Acute heart failure is a whole complex of symptoms, characteristic of the violation of the basic function of the heart - maintaining normal blood flow in the body.
This is a general heart rhythm disorder caused by both deterioration of the pump function, and the work of the myocardium or the transmission of a sinusoidal signal( it is responsible for the moment and period of contraction of each heart muscle compartment).
With all this, this disorder carries a threat to human life. What principles of treatment of acute heart failure are used in modern medicine? Can I completely get rid of heart failure?
General information on the therapy
Therapy that is used in acute heart failure can be divided into two categories: diagnosis and, directly - treatment. And it is the diagnosis that takes most of the time. Heart failure -
is not a disease, but a patient's condition, indicating that his heart is functioning with multiple failures of .And what does diagnostics include? Patient should go through:
- a primary examination with a doctor;
- analysis of anamnesis of life;
- ECG( electrocardiography);
- common blood tests, urine, feces;
- biochemical blood test;
- analysis of biomarkers;
- MSCT( computer multispiral tomography);
- MRI of the heart muscle.
And above only the basic set of analyzes through which it is necessary to pass the patient is indicated. At the request of the cardiologist - , additional ones are assigned, aimed at detecting the concentrations of BNP-peptides, cholesterol, proteins, sugar and so on.
In fact, doctors are looking for any possible factors of negative impact on the heart muscle, which causes acute failure.
Based on the diagnosis, the following factors in the development of OSH are established:
- cardiogenic shock - develops against a background of a systolic blood pressure drop to a critical level of 90 mm.gt;post. Because of this, perfusion of soft tissues and organs is broken, the so-called "cardiac ejection";
- puffiness of the lungs - failure develops against a background of respiratory perturbation. When diagnosed, too low a concentration of oxygen in the blood, which provokes shortness of breath;
- hypertensive crisis - too high blood pressure, because of what the heart muscle is in constant tension. May provoke myocardial infarction or complication in the form of a stroke;
- Acute decompensation of - means that DOS does not meet the above mentioned cardiovascular system disorders. Most often it turns out that the "culprit" is neuralgia and an incorrect transmission of signals towards the heart.
Medications used
The set of medications prescribed to the patient when determining OCH is highly individual. Depends solely on the violations found in the work of the cardiovascular system, as well as the likelihood of developing additional complications. The standard therapy list includes:
- Pressor amines ( Norepinephrine, Dopamine, Dobutamine).With their help, the function of the myocardium is regulated( it is gradually stimulated).Dosage selection is performed personally( invasively), starting with the minimum. Optimum is determined within 1-2 weeks.
- Inhibitors of phosphodiesterase ( 3-phase action).The recommended drugs of this group are Milrinon, Amrinon.
Strengthens the tone of the pulmonary vessels, thereby eliminating the signs of shortness of breath and pulmonary insufficiency.
Dosage is also determined individually for each patient to increase the hermodynamics of the arteries to a level of 17-19 millimeters of mercury or higher.
- Levosimendan .This is the only drug available in domestic pharmacology, with the help of which the work of microfibrils( their contractile function) is regulated from the concentration of calcium. With OCH, such a reaction drastically deteriorates, which causes a malfunction in the cardiovascular system. As a rule, prescribe this drug only in the early stages of DOS at the exact moment until the effect of the main therapy is obtained.
- Digoxin .It is rarely used in practice due to many side effects. Used to reduce the frequency of ventricular contractions of the heart muscle with arrhythmia.
- Nitroglycerin .Causes relaxation of the smooth walls of blood vessels, thereby reducing the body's response to high blood pressure( at the time of ejection of blood).It is applied directly if necessary. The effect after taking the drug begins in a few minutes, the effect persists to 0.5 hours.
- sodium nitroprusside .Like nitroglycerin, it is used to quickly eliminate the painful symptoms of OSH.Take 0.1-3 mg per kilogram of live weight. It is not recommended to apply more than 4 times a week.
- Furosemide .It gives a venodilating effect and accelerates the outflow of urine, removing effusions in the lower and upper extremities. Apply if necessary with a dosage of 0.1-1 milligram per kilogram of live weight( dosage should be specified by the attending physician).
- Morphine .An analgesic with a pronounced narcotic effect. Used in extreme cases to increase vagal tone and short-term optimization of the heart muscle. Has multiple side effects and a pronounced addictive effect. Applied only with the issuance of permission by the attending physician( in hospital).
Quite often, doctors prescribe those groups of drugs that do not apply to the above.
Tactics for the treatment of individual manifestations of the
OSN When swelling of the lungs, the main task is to normalize the pressure in the vessels, thereby speeding the blood flow and oxygen saturation of the blood. For the most part, phosphodiesterase inhibitors are used for this, and in addition to this, the patient is recommended to perform so-called cardio training( under the supervision of the attending physician).
The main task of doctors is to quickly reduce pressure and prevent hypoxia. The latter is achieved by taking diuretics. In critical situations, morphine is used - it almost instantaneously reduces pressure by increasing the vagal tone and patency of the capillaries.
With cardiac shock and hypertension, against which heart failure develops, the primary task is to normalize blood pressure and regulate the pumping function of the heart muscle.
The latter is performed by taking potassium and nitrogen oxide synthesis inhibitors , and pressure adjustment is performed by diuretics or the same nitroglycerin( taking only if necessary).
If the conduction of the cardiac muscle or partial absence of a sinusoidal pulse( signal) is disturbed, myocardial response is stimulated. For this, pressor amines are used, and a specialized diet is also prescribed, weight optimization.
That's why patients with suspicion of OSD are strictly prohibited fried, fatty, peppery, salty, products containing cholesterol and so on. But for the rapid elimination of tachycardia apply Digoxin in therapeutic dosage( it is 1.5 times the recommended).But this drug should be taken with extreme caution!
And against the backdrop of any disorders in the work of the cardiovascular system , doctors will regulate the concentration of magnesium, calcium, nitrate oxide in the blood .For this purpose, prescribe classic antiarrhythmics and advice from a nutritionist.
Otherwise, the patient should be prepared to worsen health conditions and increase the likelihood of a heart attack, stroke. The heart muscle, unlike other soft tissues, is restored at an extremely slow rate of , especially in people of retirement age( namely, they often have OCH.)
See a video about a new treatment for heart failure:
