Compensated and decompensated heart failure occurs. Compensated is mild insufficiency (stage 1).
Decompensated heart failure is the terminal stage of the disease, which is the result of the fact that the damaged heart muscle is not able to deliver blood to various functional systems of the human body. A characteristic feature is the manifestation not only during periods of physical activity, but also at rest. Often with decompensated heart failure, hefty cardiac pathological and functional transformations occur. These changes, as a rule, are irreversible and can end fatally. This type of pathology refers to a severe form (stage 3).
In this article, decompensated heart failure will be examined in detail: what it is, what types exist, the symptoms of the disease, and possible methods of treatment.
Causes of SDS
Unfortunately, the origin of this ailment by scientists is not fully understood. However, studies in this area indicate that decompensated heart failure can occur if there are provocative factors. These factors can be the root cause of the disease. Among them:
- Myocardial hypertrophy.
- A change in the structural integrity of the myocardium caused by a heart attack, trauma, ischemia, or myocarditis.
- Hypertensive crisis.
- Arrhythmic phenomena.
- Cases of a sharp increase in pressure in the pulmonary circulation.
This is how decompensated heart failure manifests itself. What is it that interests many.
Along with the above, also the root causes of the disease can be various kinds of stagnant processes of the respiratory system. In all these cases, there is a general rule: SDS, like other types of heart failure, occurs as a result of critical overloads, as well as excessive fatigue of the heart muscle.
The clinical presentation and varieties of decompensated heart failure are described below.
Before you begin to study the symptoms of SDS, it should be noted that the clinical picture of the disease depends entirely on the type of heart failure. Specialists distinguish two forms - chronic and acute. Let us dwell on each of them.
Acute decompensated heart failure
It arises and develops after rapid decompensation, the appearance of compensation at which it is impossible. Mechanisms in heart failure, such as an increase in venous tone, an increase in tonic function, or an increase in the volume of diastolic filling of the ventricles with blood, cannot appear due to the physiological features of the acute form of SDS. These features include:
- Left ventricular SDF in acute form. It develops as a result of a heart attack or mitral valve stenosis . Characteristic symptoms are excessive pulmonary edema and overfilling of the blood vessels of the respiratory system. What else is decompensated heart failure? Symptoms will be considered later.
- Right ventricular SDF in acute form. It arises as a result of a patient's heart attack or thromboembolism, which violates the functionality and integrity of the interventricular septum. The characteristic symptoms for acute left ventricular SDF are as follows: a sharp increase in the liver occurs, blood stasis is fixed on a large circle of blood circulation, the lungs can be filled with blood.
What is the danger of acute form?
Unfortunately, the acute form is characterized by a high level of deaths due to the fact that the heart muscle is unable to drive the right amount of blood and there is no compensation function (or is insufficient), as well as due to pulmonary edema or myocardial infarction. In the case of the manifestation of an acute form of SDS, urgent intervention of specialists is required, who will put the patient in a hospital and carry out a number of necessary resuscitation actions.
Chronic decompensated heart failure also occurs. What it is? About it further.
Chronic SDS
CHF can occur in a decompensated form. In this case, the manifestation of various symptoms is possible, the full clarification of which is carried out by means of diagnostic studies. For CHF, the following clinical picture is characteristic:
- Signs of severe swelling of the legs, lower abdomen, scrotum, as well as in the pericardium.
- Arrhythmia and hypoxia.
- Cold limb syndrome.
- A sharp increase in body weight.
- Manifestations of mitral and tricuspid insufficiency.
- The appearance of shortness of breath, including in the absence of physical activity.
Decompensated chronic heart failure is a pathology in which disturbances in the functioning of the respiratory system are often manifested. When examined by a specialist, pulmonary wheezing can be detected (when the patient is lying down). The cause of such manifestations is an excessive flow of blood to the respiratory system. Another symptom may be hypoxia and, as a result, clouding of consciousness. Hypoxia occurs as a result of insufficient blood supply to the brain of the head and oxygen deficiency.
It is important to timely identify such an ailment as chronic decompensated heart failure (what it is, now it’s clear).
Diagnostics
The complex of diagnostic measures includes the study of the level of change of the beta-type urethic peptide, the H-neutral peptide, as well as conducting echocardiography and x-rays of internal organs, transcoronal echocardiography.
Specialists can obtain more accurate information about the force of blood pressure in the heart chambers by carrying out a special procedure during which a catheter is inserted into the central vein or pulmonary artery and the necessary measurements are made.
Also, the diagnosis of any form of heart failure involves a series of laboratory tests, including a blood test for creatinine and urea, electrolytes, transaminases and glucose, and other blood and urine tests; study of the presence and ratio of gases in the blood of arteries.
Decompensated heart failure: treatment
According to statistics for 2010, about 1 million people die from heart failure in Russia every year. It is the occurrence of decompensation and cardiac arrhythmias that is called by specialists the main cause of high mortality. Decompensation often requires immediate medical attention. In this regard, in addition to rare exceptions, drug treatment is carried out by administering drugs intravenously (to obtain a controlled and prompt result).
More about decompensation therapy
The main goal of therapy is to maintain a normal level of saturation of hemoglobin with oxygen, which allows for a normal supply of oxygen to tissues and organs and to avoid multiple organ failure.
One of the applicable methods is oxygen inhalation (as a rule, non-invasive ventilation (NSAID) is used at positive pressure), which allows you to refuse the use of endotracheal intubation. The latter is used for mechanical ventilation in case of impossibility to eliminate pulmonary insufficiency by NSAID.
Medication treatment
In the treatment of decompensation, drug therapy is also used. Used drugs and their groups:
- "Morphine" and its analogues. It is used to reduce heart rate and reduce pain.
- Diuretics. Used for symptoms of fluid retention in the body;
- Inotropic drugs eliminate peripheral hypoperfusion.
- Vasopressor agents for the development of normal organ perfusion.
- Dobutamine increases cardiac output.
- Norepinephrine improves vascular resistance.
- Cardiac glycosides lower blood pressure and lower the risk of acute decompensation.
However, only the attending physician can determine and compile the exact list of necessary medicines for stopping and treating SDS.
We examined what decompensated heart failure means.