Treatment of pulmonary heart failure. Acute pulmonary heart failure

04.03.2020 -

Cardiac pathologies in modern world occur quite frequently. They can hurt even people who have never complained of pain in the chest area or other symptoms characteristic of heart disease. Therefore, in order to be confident in your health, it is necessary to undergo annual examinations by specialists.

A disease that affects the pulmonary circulation, which is responsible for enriching the blood with oxygen, is called cardio- pulmonary insufficiency. The progression of the disease increases the muscle mass of the right side of the heart. Everyone knows that any failures in the work of this body entail irreversible consequences throughout the body.

Only the correct and timely treatment tactics can alleviate and save you from pathology. In this article I would like to talk about cardio-pulmonary insufficiency, the most common causes occurrence, symptoms and consequences.

Cardiopulmonary failure

Cardiopulmonary failure - clinical syndrome, characterized by a combination of heart failure and associated pulmonary insufficiency. The development of pulmonary insufficiency (more often with heart defects and myocarditis) is due to impaired blood circulation in the vessels of the lungs (stagnation, increased blood pressure, inclusion of anastomoses), which leads to a decrease in blood oxygen saturation.

In medical practice, chronic pulmonary heart failure is more common - a combination of pulmonary and associated heart failure. It is observed with the so-called. cor pulmonale in patients with chronic diseases lungs (see Pneumosclerosis).

The reasons for the development of heart (right ventricular) insufficiency are hypertension of the pulmonary circulation (systolic pressure in the pulmonary artery exceeds 30 mm Hg, and diastolic pressure is above 15 mm Hg), hypoxia, acidosis, a decrease in the pulmonary vasculature, bronchial infection, polyglobulia.

The first clinical manifestation is shortness of breath on exertion; later it becomes constant. A decrease in arterial oxygen saturation (90% or less) leads to the appearance of cyanosis (cyanosis). Signs of right ventricular insufficiency join.

A frequent increase in the content of erythrocytes and hemoglobin in the blood is a manifestation of the compensatory reaction of the body to a decrease in the concentration of oxygen in arterial blood. To diagnose cardiopulmonary insufficiency, X-ray examination, electrokymography, electrocardiography, catheterization of the right cavities of the heart and pulmonary artery, and other research methods are used.

The weakening of the contractility of the heart muscle leads to a decrease in the volume of blood pumped by it. Circulatory disorders are fraught with:

Hypoxia of organs and tissues that do not receive enough oxygen from the blood;
Stagnation of blood in the lungs, which causes its insufficient oxygen saturation.

Violation of blood circulation in the vessels of the lungs is a consequence of heart failure, so the syndrome is a comorbidity.

The disease can be chronic and manifest itself in the form of:

causeless dizziness;
shortness of breath even with slight exertion;
decrease in working capacity;
sensations of pulsation in the epigastric region;
acrocyanosis of the fingers and the area of the nasolabial triangle.

In some cases, such patients have an increase in the level of hemoglobin and the number of red blood cells per unit of blood. This is due to the inclusion of certain compensatory mechanisms.

The formation of cardiopulmonary insufficiency is based on persistent pulmonary hypertension, which at a certain stage causes a breakdown of compensatory mechanisms, as a result of which the hypertrophied right ventricle ceases to cope with pumping the incoming blood into it. venous blood.

Right ventricular dysfunction can be caused by three groups of causes:

bronchopulmonary,
vascular,
thoracophrenic.

The first group of causes includes more than 20 known nosologies, it accounts for 80% of all cases of cor pulmonale.

The most common among them are diseases that violate the air filling of the alveoli:

obstructive bronchitis.
bronchial asthma.
lobar pneumonia.
fibrosing alveolitis.
pulmonary tuberculosis.
pneumoconiosis.
pneumosclerosis.
Beck's sarcoidosis.
cystic fibrosis.
polycystic lung.

The development of cardiopulmonary insufficiency of bronchopulmonary genesis is possible with collagenoses (systemic lupus erythematosus, systemic scleroderma, dermatomyositis, etc.). In some cases, extensive lung resections are the cause of cor pulmonale decompensation.

The second group of factors affects the lesion of the pulmonary vascular bed.

In most cases, the formation of cardiopulmonary insufficiency is preceded by PE. compression of the pulmonary veins and pulmonary artery tumor formations, pulmonary vasculitis. sickle cell anemia.

The third group of causes includes conditions accompanied by limited mobility of the chest and diaphragm.

Among them are various deformities of the chest and curvature of the spine (kyphosis, kyphoscoliosis), massive pleurisy. multiple rib fractures. ankylosing spondylitis. Pickwick's syndrome (obesity-hypoventilation).

Diaphragm mobility disorders are characteristic of chronic neuromuscular diseases (myasthenia gravis, poliomyelitis), botulism. paresis and paralysis of the diaphragm. Diseases of the second and third groups in total cause cor pulmonale in 20% of cases.

The acute type of disease occurs suddenly and the patient should immediately seek help from a specialist.

A sudden increase in pressure in the pulmonary trunk can be triggered by the following factors:

spasm of the pulmonary arteries;
blockage of one of the branches of the veins and capillaries by a thrombus, leading to ischemia of this area;
a blood clot in the heart and a heart attack;
acute phase of asthma;
severe pneumonia, covering the tissues of the entire lung;
trauma or medical error, leading to the filling of the pleural cavity with air and stop the lung.

Malfunction of the mitral valve, which is a common heart disease, leads to blood retention in the atrium and its secondary expulsion. There is stagnation of blood in both circles. The myocardium itself does not receive enough oxygen and the muscle begins to deform.

Ischemia leads to rupture of connections in the papillary muscles. A similar condition can also occur due to mechanical injury.

Wearers of a prosthetic valve may be at risk of blood poisoning with the same results, or malfunction of the valve itself due to latent defects.

Symptoms of cardiopulmonary failure

Acute cardiopulmonary failure is characterized by a sudden onset and a sharp deterioration in the patient's condition in just a few minutes or hours. There are pains in the region of the heart, which are accompanied by severe shortness of breath, a feeling of suffocation and fear of death.

Characterized by cyanosis arterial hypotension. These symptoms are aggravated in a standing or sitting position, which is associated with a decrease in blood flow to the right half of the heart. Death can occur within minutes from ventricular fibrillation and cardiac arrest.

In other cases, the picture of acute cardiopulmonary insufficiency may not unfold so rapidly. Shortness of breath is accompanied by chest pain associated with breathing, hemoptysis, tachycardia.

With progressive right ventricular failure, severe pain occurs in the right hypochondrium, due to an increase in the liver and stretching of its fibrous membrane. Due to an increase in central venous pressure, swelling of the jugular veins appears.

Chronic cardiopulmonary insufficiency develops gradually and is a reflection of stagnation of blood in the venous system. great circle circulation. Tolerance to physical activity decreases, shortness of breath is permanent. The cyanosis of the nasolabial triangle, the tip of the nose, chin, ears, and fingertips draws attention.

There are attacks of retrosternal pain (pulmonary "angina pectoris"), not stopped by taking nitroglycerin, but decreasing after the administration of aminophylline. Patients with chronic cardiopulmonary insufficiency note fatigue, fatigue, drowsiness. With physical exertion, fainting may occur.

Decompensation of chronic LS is also indicated by heaviness and pain in the right hypochondrium, nocturia, and peripheral edema. AT late stages edematous syndrome, hydrothorax is detected. ascites cardiac cachexia.

Considering in more detail the symptoms and treatment of pulmonary heart failure, first of all, it is worth immediately stipulating that in medicine it is customary to distinguish between acute and chronic forms of the development of pathology. Proceeding from this, the method of treatment chosen for each specific case will directly depend.

Acute deficiency.

This form always arises spontaneously and develops quite sharply. Symptoms are pronounced, the patient's condition is rapidly deteriorating. If such a person is not delivered to the intensive care unit of a hospital in a timely manner, then most likely it will end in death.

Often, death occurs against the background of thromboembolism, when pain shock rapidly develops, as well as extensive pulmonary edema.

Most often, this problem can be provoked by:

the inflammatory process affects too much lung volume;
pulmonary thrombosis. This is most often due to the formation of a blood clot;
failure of the prosthetic valve;
pneumothorax;
rapid deterioration in the presence of a diagnosis of "bronchial asthma";
serious chest injury;
interruptions in the work of the mitral valve.

This form of pulmonary heart failure usually has sufficiently pronounced symptoms, which makes it easy to diagnose such a patient:

a rapid drop in blood pressure to critical values. Collapse can often occur quickly;
rapid shallow breathing, often it is quite difficult;
an increase in the size of the veins in the neck;
breathing is mainly complicated on inspiration;
bluing of the skin. Blue extremities and cyanosis are especially pronounced;
cold hands and feet;
chest pain of varying intensity;
sticky sweat on the body;
difficulty breathing up to the occurrence of suffocation.

If a person does not receive help in a timely manner, then quickly enough he can die from pulmonary edema or simply from suffocation. First aid in this case should consist primarily in ensuring normal free access of oxygen to the lungs.

If necessary, give the patient artificial respiration until the ambulance arrives. This condition is especially dangerous because it almost always develops suddenly.

Sometimes even without any apparent reason (for example, a person may experience a blockage of the pulmonary trunk by a thrombus, the presence of which the person does not even suspect). But at the same time, the patient's condition worsens too quickly and therefore sometimes a person may die even before the ambulance arrives.

Chronic form.

This form often has a fairly mild course at an early stage of development. Very often, it can develop very slowly (for years, a person may not even be aware of the presence of such an ailment in himself, attributing the main symptoms to age-related changes in the body or to other concomitant diseases).

Most often, the main symptomatology in this case is the manifestation of the root cause. Simply put, usually a person pays attention rather to the symptoms of the pathology that led to the development of this problem. At the same time, insufficiency may not be paid attention to.

It often has the following symptoms:

the skin, especially the limbs and the nasolabial triangle, acquire a bluish tint;
severe dizziness;
heart palpitations;
fatigue, weakness.

At the same time, the intensity of the development of symptoms directly depends on the stage at which the disease is located. For example, fatigue and shortness of breath will be more acute in the later stages of chronic lung failure.

But at the same time, in later stages, additional forms of manifestation may also be added to these symptoms.

This is primarily due to the fact that irreversible processes are already beginning to occur in the organs and tissues of the body due to a severe form of insufficiency. The main manifestations of this stage:

intense shortness of breath at rest, while in the supine position the situation only worsens;
pain in the region of the heart;
on inspiration, severe swelling of the veins in the neck;
tachycardia, constantly low blood pressure;
swelling that is not amenable to treatment methods;
heaviness in the right hypochondrium, discomfort in the region of the liver.

At this stage, they may develop severe complications in the work of the brain. Kidney function is also impaired, which very often leads to a complete cessation of urine output.

Violations of blood vessels, heart and respiration are classified according to the severity of the pathological process. Classification of respiratory failure:

In the first stage (preclinical), a transient form is observed pulmonary hypertension. This condition is characterized by symptoms of a load on the right ventricle of the heart.
In the second stage, signs of hypertrophy appear. The right ventricle of the heart increases in size. Pulmonary hypertension becomes permanent. Circulatory failure at this stage does not yet occur.
At the third stage of disease progression, decompensation of cardiopulmonary insufficiency occurs. This occurs against the background of right ventricular failure.

Specialists identified 4 degrees of pulmonary insufficiency, which also affects the right ventricle, which is accompanied by its overload. In this case, there is a supersaturation of the blood with oxygen, which leads to insufficiency of circulatory processes. At the very beginning of progression, pulmonary valve insufficiency is accompanied by a decrease in lung volume.

The heart enlargement that has occurred is not traceable on the ECG, but can be determined using echocardiography. Circulatory failure develops at stages 2 and 3 of progression pathological changes.

Lung valve insufficiency leads to a decrease in oxygen in the blood, which is fraught with the development of a serious degree of hypoxia. The volume of the lungs in this case is reduced by 40%. At rest, the patient has shortness of breath. Pulmonary valve insufficiency is accompanied by disorders such as the lack of ability to close the valves.

This process is characterized by a reverse flow of blood. This is due to right ventricular diastole. Pulmonary valve insufficiency at the 4th degree of progression is accompanied by a decrease in blood oxygen saturation by 50%. Dilatation is added to the increase in the right ventricle of the heart. At this stage of progression, the insufficiency of the circulatory process reaches stage 2B.

Diagnostic search in the development of cardiopulmonary insufficiency is aimed at identifying the underlying disease, as well as assessing the degree of decompensation. For the correct interpretation of physical and instrumental data, the patient needs to be examined by a pulmonologist and a cardiologist.

An objective examination in patients with cardiopulmonary insufficiency shows barrel-shaped deformity of the chest, hepatomegaly. pastosity of the feet and legs. On palpation of the precordial region, a cardiac impulse is determined, with percussion - an expansion of the boundaries of the relative dullness of the heart.

Typically, a decrease in blood pressure, frequent arrhythmic pulse. Auscultatory data are characterized by muffled heart sounds, accent II tone over the pulmonary artery, splitting or bifurcation of II tone, the appearance of pathological III and IV tones, systolic murmur, indicating tricuspid insufficiency.

The most valuable laboratory criteria for cardiopulmonary insufficiency are blood gases. decrease in pCO2, increase in pCO2, respiratory acidosis. Chest X-ray can detect not only lung damage, but also signs of cardiomegaly and pulmonary hypertension. Angiopulmonography and ventilation-perfusion lung scintigraphy are indicated for suspected PE.

The study of respiratory function in cardiopulmonary insufficiency is used to assess the nature and severity of ventilation disorders, to detect bronchospasm. Electrocardiography in acute LS allows you to reliably determine the signs of overload of the right heart, and in chronic LS - to identify direct and indirect markers of right ventricular hypertrophy.

EchoCG is the main non-invasive method to assess intracardiac hemodynamics, determine the size of the heart cavities and the right ventricular wall, and determine the degree of pulmonary hypertension.

In some cases, if it is impossible to establish the fact high blood pressure in the pulmonary artery, resort to catheterization of the right heart. Sometimes, transbronchial or transthoracic lung biopsy is performed to verify the genesis of cardiopulmonary insufficiency.

Decompensation of drugs should be differentiated from heart defects. cardiosclerosis. dilated cardiomyopathy and other cardiac pathology.

To diagnose the disease, the specialist uses several techniques:

Muffled heart sounds and tachycardia will be recorded on auscultation.
The radiograph has the following features: pathological changes in lung tissue and expansion of the borders of the heart to the right.
For a more detailed study of the altered areas of the lungs and myocardium, computed tomography may be prescribed.
For rate functional state valvular apparatus and contractile activity of the heart muscle, an echocardiographic study is prescribed.
Electrocardiography (ECG) is performed to evaluate the conduction and excitability functions of the heart tissue; as well as identifying hypertrophied areas of the myocardium, localization of ischemic foci, rhythm disorders.
Angiography of the lungs allows you to visualize the degree of vascular damage, the presence of blood clots, atherosclerotic vascular damage.
To measure the pressure in the cavities of the heart and large vessels, catheterization is performed with a manometer.
Spirometry allows you to assess the severity of respiratory failure.

Such comprehensive examination will allow you to quickly identify the symptoms of cardiopulmonary insufficiency and treatment is prescribed immediately to avoid the occurrence of life-threatening complications. It is necessary to diagnose the disease as soon as possible. early dates, as this will avoid the development of irreversible changes in the heart muscle, liver, brain, kidneys.

First aid for pulmonary edema

If the pathological process increases by the minute, it is necessary not only to call " ambulance", but also independently carry out important activities:

Move the patient to a sitting position.
Make sure the room is well ventilated.
To reduce the pressure, you need a nitroglycerin tablet.

It must be dissolved under the tongue to provide an almost instant effect. Before deciding on the use of the drug, you should make sure that at the moment the patient does not have low blood pressure.

Also, you can not use medications on their own if the patient is unconscious.

If the process proceeds in a mild or moderately severe form, a diuretic can be given. So the swelling is quickly removed, due to which there is a disposal of excess fluid.
In the event of an excessive increase in pressure, it is necessary to ensure the removal of blood from the lungs in order to avoid its accumulation. To do this, at home, you can take a basin, pour heated water. Ask the patient to lower their legs into it.
Soak gauze in alcohol, give to the patient. Inhaled vapors will help to slightly reduce negative symptoms.

In order not to harm a person, it is advisable, when calling the ambulance team, to consult with a specialist about what measures can be taken under specific patient conditions.

Therapy of acute cardiopulmonary insufficiency caused by pulmonary embolism is carried out in the ICU. The most important components of treatment are oxygen therapy. pain relief, thrombolytic therapy (urokinase, streptokinase, tissue plasminogen activator), anticoagulant (heparin, warfarin) and antiplatelet therapy (pentoxifylline). In some cases, a surgical tactic is indicated - thromboembolectomy from the pulmonary artery.

With cardiopulmonary insufficiency that has developed against the background of bronchopulmonary pathology, the principles of therapy are determined by the underlying disease. So, in the case of COPD and bronchial asthma, bronchodilators, mucolytics, expectorants are used; with pulmonary tuberculosis - specific anti-tuberculosis antibiotics; with interstitial lung diseases - glucocorticoids, cytostatics, interferon, etc.

At all stages of therapy for cardiopulmonary insufficiency, oxygen inhalations are carried out. Vasodilators (theophylline, calcium antagonists, nitrates, ACE inhibitors) are used to reduce pulmonary vascular resistance and pressure in the pulmonary artery.

Patients with edematous syndrome are prescribed diuretics under the control of water-electrolyte balance and acid-base balance. The question of the advisability of prescribing cardiac glycosides in cardiopulmonary insufficiency remains controversial. As a palliative measure, repeated bloodletting is used, which temporarily improves the patient's condition.

Patients with pulmonary hypertension refractory to conservative treatment can undergo surgery:

balloon atrial septostomy.
sympathectomy.
reduction of lung tissue.
lung or heart-lung transplantation.

If cardiopulmonary insufficiency is diagnosed, treatment should be started as soon as possible. The sooner the main therapy is started, the more likely it is that after its favorable completion, no irreversible processes that have already occurred in the patient's body will be detected.

In addition, if we are talking about the acute form of the development of the disease, then the timely treatment will depend on whether the patient will live.

In this case, the difference between the two forms will primarily consist in the fact that in the acute phase it is necessary first of all to restore the normal supply of oxygen, while in the chronic form it is necessary to start complex treatment the illness that caused the failure.

In the acute form, the root cause will also need to be treated, but such therapy is prescribed later, when there are no fears for the patient's life. In the acute form of insufficiency, treatment consists of the following main actions:

administration of thrombolysis drugs. They are especially effective if the insufficiency has arisen due to blockage of the pulmonary trunk by a thrombus;
papaverine. Helps to relax the walls of blood vessels and thereby improve blood flow;
anticoagulants. Prevent the formation of blood clots and stagnation of blood due to liquefaction;
atropine. Relaxes the muscles of the bronchi and thus facilitates the respiratory function.

In the case of a chronic form of insufficiency, treatment should always be comprehensive and consist of the following main points:

treatment of the underlying provoking disease;
taking anti-inflammatory drugs;
blood thinners;
relaxing muscles and contributing to the expansion of the bronchi;
various hormonal preparations.

Summing up, it is worth noting once again that in order to improve the quality of life of patients and ensure a more favorable prognosis, it is very important to diagnose this pathology and as soon as possible to begin treatment of not only the main symptoms, but also the root cause.

Without the elimination of provoking factors, it will not be possible to achieve a high-quality and lasting result. The sooner treatment is started, the greater the chance of getting rid of the disease and the longer the life of patients with such a pathology can be.

For drug therapy use:

Inotropic drugs that help the heart contract and increase the force of contraction.

These are Adrenaline and Dopamine. Dopamine supports the work of the heart and is administered intravenously. Cardiac arrest may require intracardiac adrenaline.

Diuretics needed to reduce the workload on the heart.

The best option is to choose the right combination, which will consist of Veroshpiron, Furosemide and Hydrochlorothiazide. Diuretics are excellent excess liquid and stabilize the pressure.

Inexpensive and at the same time effective - Hydrochlorothiazide, Ethacrynic acid and Furosemide. Thanks to this therapy, the electrolyte balance of potassium is maintained and excess fluid is removed from the body.

Cardiac glycosides strictly in the prescribed dosage - Strofantin, Digitalis.

Such drugs have cardiotonic and antiarrhythmic action. Their use significantly improves the lives of patients with heart and lung diseases.

Beta-blockers (taken very carefully, as they worsen the course of lung pathology by reducing the diameter of the bronchial lumen).

The effect of such drugs is that they block beta-adrenergic receptors in the heart, resulting in the neutralization of the effects of adrenaline on these receptors.

This leads to the fact that the heart begins to contract less frequently, and blood pressure decreases. Such drug treatment is effective in pulmonary heart disease.

final stage medical measures is rehabilitation and supportive care.

For this purpose, a restricted diet is indicated. fatty foods and the inclusion of a small amount of protein in the diet. This is a lightly salted low-fat food, for the digestion of which a large expenditure of energy on the part of the affected organism is not required.

In this case, the fluid must be limited, since another attack of cardiopulmonary insufficiency may develop.

AT recent times for the treatment of cor pulmonale, long-term oxygen inhalations began to be used (7-10 hours every day for several months). Continuous oxygen treatment leads to regression of structural changes in the pulmonary arterioles, a drop in pressure in the pulmonary artery and a decrease in the load on the right ventricle.

ethnoscience

The treatment of this disease is aimed primarily at improving the supply of oxygen to the blood, eliminating the underlying pulmonary disease, and relieving unpleasant symptoms. We have selected for you the best remedies that you can prepare and take at home.

Pumpkin juice.

The patient will significantly improve pulmonary ventilation if he undergoes a course of treatment with pumpkin juice. Take it raw, half a glass in the morning and evening. Add a spoonful of natural honey or a couple of drops to the drink lemon juice. The course of treatment is one month.

Madder.

Madder root and rhizome has long been used by patients who have lung failure with complications on circulatory system. Grind the plant into powder, mix with the same amount of honey and ground walnuts. Take this mixture with a dessert spoon each morning after waking up.

Sagebrush.

Wormwood will help reduce swelling, cyanosis of the skin, shortness of breath and other unpleasant symptoms. Soak a tablespoon of dry grass overnight in 300 ml of water and leave until morning. After waking up, put the mixture on the fire and wait until it boils. Immediately after boiling, remove the drink from the stove, cool and strain.

Drink 100 ml three times a day 30 minutes before meals. This treatment will give results in a few weeks, but you should continue the course for 2-3 months. You can repeat therapy courses as needed.

Lobelia bloated.

Remedies based on swollen lobelia help well. This herb helps to cure major respiratory diseases leading to cardiopulmonary insufficiency, as well as to maintain normal condition patient. There are several ways to use lobelia.

