3 Causes of development of
In addition to the effects of damaging factors affecting the functioning of the heart muscle, the progression of chronic cardiovascular diseasessystems to the development of CHF lead and age-related changes in biochemistry and physiology of the myocardium.
The first signs of heart failure appear on average in 70-75 years. At 15% of elderly people, heart diseases by this time pass into a decompensated stage.
- The progressive atherosclerotic changes lead to the consolidation of vascular walls. The pathological process involves the aorta, main arteries and arterioles. Small vessels of the arterial bed are stretched, the defeat extends to the vessels of the brain and heart.
- Due to myocardial ischemia, muscle tissue is gradually replaced by fibroids, diffuse or focal cardiosclerosis develops, myocardial contractility is progressively worse.
- Vessel stenosis and other changes in the vessels lead to left ventricular overload .Orthostatic hypotension develops, manifested by dizziness when the position of the body changes.
- Cicatricial changes affect the aortic valve, the loss of plasticity is aggravated by the gradual calcination of tissues. Violation of the closure of the valves increases the load on the left ventricle.
- The mitral valve is involved in the pathophysiological process. Manifestations of valvular insufficiency occur about 10 years later.
- With age, the function of the thymus gland weakens, immune defense mechanisms that compensate for functional disorders are disrupted.
Ultimately, the ability of the heart to pump the necessary amounts of arterial blood is reduced, the tissues of the body suffer from oxygen starvation, the right heart is overloaded.
The risk of developing CHF is increased when there are the following medical conditions:
- hypertension;
- thyrotoxicosis;
- myocarditis;
- hypothyroidism;
- acquired and congenital heart defects;
- pericarditis;
- chronic obliterating lung disease;
- cardiosclerosis of atherosclerotic or post-infarct origin;
- toxic and allergic myocardial damage.
Signs of
Early signs indirectly indicating the development of heart failure are:
- stressed superficial veins on the temples, on the forehead, pulsation of the cervical vessels;
- dyspnea with difficulty breathing at rest;
- "cold" cyanosis of the fingers, ears, nose, lips;
- pastosity, swelling of the feet and shins.
The onset of one or more symptoms is already an occasion for a general practitioner or geriatrician.
If suspected of CHF, the patient will be referred to the cardiologist .
With the progression of CHF, the severity of symptoms increases, different symptom complexes are formed, clinically reminiscent of the course of other pathologies, including non-cardiac diseases.
Among the most common variants of CHF flow:
- Arrhythmic .The patient has feelings of heart rhythm disturbances, accelerated heartbeats, heart pangs.
- Abdominal .Patients complain of weight in epigastrium, poor appetite, digestive disorders.
- Renal .The feet and shins are swollen, the intake of diuretics does not affect the degree of swelling in heart failure in the elderly. The excretion of urine is lowered.
- Pulmonary .The patient is concerned about shortness of breath and cough, not related to colds. Increase with physical activity and with a horizontal position of the body.
- Cerebral .Disorders of orientation in space, general weakness for no apparent reason, emotional imbalance, anxiety, drowsiness.
In ischemic heart disease, similar symptomatic complexes may indicate atypical attacks of angina pectoris or rare forms of myocardial infarction.
Patients often do not take their ailment seriously, writing off its manifestations for age, forced idleness.
Diagnosis
Diagnosis of heart failure is performed by instrumental methods:
- ECG .On the cardiogram, it is possible to identify changes that indicate a transferred infarct, blockade of the bundle of the bundle, aortic valve defects, ventricular myocardial hypertrophy, and other possible causes of heart failure.
- Radiography .It allows to determine pulmonary edema, congestion, changes in heart size, aneurysm, calcification of valve flaps.
- Echo-KG .It allows to determine the presence and causes of cardiac dysfunction.
How to treat, which drugs are used in this case
First of all, the quality of nutrition should be radically changed. The use of salt is limited, with the proven violation of lipid metabolism - fats of animal origin. With the patient's propensity for puffiness, the consumption of free liquid is limited.
Smoking and alcohol should be completely ruled out.
In case of decompensated heart failure, the patient is assigned bed rest. In the compensation stage, moderate physical activity is shown in the patient-friendly mode. And what medicines can be prescribed in the first place by the attending physician in case of heart failure in elderly people?
Treatment of chronic heart failure in elderly patients is carried out in a complex, simultaneously with the therapy of concomitant diseases. The course of treatment includes:
- Diuretics .Are appointed to normalize water metabolism. The drug and dosage prescribed by the results of clinical observations of the patient. The most commonly prescribed furosemide.
- ACE inhibitors ( angiotensin converting enzyme).ACE inhibitors slow the formation of e angiotensin and thus prevent the narrowing of the lumen of the vessels.
The action of the drug improves the pump function of the heart, normalizes the blood flow, in particular, in the portal system of the kidneys.
In combination with diuretics, ACE increases exercise tolerance, improves the patient's condition, reduces the risk of myocardial infarction. The drug of the first choice is Prestarium, the most safe and convenient to use.
- Other vasodilator preparations .When intolerant drugs from the group of ACE inhibitors are prescribed long-acting organic nitrates in combination with hydralazine.
- Cardiac glycosides .Digoxin. It is prescribed for atrial fibrillation and sinus rhythm disturbances. The effect on mortality rates has not been accurately studied, therefore, the drug is used cautiously, in cases of ineffective treatment with diuretics in combination with ACE inhibitors.
- Anticoagulants and disaggregants .In the presence of vascular pathologies, maintenance of life-long therapy with aspirin is prescribed to improve blood flow and prevent thrombosis. Atrial fibrillation and history of thrombosis are indications for the appointment of an anticoagulant drug warfarin.
In addition, the following can be prescribed:
- beta-blockers;
- calcium antagonists;
- antiarrhythmic drugs.
Folk methods of treatment
Cardiovascular diseases rank first among the causes of death of patients with , therefore use folk remedies should be extremely cautious, as an addition to the main treatment and only after agreement with the cardiologist.
By analogy with official medical treatment, a comprehensive approach is applied. The course includes funds that improve metabolic processes in the myocardium, diuretics and soothing agents.
Prevention in people at risk
For chronic heart failure, patients receive life-long maintenance therapy. For proper nutrition, elderly people with heart failure are recommended to adhere to the diet number 10 , to stop using alcohol and tobacco.
The diet should include products rich in potassium and magnesium .It shows moderate physical activity and walks in the fresh air.
The load should be affordable and pleasant for the patient. An important condition is the maximum emotional rest.
Now you know about the signs and symptoms of heart failure in old age, and about the tactics of treatment in women and men at this age. It is very important to consult a doctor in a timely manner if any changes appear, indicating a possible disease for its rapid detection and elimination.
See a video about the symptoms and treatment of heart failure:
