Nội dung
Heart failure is manifested by congestion in the pulmonary or systemic circulation, as well as deterioration in myocardial function. This phenomenon is always accompanied by the occurrence of shortness of breath.
Causes of shortness of breath in heart failure
When the heart cannot cope with the loads placed on it, shortness of breath develops. In the vascular system of the lungs, blood flow slows down, and pressure in the arteries increases. Small branches of the blood lines that feed the lungs experience spasm, gas exchange is disturbed.
The mechanism of development of shortness of breath in heart failure:
When the left side of the heart is affected, the volume of blood ejected decreases. Congestion forms in the lungs, as they are overfilled with blood.
Stagnation contributes to the disruption of gas exchange in the respiratory tract, which leads to a deterioration in their ventilation.
The body stimulates the respiratory function, increases the frequency of breaths and their depth. Therefore, the person experiences shortness of breath.
Interstitial pulmonary edema develops.
The brain receives a signal that the lungs are suffering from hypoxia. It activates the respiratory center, causing a person to take more frequent and deeper breaths.
Diseases that can provoke heart failure with shortness of breath:
Tăng huyết áp động mạch.
Mitral valve stenosis.
CHD.
Bệnh cơ tim.
Dị tật tim.
Inflammation of myocardial tissue.
cardiac dilatation.
Ngộ độc với các chất độc hại.
If a person has diabetes mellitus or other endocrine pathologies, then chronic heart failure will progress rapidly. At the same time, attacks of shortness of breath will begin to turn into attacks of suffocation.
With damage to the right ventricle of the heart, shortness of breath may be absent altogether.
Symptoms of shortness of breath in heart failure
The following symptoms will indicate that a person has shortness of breath precisely with heart failure:
It is very difficult for the patient to inhale.
If heart failure has a chronic course, then respiratory dysfunction occurs at any load. The more intense it is, the harder it will be for a person to breathe. Such shortness of breath will increase with neuropsychic stress.
Shortness of breath will disturb the person when he lies down. In a horizontal position, the heart fills with blood, so it begins to work harder. If a person sits down, then breathing is more or less normal. Therefore, shortness of breath attacks most often occur at night.
If an attack of shortness of breath manifests itself at night, then the person wakes up from the fact that he has nothing to breathe. The attack turns into suffocation, a dry cough appears. Sometimes a small amount of sputum is secreted. To alleviate his condition, a person intuitively gets up or sits down, and lowers his legs down.
A person breathes through his mouth, it can be difficult for him to speak.
The nasolabial triangle turns blue, the nail phalanges become blue.
With heart failure, there is always a risk of developing pulmonary edema. At the same time, a person experiences severe weakness, breathing becomes heavy, his lips turn blue. It is not possible to cope with shortness of breath with the usual methods.
The lungs become rigid, congestive bronchitis, cardiogenic pneumosclerosis develop. In addition to shortness of breath, the patient often has a cough, during an attack, sputum with blood can be released. When a bronchospasm occurs, the patency of the bronchi will be disturbed, therefore, such shortness of breath is often confused with bronchial asthma.
Such a phenomenon as cardiac asthma is characterized by a sudden attack of inspiratory dyspnea. This clinical syndrome is a manifestation of acute heart failure of the left heart. Shortness of breath can turn into suffocation.
Chẩn đoán
Shortness of breath can disturb a person with various diseases. If the patient’s heart failure has just begun to develop, then it will be weak, breathing difficulties appear only during exercise and at night.
To identify the causes of shortness of breath, you need to contact a therapist or a cardiologist.
The doctor may prescribe the following diagnostic procedures to the patient:
Điện tâm đồ.
Hiến máu để phân tích tổng quát và sinh hóa.
Siêu âm tim.
Performing coronary angiography.
X-quang ngực.
According to the results of the study, it will be possible to make a diagnosis and prescribe treatment.
Sơ cứu
If a person with heart failure develops a severe attack of shortness of breath, you should immediately call an ambulance.
Prior to the arrival of the medical team, you can take the following measures:
Open windows to let fresh air into the room.
Remove from the neck and chest of the person all items of clothing that may restrict breathing.
To provide the patient with complete rest, you can offer him a nitroglycerin tablet, which is placed under the tongue.
It is necessary that the person was in a sitting position with his legs down.
If the patient’s consciousness is not disturbed, then before the arrival of the medical team, his blood pressure can be measured.
Treatment of shortness of breath in heart failure
Cardiologists with shortness of breath due to heart failure may prescribe the following treatment:
Drugs for the treatment of a disease that caused heart failure.
Drugs from the group of beta-blockers.
Diuretic drugs that help reduce blood volume in the body, thereby relieving stress from the heart.
Be sure a person must adhere to proper nutrition, reduce the amount of salt consumed, include fatty red fish, linseed oil and nuts in the menu.
Shortness of breath in heart failure can be reduced by taking anxiolytic drugs. They reduce anxiety, allow you to eliminate the fear of suffocation, help a person calm down. Breathing normalizes and evens out, the attack of shortness of breath recedes.
Prolonged inhalations of oxygen through ethyl alcohol help to reduce swelling of the lung tissue.
In severe cases, the patient is shown surgery.
Đang dùng thuốc
Since shortness of breath is only a symptom of heart failure, to get rid of it, it will be necessary to direct efforts to correct the underlying pathology. Treatment cannot be quick. Often it continues for many years and even until the end of a person’s life.
Drugs that are prescribed to patients with heart failure:
Glycosides that increase the efficiency of the heart muscle. These include drugs Digoxin, Korglikon, etc.
ACE inhibitors. They help lower blood pressure, relieving stress from the heart and blood vessels that feed the lung tissue. These can be drugs such as Captopril, Ramipril, Trandolapril, etc. Taking them allows you to dilate blood vessels, relieve spasm from them.
Diuretic drugs (Furosemide, Britomar) reduce the load on the heart, removing excess fluid from the body. Their reception will prevent the formation of edema.
Vasodilators such as Minoxidil or Nitroglycerin. They are used to relieve tension from the smooth muscles of the muscles.
Beta-blockers, for example, Metoprolol, Celiprolol, etc. They allow you to eliminate the effects of arrhythmias, reduce blood pressure, and remove hypoxia from tissues.
Anticoagulants prevent the formation of blood clots, reduce the negative symptoms of heart failure, which include shortness of breath. These can be drugs such as Warfarin, Fragmin, Sinkumar, etc.
Statins (Rosuvastatin, Lovastatin) are prescribed to patients with heart failure caused by atherosclerosis of the vessels.
If shortness of breath in heart failure is accompanied by pain, then the patient is prescribed analgesics.
Can thiệp phẫu thuật
An emergency method of unloading the pulmonary circulation in venous congestion is bloodletting. In this case, a person can be released from 300 to 500 ml of blood.
Sometimes heart failure can’t be managed with medication. In this case, the patient is referred for surgery. In the course of its implementation, a pacemaker can be installed for a person. Sometimes they perform surgery on the valves of the heart, on its ventricles.
Surgical intervention is not directly related to shortness of breath, but it is aimed at eliminating the underlying pathology. If you manage to get rid of it, then breathing problems will disappear by themselves.
Prevention of attacks of shortness of breath in heart failure
There are non-pharmacological methods for the prevention of shortness of breath that are applicable for people with chronic heart failure:
It is necessary to limit the intake of salt with food.
It is important to monitor your own weight, to prevent its increase. The greater the body weight of a person, the harder it will be for the heart and lungs to cope with the loads placed on them.
It is necessary to give up bad habits, exclude alcohol and smoking from your life.
Physical activity should be agreed with the doctor.
Be sure to control blood pressure and prevent its increase.
The head of a person’s bed should be raised.
You need to go to bed in clothes that do not restrict breathing.
It is impossible to completely recover from chronic insufficiency, but it is quite possible to improve the quality of your life and make shortness of breath easier. Comprehensive treatment allows you to maintain performance for many years. In general, the prognosis for heart failure depends on the underlying pathology that led to such a violation.