The first way is to grind dry grass into powder and take 1 gram each time before meals, snacking on a small amount of honey.
The second way - brew 1-2 g of a dry plant in a glass of boiling water and drink instead of tea. Continue treatment for at least 3 months.
The third way is to prepare the syrup. A handful of swollen lobelia pour 500 ml of hot red wine, add 5 tablespoons of honey and leave for 2 weeks. Strain the finished syrup and take a tablespoon three times a day an hour after meals.

Lespedetsa kopechnikovaya.

To restore pulmonary circulation and reduce unpleasant symptoms, use the properties of the herb Lespedeza. It removes excess fluid, improves breathing, supports the activity of the circulatory system.

Preparation of decoction: pour 2 tablespoons of dry herb into 3 cups of boiling water, cover, reduce heat to a minimum and cook the remedy for about 5 minutes. Strained broth drink a glass 2-3 times a day. Preparation of tincture: heat 500 ml of red wine almost to a boil (but do not boil), throw in 5 tablespoons of lespedeza herb, cover and leave for 3 days in a warm place.

Next, strain the infusion, add 3 tablespoons of honey and a pinch of cinnamon to it. Drink three times a day, 25 ml of medicine before meals. You can also grind the plant into a powder and take ¼ teaspoon 4 times a day with a little water.

Grass orthosiphon staminate.

If the patient has severe edema, treatment with the herb orthosiphon stamens will help. It has a diuretic effect, due to which it removes fluid from the body and relieves stress from the cardiovascular and pulmonary systems. Preparation of alcohol tincture: Pour 4 tablespoons of dry chopped grass into a bottle of vodka, close with a cork and leave for 20 days.

Strained drug drink a teaspoon each time before meals. Preparation of wine elixir: heat 500 ml of fortified red wine, pour a handful of dry orthosiphon into it, cover the pan with a lid and wrap it with a blanket. Infuse the product for 3 days, then strain, add 5 tablespoons of aloe juice, 5 tablespoons of natural honey and a tablespoon of grated ginger.

Take 25 ml each time after meals. Orthosyphon grass can also be brewed instead of tea and drunk several times a day, but water infusions are not as effective as alcohol or wine medicines.

A mixture of tinctures.

A special mixture of alcohol tinctures will help to overcome the disease:

Celandine herb tincture - 7 ml;
Lobelia herb tincture - 7 ml;
Licorice root tincture - 5 ml.

You can buy these tinctures from a herbalist, or make your own (the ratio of plant and alcohol is 1:10, leave the mixture for 10 days, then strain). Drink the remedy 20 drops, diluted in 1 tablespoon of boiled warm water, 15 minutes after each meal.

Comfrey.

Comfrey has a very good effect on the lungs, increasing their volume and elasticity. It also supports the work of the heart muscle at the proper level. Comfrey Powder: Dry the root of the plant and grind it into a powder. Take 3-4 times a day, one mustard spoon, dissolving this remedy in warm tea or milk.

Comfrey-based elixir: For each teaspoon of plant powder, add 1 tablespoon of honey and half a teaspoon of glycerin, mix everything gently. Eat 1 tablespoon of the elixir 3-4 times a day. Glycerin extract of comfrey: half a glass of fresh or dried root, pour 300 g of glycerin; keep the mixture in a dark place for seven days, then strain.

Take 1 tablespoon of glycerin extract internally, mixing it with 100 ml of lemon juice or any other juice. Comfrey syrup: 4 tablespoons of dry chopped root, pour 2 cups of water, boil and cook for 10 minutes; strain through a cheesecloth and top up with the missing water (so that you have 2 cups of the product again).

Add 100 ml of honey and half a glass of sugar, stir it all until all the ingredients are completely dissolved. Also add the juice of one lemon and 30 g of glycerin. Drink the resulting syrup 4-6 times a day, 1 tablespoon. Shake the contents of the bottle before taking. Store the potion in a cool place.

Herbal collections.

good effect gives treatment herbal preparations. Here is one of the most popular recipes:

Leaf or flowers of coltsfoot - 100 g;
Plantain leaves - 100 g;
Flax-seed- 100 g;
Lungwort leaves - 100 g;
Mint leaves - 100 g;
Marjoram grass - 100 g;
Flowers or cornflower grass - 100 g;
Licorice root - 100 g;
Black mallow flowers - 100 g;
Blue grass - 100 g.

Mix all ingredients. Throw a tablespoon of the collection into a pot of boiling water (300 ml) and cook for 5 minutes. Cooled drug take ½ cup several times a day. Within a week you will feel better.

In order for your pulmonary system to recover, prepare a decoction from this collection:

Common pikulnik herb - 100 g;
Horsetail herb - 100 g;
Knotweed rhizome - 100 g;
Meadow geranium leaf - 100 g;
Grass of the present bedstraw - 50 g;
Black marigold flowers - 50 g.

Mix all herbal ingredients. Boil 2 cups of water, throw in 2 tablespoons of the collection, cover and cook for 5 minutes, then set the bowl aside for 30 minutes in a warm place. Strain and drink every 6 hours 100 ml of medicine.

The following drug supports the cardiovascular and respiratory systems well:

Flowers or leaves of tansy - 200 g;
Carrot seeds - 100 g;
Evening primrose seeds - 100 g;
Goose grass - 100 g;
Mint leaves - 100 g;
Cherry branches - 100 g;
Nettle leaves - 100 g;
Lily of the valley leaves - 100 g;
Barberry root - 100 g.

Pour 1 liter of boiling water into a thermos and add 3 tablespoons of the herbal mixture. Leave to infuse overnight, strain in the morning and take the infusion (it can be sweetened) instead of regular liquids. The course of treatment is 4-6 weeks.

Consequences and prevention of the disease

The consequences of heart failure can be very diverse. It is important to realize that heart failure is constantly progressing, it does not stop at any one point. Therefore, it is so important to notice the disease in the early stages of development, because it will be more and more difficult to get rid of it.

Development forecasts cannot be unambiguous. The main "way of development" is that the heart muscle eventually weakens completely and loses the ability to contract at all. The tissues of the heart are replaced with a material that is basically “immobile”. The patient begins to experience severe shortness of breath, swelling appears, it becomes difficult to move around. The person's weight is increasing.

If you don't seek help, heart failure can lead to death.

In adults, heart failure as a process is difficult, but in children it is even more difficult, since their body is just being formed, and some are already born with this disease. In infants, the left ventricle is most often affected, as it is weaker. Therefore, problems arise with a small circle of blood circulation.

Prevention of heart failure mainly consists of regular follow-up with a cardiologist, especially if you also have any heart problems or are forced to do so by age. Trust me, it's better to take care of yourself. Another important point is the control of body weight, because it is widely known that with a large weight, the load on the heart only increases.

An excessive amount of salt in the body can also provoke illness, so reduce its use. Coffee and tea should also be drunk in moderation, just like alcoholic beverages. If you smoke, then quit. Smoking in any case will have a detrimental effect on your health.

In case of cupping acute stage cardiopulmonary insufficiency, with the onset of remission of the chronic form of the disease, there is a risk of developing complications:

Infection. If the patient has pulmonary edema, their inflammation, bronchitis, is possible. With reduced functionality immune system treatment of these diseases is complicated.
Chronic hypoxia of organs. Oxygen starvation manifests itself in vital important organs especially the brain and heart. Need to start on time medical preparations to prevent irreversible damage.
Ischemic tissue damage with insufficiently rapid removal of symptoms of hypoxia.
Atherosclerosis of the lungs. The formation of a site whose functioning is impaired due to fluid exposure.

To cure cardiopulmonary insufficiency, it is necessary to diagnose this disease in a timely manner.

Constant monitoring of the patient, conducting regular courses of therapy will help to avoid dangerous complications, reduce the likelihood of irreversible disorders, which positively affects the prognosis and increases life expectancy. listen to simple advice, control your own condition and be healthy!

Pulmonary insufficiency is a pathology in which the lungs do not enrich the blood with oxygen in the required amount.

This state is characterized by the fact that the oxygen pressure does not exceed 80, and carbon dioxide is more than 45 mm Hg.

With pulmonary insufficiency, the body is not able to maintain the optimal ratio of gases in the blood.

Disease classification

Depending on the mechanism of development, 3 forms of pulmonary insufficiency are distinguished:

Hypoxemic;
Hypercapnic;
Mixed.

In the hypoxemic form, there is a lack of oxygen in the tissues. It is difficult to bring the condition back to normal even with the help of oxygen therapy. This type pathology characteristic of lesions respiratory system and those pathologies in which lung tissue is replaced by connective tissue.

The alveoli are affected peripheral system nerves responsible for the coordinated work of the respiratory organs, the muscles involved in breathing, the central nervous system, the chest, the respiratory tract.

In hypercapnic form, carbon dioxide accumulates in the tissues. This type of disease is also characterized by a lack of oxygen.

It is possible to normalize the condition with the help of oxygen therapy.

The disease develops against the background of weakness of the muscles that regulate the work of the respiratory system, obesity, chronic obstructive pulmonary disease.

Oxygen Therapy Procedure

The mixed form is characterized simultaneous combination of hypoxemia and primary hypercapnia.

According to the rate of progression, the forms are distinguished:

acute
Chronic

Symptoms acute form the disease manifests itself in a few minutes or hours, less often - a few days. During this period, the compensatory abilities of the body do not have time to turn on.

This is a rather dangerous pathology that threatens life. It is possible to normalize the condition only with the help of intensive care in intensive care.

The chronic form of the disease develops slowly. Pathology can progress without threatening the patient's life for many months or years.

During the specified time, the body manages to turn on the mechanisms of adaptation and provides the optimal gas composition of the blood. This type is considered safe, because it can be identified in a timely manner and normalize the patient's condition.

Specialists distinguish 3 degrees of pulmonary insufficiency, which occurs in a chronic form:

Depending on the severity of the pathology, 3 stages of the disease are distinguished:

I (light) stage: the partial pressure of oxygen is in the range of 60-80 mm Hg, the blood is saturated with oxygen at the level of 90-94%;
II stage: partial oxygen pressure drops to 40-59 mm Hg, oxygen concentration in the blood varies within 75-89%;
III stage: the state is critical, the oxygen pressure becomes less than 40 mm Hg, the oxygen concentration in the blood drops to a level of less than 75%.

With the development of pulmonary insufficiency, it is necessary to understand the causes of its occurrence. Further treatment will depend on this.

Separately, pulmonary heart failure is distinguished. This disease is associated with disruption of the heart, blood vessels and respiratory organs. In some patients, failure develops against the background of regurgitation - throwing part of the blood back into the right atrium.

With this pathology, the blood does not fully enter the respiratory organs. Pulmonary regurgitation of the 1st degree is considered not dangerous, the stream of thrown blood is practically not visible. At the 4th degree, only surgical intervention allows to preserve the health of the patient.

Disease development factors

The causes of pulmonary insufficiency depend on the form of the lesion. The hypoxemic type develops when blood circulation fails in the lungs.

This occurs due to the fact that there is a full exchange of gases between the blood and the alveoli, but the process of gas exchange between the alveoli and environment violated.

During shunting, the blood from the veins is not saturated with oxygen, it immediately passes into the arteries.

Hypercapnic form develops due to alveolar hypoventilation and violations of ventilation-perfusion mechanisms (the alveoli are not sufficiently ventilated).

The hypercapnic form most often develops against the background of bronchial asthma, prolonged bronchitis, bronchial tumors, bronchopneumonia.

Severe lesions of the lung parenchyma lead to the hypoxemic form.(fluid aspiration, pulmonary edema, inhalation of toxic gases).

Mixed form appears with lung lesions, which provoke hypoventilation of the obstructive type (pneumonia, abscesses, bronchial asthma, obstructive pulmonary emphysema, bronchitis).

The cause of cardiopulmonary failure is considered to be an increase in pressure in the pulmonary circulation (it is responsible for how the process of filling the blood with oxygen occurs).

Hypertension provokes an increase in the activity of the right ventricle and an increase in the intensity of the ejection of blood entering the pulmonary artery. As a result, the myocardium hypertrophies.

All causes of insufficiency are divided into groups depending on which system of the body failed.

Neuromuscular system. Pulmonary insufficiency develops and progresses against the background of infectious and neurological lesions that negatively affect the central nervous system, disrupt the transmission of impulses from the brain to the respiratory muscles. It is observed with botulism, myasthenia gravis.
Respiratory center and central nervous system. The progression of the disease leads to damage to the brain tissues that have developed against the background of failures. cerebral circulation, taking drugs.
Rib cage. With scoliosis, accumulation of exudate in the pleural cavity, pneumothorax, these problems appear.
Oxygen delivery routes. The lesion develops with chronic obstructive pulmonary disease, laryngeal edema, the appearance of embolism in the bronchi.
Alveoli. Problems begin with pulmonary edema, pneumonia and other diseases that lead to growth in the lungs connective tissue.

Alveoli

The main causes of heart and lung failure include the following:

Bronchiolitis and bronchitis in a chronic form;
extensive pneumonia;
Bronchial asthma;
Tuberculosis;
pneumosclerosis;
emphysema;
Sarcoidosis;
bronchiectasis disease.

These are the most common bronchopulmonary factors. But vascular and thoraphragmatic factors can lead to the above problems.

Among them:

Tumors of the mediastinum;
Atherosclerotic changes in the pulmonary trunk;
Inflammatory lung disease (vasculitis);
Polio;
Thrombosis of the artery going to the lungs;
Bechterew's disease;
Compression of the right side of the heart by a growing aneurysm;
Kyphoscoliosis;
Incorrect innervation of the diaphragm.

Problems are indicated characteristic symptoms. If you know them, you can have time to seek medical help even with an acute form of the disease.

The main signs of the disease

To understand that pulmonary insufficiency develops, it will turn out if you know what kind of disease it is and how it manifests itself.

The main symptoms of the disease include:

Shortness of breath (regardless of its intensity);
Headaches that disturb patients mainly in the morning;
Increased frequency of contractions of the heart muscle;
insomnia;
Reducing the level of pressure;
Vomiting, nausea;
Blueness of the skin;
memory problems;
Changes in breathing (the depth and frequency of inhalations / exhalations changes);
Participation of auxiliary muscles in the process of breathing.

Patients complain of suffocation, severe shortness of breath. Problems with consciousness and memory are caused by a lack of oxygen in the bloodstream and the accumulation of carbon dioxide in excessive amounts. In severe cases, this causes loss of consciousness or the appearance of a coma.

The most dangerous sign is a drop in respiratory rate: if the patient takes less than 12 breaths per minute, then this indicates the beginning of the process of stopping breathing.

When such signs appear, it is necessary to understand how the disease is diagnosed and treated.

To determine the cause of the above symptoms, it is required:

If signs of pulmonary insufficiency appear, the patient is sent to a medical facility for inpatient treatment.

The choice of treatment tactics

In 30% of cases, patients are admitted to the hospital with acute pulmonary insufficiency.

Save the life of the patient can only timely rendered competent first aid.

It should be aimed at normalizing the airway patency, eliminating hemodynamic disorders and restoring perfusion and lung ventilation.

Information about methods of emergency assistance is given in the table.

The action of medical personnel	Characteristic
Examination of the oral cavity	Required to extract the trapped foreign bodies, get the sunken tongue, aspirate the airways
Oxygen therapy	Needed to maintain proper blood gas levels
Vibromassage of the chest	Provides restoration of bronchial patency
Carrying out artificial ventilation of the lungs	It is prescribed for the diagnosis of pulmonary insufficiency of the 2nd degree
Tracheal intubation	Necessary when there is a high risk of suffocation against the background of the lack of progress from the first aid provided
Pleural drainage	It is carried out with hemo- and pneumothorax

With the normalization of pulmonary ventilation, treatment continues. If necessary, continue to supply humidified oxygen: do it with a nasal catheter, through an oxygen mask or tent.

If the problems were caused by bronchospasm, then glucocorticosteroids and bronchodilators are prescribed.

The method of therapy is chosen by the doctor: inhalation or systemic administration of these drugs is possible. Simultaneously prescribed drug therapy.

If the pathology is accompanied painful sensations give analgesics. To stimulate the work of the heart, blood vessels, cardiac glycosides are prescribed, respiratory organs - respiratory analeptics. Eliminate signs of intoxication and hypovolemia allows infusion therapy.

To avoid negative consequences from the onset of acute respiratory failure is difficult. But with timely medical care, a favorable prognosis is possible.

When restoring the work of the respiratory system, it is required to carry out simultaneous treatment of the underlying disease, which provoked the development of pulmonary insufficiency.

Video: Pulmonary hypertension. Why is it difficult for the lungs to breathe?

Cardiopulmonary insufficiency (CLN) is a pathological condition resulting from an increase in pressure in the pulmonary circulation. This clinical syndrome leads to increased load on the right ventricle of the heart during its work (in the process of ejection of the pulse volume of blood into the pulmonary artery).

Such an increased mode of the heart causes thickening (hypertrophy) of the corresponding sections of the myocardium over time.

What causes pulmonary hypertension?

In the case of underlying pulmonary pathology, SLN may be referred to as "cor pulmonale". However, only the terminal, decompensated phase of the cor pulmonale can be designated by the concept of cardiopulmonary insufficiency. The preclinical and compensated stages proceed, as a rule, in the absence of insufficiency of the right ventricular function.

The consequence of pulmonary hypertension is a violation of the process of oxygenation of blood in the lungs. To compensate for the lack of oxygenation, the right ventricle of the heart reflexively increases the volume of blood ejected into the pulmonary artery. When working in this mode for a long time muscle mass the corresponding part of the heart increases.

Stages of development of the disease

stage of compensation. This is the period during which the myocardium of the right ventricle, increasing and developing, compensates for the lack of blood oxygenation by increasing the volume of blood ejection.
stage of decompensation. It leads to the progression of the anomaly, as a result of which the compensation mechanisms fail.

Why does pulmonary hypertension develop?

This state of affairs can be caused various diseases affecting various organs and systems of the body.

On the part of the respiratory system (bronchopulmonary factors), the following reasons can be distinguished:

Chronic bronchitis.
Diseases associated with bronchial obstruction.
Emphysema of the lungs.
Pneumonia, characterized by an extensive lesion.
Sclerosis of lung tissue.
Tuberculosis of the lungs.
Bronchiectasis.
Bronchial asthma.
Cystic fibrosis.
Diseases belonging to the group of collagenoses.

Vascular pathology leading to the development of the disease:

Atherosclerotic vascular disease.
Aneurysm compressing the right side of the heart.
Inflammatory lesion of the vessels of the lungs.
Thromboembolism of the pulmonary trunk and its branches.

Causes of the chest, diaphragm and mediastinum:

Tumors of the mediastinum.
Scoliotic or kyphoscoliotic deformity.
Ankylosing spondylarthrosis.
Lack of innervation of the diaphragm (for example, in the pathology of the cervical plexus).
Diseases that are characterized by a disorder of innervation and, as a result, paresis or paralysis of the diaphragmatic muscle (poliomyelitis, myasthenia gravis, botulism).

Forms and clinical manifestations

According to the nature of the course, two forms of cardiopulmonary insufficiency are distinguished:

Acute cardiopulmonary failure.
Chronic form of cardiopulmonary insufficiency.

Options for the course of the disease

Different types of the course of cardiopulmonary insufficiency are determined taking into account the prevailing symptoms.

Respiratory. The clinical picture is dominated by shortness of breath with episodes of suffocation, respiratory failure, wheezing when breathing, coughing.
Cerebral. Symptoms of brain pathology prevail: psychomotor agitation, aggression, euphoria, psychotic manifestations, depressed mood, depression, stupor are possible.
Anginal. Clinical picture with this variant of the course, it is similar to the clinic of an angina attack - pains in the region of the heart without irradiation are characteristic.
Abdominal. Due to pain in the epigastric region and dyspeptic symptoms, this variant of the course of the pathology must be differentiated from an exacerbation of peptic ulcer.
Collaptoid. It is characterized by attacks of severe arterial hypotension with severe physical weakness, blanching and cold extremities, tachycardia.

Acute form of the disease

Acute pulmonary insufficiency refers to emergency conditions requiring immediate hospitalization of the patient in the intensive care unit.

Causes of the acute form of the disease:

Thromboembolism of the pulmonary artery, or its spasm.
Inflammatory process that captures a large amount of lung tissue.
Prolonged asthmatic attack.
Pneumo- or hydrothorax.
Severe mitral valve insufficiency.
Traumatic injuries of the chest.
Valve prosthesis insufficiency.
Mediastinal emphysema.

Signs of an acute form of insufficiency

For this form of cardiopulmonary insufficiency, the following symptoms are characteristic:

Shallow breathing, very rapid.
Pressure drop.
Dyspnea.
Bulging veins in the neck.
Subjective feeling of insufficiency of inspiration, lack of air, up to suffocation.
Lowering the temperature of the extremities.
Cyanosis.
Cold sweat.
Soreness in the chest.
In some cases, there is a pulsation in the epigastric region.

Chronic form

If you do not attach importance to the symptoms and do not treat the pathology, then you can provoke the development of chronic cardiopulmonary insufficiency, which lasts for a long time - for several months, and in some cases - years.

Typical manifestations of this form of insufficiency are the following symptoms:

The occurrence of shortness of breath, up to respiratory failure, during physical exertion.
Rapid fatigue.
The presence of pulsation in the epigastrium.
Bluish discoloration of limbs.
Dizziness, lack of balance.
Increased heartbeat.

The following signs will indicate the progression of cardiopulmonary insufficiency and the onset of the stage of decompensation:

The presence of shortness of breath at rest with a clear increase in its in the supine position.
Pain in the region of the heart ischemic.
Swelling of the veins of the neck, including during inspiration.
Arterial hypotension.
Diffuse cyanosis of the skin.
Feeling of heaviness in the right hypochondrium, hepatomegaly.
Edema resistant to anti-edematous therapy.

With further progression of the disease and an increase in hypoxia, the terminal stage sets in, toxic encephalopathy and nephropathy develop, which is manifested by the appearance of the following symptoms:

Lethargy.
Apathy.
Increased sleepiness.
Insufficiency of mental functions.
Decreased urine output, kidney failure.
In the blood - erythrocytosis and an increase in hemoglobin.

Diagnostic approaches

To diagnose the disease, the specialist uses several techniques:

Muffled heart sounds and tachycardia will be recorded on auscultation.
The radiograph has the following features: pathological changes in lung tissue and expansion of the borders of the heart to the right.
For a more detailed study of the altered areas of the lungs and myocardium, computed tomography may be prescribed.
To assess the functional state of the valve apparatus and the contractile activity of the heart muscle, an echocardiographic study is prescribed.
Electrocardiography (ECG) is performed to evaluate the conduction and excitability functions of the heart tissue; as well as identifying hypertrophied areas of the myocardium, localization of ischemic foci, rhythm disorders.

Angiography of the lungs allows you to visualize the degree of vascular damage, the presence of blood clots, atherosclerotic vascular damage.
To measure the pressure in the cavities of the heart and large vessels, catheterization is performed with a manometer.
Spirometry allows you to assess the severity of respiratory failure.

Such a comprehensive examination will allow you to quickly identify the symptoms of cardiopulmonary insufficiency and treatment is prescribed immediately to avoid the occurrence of life-threatening complications.

It is necessary to diagnose the disease as early as possible, as this will avoid the development of irreversible changes in the heart muscle, liver, brain, kidneys.

Tactics of treatment in acute form of the disease

Treatment of cardiopulmonary insufficiency, its timing and specifics - depends on the form of the disease.

Therapeutic measures should be carried out in the intensive care unit, since the acute form of the disease is a life-threatening condition.

In this case, drug treatment is carried out by introducing the necessary medicines intravenously.

By installing a nasal catheter, it is necessary to ensure that the patient inhales an oxygen mixture to better saturate the blood with oxygen molecules. This measure alleviates the pathogenic effect of oxygen deficiency on the organs and tissues of the body. In the most severe cases shown artificial ventilation lungs.
In case of thromboembolism of the pulmonary artery trunk, as well as its branches, the introduction of thrombolytic drugs is indicated.
To relieve spasm of the bronchial walls and normalize breathing, the introduction of atropine is indicated.
To relieve hypertension in the small circle and normalize vascular tone, papaverine is administered.
The introduction of anticoagulant drugs is the prevention of thrombosis of the heart cavities and blood vessels.
The contractility of the heart muscle normalizes aminofillin. The same remedy minimizes the manifestation of respiratory failure.

Therapeutic measures in the chronic form of the disease

In this case, the treatment of the underlying pathology that caused the pathology comes to the fore in the therapeutic scheme:

Bronchodilators are used for bronchopulmonary pathology.
Hormonal agents (glucocorticosteroids as anti-inflammatory drugs).
Potassium-sparing diuretics to reduce congestion and remove excess fluid.
With insufficient contractility of the heart muscle, it is customary to use cardiac glycosides.
Blood pressure is normalized with the help of drugs from the group of beta-blockers.

In case of insufficiency of the functions of respiration and heartbeat, camphor or caffeine is administered to stimulate them at the central level, relying on their ability to stimulate the vasomotor center.
Means with a cardioprotective effect are the protection of myocardiocytes and cells of the vascular wall from destruction as a result of oxygen deficiency. This is the prevention of insufficiency of the contractile function of the myocardium.
Potassium- and magnesium-containing drugs have a beneficial effect on metabolic processes in tissues damaged by hypoxia.
Severe erythrocytosis requires intervention in the form of bloodletting, followed by replacement of the required volume of blood with special solutions.
In the future, the patient is strongly advised to exclude bad habits, eat a salt-free, low-fat diet, and limit fluid intake. Physical activity and psycho-emotional stress should also be limited.

Severe complications of cardiopulmonary insufficiency can be avoided by regular monitoring by the attending physician and timely preventive measures.

Pulmonary insufficiency is a condition characterized by the inability of the pulmonary system to maintain a normal blood gas composition, or it is stabilized due to a strong overvoltage of the compensatory mechanisms of the external respiration apparatus. The basis of this pathological process is a violation of gas exchange in the pulmonary system. Because of this, the required amount of oxygen does not enter the human body, and the level of carbon dioxide is constantly increasing. All this becomes the cause of oxygen starvation of organs.

With pulmonary insufficiency, the partial tension of oxygen in the blood decreases below 60 mm Hg. Art. At the same time, an increase in the partial tension of carbon dioxide is observed. Its performance exceeds 45 mm Hg. Art. This pathological syndrome can begin to progress in people from different age categories. He is not gendered.

Etiology

The main cause of the progression of pulmonary insufficiency in humans is damage to external apparatus respiration at its various levels:

neuromuscular system. The causes of the progression of pulmonary insufficiency can be various infectious or neurological diseases that have a damaging effect on the central nervous system and disrupt physiological mechanisms transmission of impulses from the brain to the muscles of the respiratory apparatus. Such pathologies include, and so on;
respiratory center and CNS. In this case, the causes of the progression of pulmonary insufficiency can be brain damage of varying severity, the use of potent drugs, impaired blood circulation in the brain, and so on;
rib cage. The accumulation of excess exudate in the pleural cavity can also lead to pulmonary insufficiency;
damage to the airways: laryngeal edema, embolus in the bronchi,;
alveoli. Pulmonary insufficiency is often manifested by the main symptom, as well as ailments characterized by the growth of connective tissue in the lungs.

Varieties

According to the mechanism of progression:

hypoxemic. In this case, there is a decrease in the concentration of oxygen in the blood (hypoxemia). It is difficult to normalize partial pressure even with oxygen therapy. This form of pathology is more typical for diseases that directly affect the respiratory system, as well as for those diseases, the basis of which is the rapid replacement of lung tissues with connective tissue;
hypercapnic. Too much carbon dioxide accumulates in the blood. It is worth noting that in this form, oxygen deficiency is also observed, but it can be corrected with oxygen therapy. Hypercapnic pulmonary insufficiency progresses due to the weakness of the muscular structures of the respiratory system, chronic obstructive pulmonary disease, obesity, and so on.

Development speed:

acute pulmonary insufficiency. This form of pathology progresses very quickly. Symptoms of the acute form may appear within a couple of minutes, several hours or days. Since this period is very short, the body does not have time to turn on its compensatory capabilities. That is why acute insufficiency is very dangerous state threatening not only health, but also the life of the patient. To stop it, you need to resort to intensive therapy. Treatment of an acute form of pathology is usually carried out in intensive care;
chronic pulmonary insufficiency. Feature chronic form - slow development. The pathological condition progresses over several months or even years. This enables the human body to maximize its compensatory capabilities, thereby maintaining a full-fledged blood gas composition. The chronic form is safer, since in most clinical situations it is detected and treated in a timely manner. Lethal outcome is extremely rare.

Based on severity:

1 degree– partial oxygen tension (PNA) in the blood is in the range of 60–79 mm Hg. Art. Blood oxygen saturation at this degree ranges from 90 to 94%;

2 degree. PNK decreases to 40–59 mm Hg. Art., and blood oxygen saturation up to 75-89%;

3 degree. PNA in the blood decreases to critical levels - below 40 mm Hg. Art., and blood oxygen saturation is less than 75%.

Based on the severity of the symptoms manifested (only for chronic pulmonary insufficiency), the following are distinguished:

LN 1 degree. A sick person develops shortness of breath with moderate or significant physical. loads;

2 degrees. Shortness of breath occurs even with light exertion. While a person is at complete rest, it can be noted that compensatory mechanisms have activated;

3 degrees. Shortness of breath and acrocyanosis are manifested even in a state of complete rest.

Symptoms

With pulmonary insufficiency, the following symptoms appear:

shortness of breath of varying degrees of intensity;
in the morning, a sick person may experience headaches;
insomnia;
pulse rate increases;
nausea and vomiting;
the skin becomes bluish;
auxiliary muscle structures are involved in the respiratory act;
memory impairment;
decrease in blood pressure;
the frequency and depth of breathing changes;
disturbance of consciousness.

Diagnostics

The standard diagnostic plan for suspected pulmonary insufficiency includes:

collection of patient complaints;
inspection;
assessment of the gas composition of the blood;
assessment of the acid-base state of the blood;
x-ray;
spirometry.

