronic right-sided heart failure, ascites may develop, in which free fluid begins to accumulate in the abdominal cavity.

Chronic pulmonary heart

This form of the disease develops gradually, over many months, and sometimes years. The causes of chronic pulmonary heart disease may be different:

vascular lesions, for example, against the background of primary pulmonary hypertension or arteritis;
operation to partially or completely remove the lung;
obstructive airways diseases, in particular, bronchial asthma, chronic bronchitis, pulmonary emphysema, as well as various forms of fibrosis;
obesity;
adhesive process in the pleura;
damage to the chest and upper spine.

In some patients, the ailment proceeds in a compensated form - there is an increase and expansion of the right ventricle, but the pathology is almost asymptomatic. On the other hand, the disease can always go into a decompensated form, in which there are symptoms of cardiopulmonary failure.

Possible complications

Treatment of pulmonary heart in most cases allows you to control the development of the disease. Nevertheless, if the disease was diagnosed at a late stage or there were some concomitant pathologies, then the likelihood of developing very dangerous complications is high:

The most common complication of pulmonary heart disease is myocardial infarction. As already mentioned, the disease is accompanied by oxygen starvation, which leads to necrosis of muscle cells. In addition, the risk of developing myocardial infarction due to pulmonary hypertension increases with atherosclerosis, an increase in blood cholesterol. Risk factors include smoking and quitting drugs prescribed by your doctor.
Pulmonary heart disease is associated with significant impairment of blood flow. Stagnation of blood in the portal vein leads to a number of dangerous complications, in particular, peptic ulcer of the stomach and small intestine. The fact is that due to stagnation of blood and oxygen starvation, the structure of the mucous membranes of the digestive tract changes, which makes them sensitive to the negative effects of the external and internal environment. In this case, the risk factors include the penetration of Helicobacter bacteria into the body, irregular nutrition, alcohol abuse, etc. It is worth noting that ulcers that develop against the background of heart failure are very difficult to treat.
Liver cirrhosis is another possible complication that is associated with prolonged stagnation of blood inside the organ. In this case, the liver decreases, acquires a denser structure. The organ cannot filter and purify the blood, it does poorly with its functions, which leads to accumulation of fluid in the abdominal cavity, as well as an increase in the size of the spleen.
Often patients with chronic forms of pulmonary heart are faced with such an unpleasant consequence as hemorrhoids. The fact is that veins located in the anus and rectum expand against the background of stagnation of blood. There is an expansion of veins, bulging of the mucous membranes, the formation and increase of hemorrhoidal nodes. The disease is accompanied by discomfort and teeth in the anus, pain during bowel movements. Sometimes the vessels are damaged and in the feces appear a trace of red blood. Hemorrhoidal nodes can be surgically removed only after it is possible to take control of the general condition of the patient, eliminate blood stasis and remove other symptoms of the pulmonary heart.
Varicose veins are another complication, which, again, is associated with congestion. Overfilling of blood vessels with blood leads to a pathological expansion of their walls - this is how varicose veins develop. In most cases, the process encompasses the veins of the lower extremities. Patients complain of swelling, heaviness in the legs, cramping at night. In more severe cases, varicose veins are accompanied by inflammation of the vascular walls, the formation of blood clots.

During diagnosis, it is extremely important to check the patient for the above complications - you may need additional treatment.

Diagnostic measures

Of course, having noticed some disturbing symptoms, you need to see a doctor. Diagnosis of the pulmonary heart is extremely important, because the effectiveness of therapy directly depends on the correct diagnosis.

A general examination of the patient and collection of anamnesis in this case are extremely important. So the doctor can learn more about the symptoms that have appeared. The specialist also draws attention to the shape of the patient’s fingers, the presence of edema and swollen veins, an increase in the abdomen and other external symptoms.
As part of a general examination, auscultation and percussion of the heart are performed.
Electrocardiography is extremely informative. During the procedure, the doctor can diagnose tachycardia, detect certain heart rhythm disturbances, evaluate the work of the heart muscle.
Echocardiography is a procedure that allows you to examine the heart using ultrasound equipment. During the examination, the doctor can examine the departments of the heart and valves, measure the thickness of the walls of the myocardium, and also check the speed of blood flow. Thus, a specialist can detect muscle hypertrophy and an increase in the volume of the heart chambers.
X-ray studies give the doctor information about the size and location of the chest organs.
A blood test is mandatory. With pulmonary heart, there is an increase in the number of red blood cells, a decrease in their sedimentation rate, as well as an increase in the level of hemoglobin and white blood cells.
If there is a suspicion of infectious processes in the lungs, then an additional bacteriological culture is performed. For analysis, as a rule, sputum samples are taken. The procedure makes it possible to identify the pathogen, as well as evaluate its sensitivity to a particular drug.
Respiratory function tests are being conducted that help identify chronic disorders in the functioning of the respiratory system.

How to treat a disease?

Pulmonary heart treatment must be comprehensive. The treatment regimen is made by the doctor after studying the results of all studies.

Since pathology is associated with oxygen starvation, it is first necessary to restore its level. For this purpose, various drugs and techniques are used:

First of all, patients are prescribed bronchodilators. Such funds help to expand the lumen of the bronchi, resulting in improved ventilation of the lungs - tissues receive more oxygen.
Effective are oxygen inhalations. Using a special probe (in most cases it is inserted through the nasal passages), a gas mixture with a high oxygen content is delivered to the lungs. Of course, the procedure is carried out only in a hospital setting. If we are talking about the treatment of chronic pulmonary heart, then the procedure is repeated for several weeks.

Blood stasis in the lungs and other organs increases the likelihood of developing infectious diseases. That is why sometimes antibiotics are included in the treatment regimen.

It is also important to control pulmonary hypertension and normalize blood pressure in the vessels. For this purpose, different means are used:

Calcium channel blockers, in particular Diltiazem and Nifedipine, help smooth muscle relaxation, which helps to expand the lumen of the pulmonary capillaries.
ACE inhibitors (Captopril) prevent the development of vascular spasms.
Nitrates help to relieve the heart, as they reduce the return of blood to the right atrium.
Alpha-adrenergic blocking agents (for example, “Doxazosin”) act on the receptors of the capillary walls, contributing to their expansion.

Stagnation often leads to an increase in blood viscosity. This impairs fluid circulation and increases the likelihood of developing blood. In addition, thick blood does not pass through small capillaries and practically does not participate in gas exchange processes. That is why patients are prescribed blood thinners (for example, "Reopoliglyukin").

Therapy, of course, is aimed at removing the symptoms of right ventricular heart failure.

Treatment includes diuretics. They help get rid of excess body water by eliminating fluid naturally. Such drugs help cope with edema, normalize blood pressure. The dose is selected individually.
Cardiac glycosides are also used. They increase the contractile activity of the myocardium. Small doses are prescribed to patients - too large quantities of such drugs only increase the load on the heart and exacerbate the situation.

Of course, it is also necessary to treat the primary disease, because the pulmonary heart is only a consequence of one or another pathological process. For example, adequate treatment of asthma and chronic bronchitis is necessary. With pneumosclerosis, the patient requires a lung transplant.

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Predictions for Patients

How many live with a pulmonary heart? What predictions can a patient expect? It is immediately worth saying that the outcome of the disease largely depends on at what stage of development the pulmonary heart was diagnosed and whether the appropriate therapy was started on time. If an ailment is found at the compensation stage, then taking certain medications, the right lifestyle and the appropriate diet helps the patient lead a normal lifestyle (with limited physical activity, of course).

If there is a stage of decompensation, then the ailment leads to disability - a person’s performance decreases sharply, his health worsens, he often loses his ability to be served independently, even at a household level. Lack of therapy is fraught with dangerous complications until the death of the patient.

Pulmonary heart: causes, signs, treatment, diagnosis