Acute heart failure is one of the most dangerous complications of cardiac diseases, in which the pumping function of the heart is disturbed.
Myocardium is not sufficiently relaxed, the chambers of the heart are not completely filled with blood. The amount of blood entering the aorta is not enough to maintain the normal functioning of the body.
Acute heart failure refers to emergency conditions with a high probability of death and requires an emergency hospitalization of the patient. Your attention is an article about the first pre-medical and medical care for acute heart failure.
Alarms and signs
AcuteHeart failure can develop in minutes or hours .Approximately in a quarter of cases, pathological changes occur so quickly and suddenly that the patient dies even at the prehospital stage.
The main indicator of the state of the heart - the ability to withstand physical exertion.
A sharp decrease in performance, severe fatigue, dyspnoea and attacks of tachycardia under normal loads - there are sufficient reasons to listen to your own organism and consult a doctor.
Another alarm bell - swelling, appearing in the evenings. In the early stages of the development of pathology, puffiness by the morning partially or completely decreases.
Heart failure is divided into right ventricular and left ventricular. With extensive lesions of the myocardium develops a total or mixed form. One of the first signs of any form of OSS is pain in the heart region of .
With left ventricular heart failure, symptoms rapidly increase, indicating a stagnation of blood in the pulmonary circulation. The patient is tormented by growing dyspnea, some relief of breathing occurs in the sitting position.
Heart palpitations are gaining, breathing becomes noisy, bubbling, dry cough begins, turning into productive. The change in the character of the cough indicates the development of progressive pulmonary edema .Sputum is scanty, frosty, pink, or with veins of blood. There is a cold sweat, there is a cyanosis of the tips of the fingers and toes.
Acute right ventricular failure develops less often, accompanied by increasing dyspnoea and venous congestion in a large circle of blood circulation. One of the most characteristic symptoms is the swelling of the jugular veins.
Immediate action before the arrival of the doctor
The patient must be seated in a comfortable position and must always lower his legs. All clothing that impedes breathing, it is necessary to unfasten the , if possible - to remove and ensure the flow of fresh air and immediately call an ambulance.
While the patient is conscious, talk to him, calming him.
Hands and feet of the victim should be slowly lowered into warm water, measure pressure. With indicators above 90 mm Hg. Art.you need to give a tablet of nitroglycerin.
After 15 minutes from the beginning of the attack, you should apply a tourniquet to one of the hips. Before the arrival of physicians, the position of the tourniquet is changed every 30-40 minutes.
Algorithm of actions for stopping breathing:
- Put the person on his back on a flat surface, put a roller under his head.
- Fold your hands down in the palms, lean on the bottom third of the sternum and perform jerky movements 60-65 times per minute.
- Simultaneously with an indirect cardiac massage, artificial respiration is performed. If resuscitation is performed by one person, every 3 to 15 shocks are followed by 2-3 artificial inhalations. If resuscitation is carried out by two people, one inhale is necessary for 5 tremors.
- After 30-35 seconds, it is necessary to evaluate the effectiveness of resuscitation. Pupils will react to light, normal skin color will begin to recover.
- Even in the absence of visible results, resuscitation is continued until the arrival of doctors.
Learn more about the first emergency aid for acute cardiovascular failure:
What physicians should do
The first task of physicians who came to the challenge is to stabilize the patient's condition for transportation to the intensive care unit.
- First of all, it is necessary to stabilize gas exchange.
For this, oxygen therapy is carried out using an oxygen mask, inhaler or other devices, if there are indications, intubation of the trachea is performed.
- Pain relief and respiratory center depression for increased respiratory efficiency are achieved by the administration of morphine or dopamine.
- The patient is given nitroglycerin or another vasodilator from the class of organic nitrates.
- The BP is stabilized to a conditionally safe value.
- When expressed bronhospazme enter euphyllin.
- To eliminate edema, furosemide is used.
Urgent diagnosis
To determine the exact diagnosis in an emergency procedure:
- ECG;
- Echocardiography;
- Radiographic examination of the chest;
- Clinical blood tests.
Algorithm for treatment of
In hospital conditions, after finding out the causes of heart failure, the patient is treated.
With right ventricular form
Isolated right ventricular lesion is rare. To eliminate the pathological condition, as a rule, elimination of its cause is required: a thrombus or emboli in the pulmonary circulation.
For left ventricular
For left ventricular DOS:
- Artificial ventilation with antifoaming agent;
- Stabilization of the heart rhythm;
- Stabilization of blood pressure;
- Elimination of edema.
In addition, the main disease is treated.
In ascites or hydrothorax, in addition to the appointment of diuretics, a puncture is performed to pump the free fluid .
Therapy for small cardiac output
In cardiogenic shock, OOS develops as a small cardiac output. In such cases it is necessary:
- Restore a normal heart rhythm;
- Eliminate pathological reflexes that impede blood circulation;
- Normalize venous return;
- Restore tissue gas exchange;
- Eliminate myocardial contractility disorders.
Now you know how to provide first aid for acute heart failure, and what is the emergency medical help for an attack. Be healthy!