Therapeutic measures

Treatment of a pathological condition is carried out in a hospital, so that doctors have the opportunity to monitor the patient's condition. Therapy should be only complex, only then it will be possible to achieve positive dynamics:

treatment of the underlying ailment that provoked the pathology. In this case, they carry out therapy for heart failure, respiratory diseases, etc.;
oxygen therapy. It must be included in the treatment plan in order to maintain the gas composition of the blood at the required level;
postural drainage;
vibration massage of the sternum - a method of treatment that allows you to ensure the normal patency of the bronchi;
the appointment of pharmaceuticals that thin the sputum;
IVL. This method treatment is indicated for 2 degrees of insufficiency;
tracheal intubation. Conducted if there is no positive dynamics, but there is a high threat of suffocation.

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Diseases with similar symptoms:

As is known, respiratory function body is one of the main functions of the normal life of the body. The syndrome, in which the balance of blood components is disturbed, and to be more precise, the concentration of carbon dioxide greatly increases and the volume of oxygen decreases, is called "acute respiratory failure", it can also go into a chronic form. How does the patient feel in this case, what symptoms may bother him, what signs and causes of this syndrome - read below. Also from our article you will learn about diagnostic methods and the most modern methods of treating this disease.

Often we hear the expression "cardiopulmonary failure", but few can definitely say what this pathology is. What kind of disease is this, what are its signs and causes - we will understand.

Cardiopulmonary failure - what is it?

In modern medicine, cardiopulmonary insufficiency is understood as a condition in which heart failure, that is, the inability of the heart to provide normal blood supply to the body, is combined with pulmonary, which occurs due to blood in the vessels of the lungs, where gas exchange occurs. All this leads to a decrease in the level of oxygen in the blood.

In practice, more often pulmonary insufficiency develops first, the symptoms of cardiac insufficiency join it after a while. Strictly speaking, this symptom complex can be observed in many diseases of cardio-vascular system as well as lung diseases. In its course, the pathology can manifest itself in an acute form, when the symptoms increase in a short time period, and it can also have a chronic variety, when the condition worsens over several years or even decades.

Causes of acute cardiopulmonary failure

Acute pulmonary insufficiency is a complication that occurs in some conditions that threaten the life of the patient. At the same time, urgent medical intervention. As a rule, it can develop under the following conditions:

as a consequence of thrombosis or spasm of the pulmonary artery;
with thromboembolism;
with pneumo- or hydrotorex;
with exacerbation of bronchial asthma, status asthmaticus.

However, cardiac pathologies can also cause an increase in pressure in the pulmonary artery. Most often, this occurs with sudden mitral valve insufficiency. Also, the cause of the development of pulmonary insufficiency can be pulmonary valve insufficiency, acute heart attack, myocarditis, in the stage of decompensation, cardiomyopathy. At the same time, the cavity of the left ventricle expands, and the contraction of its wall is no longer able to push the entire volume of blood into the lumen of the vessel. Some of it stagnates and increases the pressure in the pulmonary veins. As the right ventricle continues to pump blood to its fullest, the pressure continues to rise, which can lead to or cardiac asthma.

Causes of chronic cardiopulmonary insufficiency

Chronic pulmonary insufficiency, in contrast to the acute form, grows slowly. The process of increasing pathological changes goes on for several years. In this case, the development of hypertension in the pulmonary vessels occurs in connection with the following pathologies:

hereditary idiopathic hypertension;
atherosclerosis;
insufficiency of the pulmonary artery, which can be caused by endarteritis or repeated embolism of small branches;
chronic lung diseases - emphysema, pleurisy, pneumosclerosis, obstructive bronchitis;
slowly progressive;
acquired valvular disorders.

Pulmonary insufficiency: severity

Due to the fact that the chronic form of this disease is characterized by a slow and often almost imperceptible increase pathological symptoms, define four degrees of severity of the disease:

I degree - there are no signs of the disease, with the usual physical activity, the manifestations of the disease are not observed, with an increase in the load, a slight shortness of breath appears.
Grade II - no symptoms at rest, but shortness of breath and palpitations appear with habitual physical exertion.
III degree - symptoms of insufficiency appear with minimal physical exertion, but are absent at rest.
IV degree - a person cannot exercise minimal physical activity, signs of the disease appear at rest.

An acute attack of pulmonary insufficiency can develop according to one of two options - right and left ventricular failure. may present with pulmonary edema or cardiac asthma.

cardiac asthma

This is a pulmonary insufficiency, the symptoms of which increase gradually. On the early stages it is manifested by shortness of breath, which appears first after physical exertion, over time it intensifies, appearing even at rest. With shortness of breath, the act of inhalation (inspiratory character) is difficult. In the future, it is replaced by asthma attacks, most often occurring during sleep. For this stage, the forced posture is indicative - a high headboard, during attacks the patient is forced to sit down, lowering his legs from the bed and leaning on his hands, in addition to shortness of breath, palpitations, sweating, and fear of death appear. The cough in cardiac asthma is dry, with scanty expectoration. The skin is pale, pronounced cyanosis of the fingers. The pulse is irregular, weak, the pressure is reduced.

Consider what features of cardiac and bronchial asthma have:

	Cardiac	Bronchial
	Noisy, bubbling, well audible at a distance	Whistling, dry
Type of breathlessness	Inspiratory (difficulty inhaling)	Expiratory (difficulty exhaling)
	Scanty, with pulmonary edema - pink foam	Lot clear sputum, which is difficult to separate
Auscultation	Wet rales	Dry, wheezing, weakened breathing
The action of drugs	The use of diuretics brings relief	With the introduction of diuretics, the condition worsens

Pulmonary edema

Acute pulmonary insufficiency may be complicated by the development of pulmonary edema. This is the release of a significant amount of blood into the lung tissue. The attack develops suddenly, regardless of the time of day. The onset is characterized by a sharp suffocation, while there is a rapid deterioration in the patient's condition:

shortness of breath intensifies, the patient does not have enough air, cyanosis of the skin of the face and extremities is noted, cold sweat;
consciousness is disturbed - it can be both motor excitement and stupor up to complete loss of consciousness;
breathing is noisy, bubbling, pink foam stands out;
if the attack occurred on the background of myocardial infarction or myocarditis, cardiogenic shock may develop.

Right ventricular failure

It can also occur as a complication of myocardial infarction or myocarditis. Its manifestations, in addition to shortness of breath and increasing suffocation, are:

cyanosis of the face and fingers;
clearly visible, especially on inspiration, swollen jugular veins;
swelling of the legs, face, abdominal wall up to ascites;
an increase in the liver, there is a pulsation in the epigastrium.

Chronic cardiopulmonary failure

Due to the fact that the chronic form of this pathology develops over many years, its clinical manifestations less pronounced. Since the disease is most often based on the pathology of the respiratory system, it manifests itself primarily in shortness of breath. It may be accompanied by the following symptoms:

chest pain;
arrhythmia;
tachycardia;
cyanosis;
swelling in the legs;
swelling of the veins of the neck;
encephalopathy.

As the disease progresses, the symptoms begin to intensify, and if at first they appeared after certain loads, then in the final stages (in the stage of decompensation) this occurs in complete rest.

Cardiopulmonary failure: treatment

The development of acute insufficiency usually requires prompt and professional intervention. As a rule, treatment is carried out in a hospital, and more often in an intensive care unit. If the attack has developed at home, you need to deliver the person to a medical facility as soon as possible. The treatment of the chronic form of the disease is integrated approach to the treatment of the disease. This is not only a medical correction, but also an optimization of the level physical activity, nutrition. Drug therapy with this pathology is the appointment of the following groups of drugs:

beta blockers;
diuretics;
cardiac glycosides.

The scheme of therapy and dosage in each case is determined by the doctor. Self-medicate in similar cases unacceptable. In case of ineffectiveness of conservative treatment, the problem is solved surgically.