Pulmonary heart failure. What is pulmonary insufficiency and what forms of it exist What is pulmonary insufficiency causes and consequences

Cardiopulmonary insufficiency (CLN) is a pathological condition resulting from an increase in pressure in the pulmonary circulation. Such a clinical syndrome leads to an 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. With prolonged work in this mode, the muscle mass of 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.

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Why does pulmonary hypertension develop?

This state of affairs can be caused by various diseases that affect different 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, and stupor are possible.
• Anginal. The clinical picture in this variant of the course is similar to the clinic of an angina attack - pain in the region of the heart without irradiation is 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, and 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.

Drug treatment in this case is carried out by administering the necessary drugs 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, mechanical ventilation is indicated.
• 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 eliminate bad habits, adhere to a low-salt, low-fat diet, and also limit the amount of fluid consumed. 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.

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 both in many diseases of the cardiovascular system and in diseases of the lungs. 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. This requires 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 in pathological symptoms, four degrees of severity of the disease are determined:

• 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. In 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:

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 are less pronounced. Since the disease is most often based on pathologies 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. Therapy of the chronic form of the disease is an integrated approach to the treatment of the disease. This is not only a medical correction, but also an optimization of the level of physical activity and nutrition. Drug therapy for this pathology consists in prescribing 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-medication in such cases is unacceptable. In case of ineffectiveness of conservative treatment, the problem is solved surgically.

Cardiopulmonary failure- a 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 lung diseases (see Pneumosclerosis). The causes of 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.

Treatment of pulmonary heart disease and cardiopulmonary insufficiency includes the treatment of a lung or heart disease that caused the development of the syndrome, the use of cardiac glycosides, aminophylline, diuretics, restoratives, and in some cases repeated bloodletting.

(Lit. Mukharlyamov N. M. Pulmonary heart. M. 1973; Sivkov I. I. Kukes V. G. Chronic circulatory failure, M. 1973. N. R. Paleva.)

Before using any information, first consult your doctor!

Cardiopulmonary failure: causes, symptoms, diagnosis and treatment

The term cardiopulmonary insufficiency is understood as a combined disruption of the respiratory and vascular systems. The basis of this pathological process is an increase in pressure in the vascular system of the small circle, which is responsible for gas exchange between the blood and the environment.

According to its clinical course, this condition can be acute, when symptoms appear and increase over a short time period, or chronic, in which the signs become noticeable only after a few years.

Causes

Acute cardiopulmonary failure is usually the result of an emergency situation and requires immediate medical attention.

• her thrombosis or spasm;
• thromboembolism from the veins or cavity of the heart;
• exacerbation of bronchial asthma or status asthmaticus;
• sharply developed total pneumonia;
• pneumothorax or hydrothorax (usually hemothrax), which in most cases are the result of trauma.

In addition to pathological changes in the respiratory system, the root cause of pulmonary hypertension may be associated with a malfunction of the heart muscle.

Most often, sudden severe mitral valve insufficiency leads to such changes. Usually there is a rupture of the papillary muscles as a result of acute myocardial ischemia or infarction. Traumatic injury is also possible. Another cause may be prosthetic valve dysfunction, which is usually associated with thrombosis and infection.

In chronic pulmonary heart failure, there is a gradual increase in pathological changes in the respiratory system. Its causes are usually associated with the following diseases:

With acquired valvular disorders, the pressure also usually rises gradually. The same can be said about unexpressed slowly progressive congenital conditions.

Symptoms

Symptoms of acute cardiopulmonary insufficiency are usually more pronounced than in its chronic course. They include:

• shortness of breath (shallow breathing, its frequency reaches 40 per minute and above);
• feeling of lack of oxygen, reaching suffocation;
• cyanosis due to hypoxia and venous congestion;
• cold or sticky sweat due to centralization of blood circulation;
• collapse resulting from a sudden decrease in systemic pressure;
• pain in the sternum, which is associated with ischemia and a change in the size of the heart.

Chronic pulmonary heart failure has less pronounced clinical signs, which are associated with the gradual development of hypertension in the vessels of the small circle.

In the early stages, there are usually no symptoms, as changes are compensated for by left ventricular hypertrophy. In the future, they begin to appear only during periods of pronounced activity.

At the final stage, the manifestations of the disease are noticeable even in a state of complete rest.

Since the cause of chronic cardiopulmonary insufficiency is often the pathology of the respiratory system, shortness of breath is mandatory. Other manifestations are listed below:

The last two signs appear with secondary changes occurring in the heart under the influence of the underlying disease.

Diagnostics

Diagnosis of this condition begins with examining the patient and asking about his health and complaints. For a more detailed assessment, an instrumental examination is carried out:

• X-ray of the lungs, which reveals both diseases of the respiratory system and changes in the size of the heart;
• Chest CT is performed if necessary, if the diagnosis remains doubtful after x-ray;
• Ultrasound of the heart allows you to establish the degree of disruption of the work of this organ;
• catheterization and invasive manometry with high accuracy determines the pressure in the pulmonary artery and heart cavities;
• The ECG reflects secondary changes in advanced cases.

Treatment

In an acute condition, treatment should be carried out in a hospital, more often in intensive care. The patient should remain calm and breathe an oxygen-enriched mixture. This is usually done using humidified gas supplied through nasal prongs or a face mask. In severe cases, tracheal intubation and artificial ventilation of the lungs are performed.

The drugs are usually administered intravenously:

• papaverine dilates blood vessels and reduces the severity of hypertension;
• aminophylline helps to stabilize heart contractions and reduce the degree of respiratory failure;
• atropine is administered to expand the bronchi by relaxing their smooth muscle cells;
• anticoagulants are effective in the presence of thrombosis;

In the case of proven pulmonary embolism, thrombolysis is performed using actilyse or streptokinase. These drugs dissolve the formed thrombotic masses and normalize blood flow. If you spend it in the first hours after the onset of the disease, then the chances of a full recovery are quite high.

Sometimes surgery is performed, but the severity of the patient's condition does not always allow the operation to be performed. In the presence of foreign objects in the pulmonary artery, they can be removed using a minimally invasive technique. In this case, the doctor works with catheters that are inserted through the femoral or radial artery.

In the case of a chronic course of pulmonary heart failure, treatment should be directed to the elimination of the underlying primary disease. For example, antibiotics are used for inflammatory changes, and hormones and other bronchodilators are used for bronchospasm.

In addition, all classes of drugs that are prescribed for heart failure (diuretics, ACE inhibitors, etc.) are used. Caution requires the use of beta-blockers, as they usually worsen the course of pulmonary pathology by reducing the diameter of the bronchial lumen.

With low pressure and respiratory depression, you can use drugs (caffeine, camphor) that stimulate the vasomotor center, which is located in the brain. Usually this happens in the terminal stage of the disease, and such drugs serve rather as a measure of desperation.

An important role in the rehabilitation process is played by constant maintenance therapy, adherence to a protective regimen and proper diet. It is also necessary to give up bad habits that can aggravate the course of the disease, such as smoking. All this allows to increase survival and reduce the manifestations of insufficiency.

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Symptoms and treatment of cardiopulmonary insufficiency

Cardiopulmonary failure is a disease that combines a decrease in the contractile function of the heart muscle and the inability of the respiratory system to provide the blood vessels with the necessary oxygen.

Cardiopulmonary failure is a disease that combines a decrease in the contractile function of the heart muscle and the inability of the respiratory system to provide the blood vessels with the necessary amount of oxygen. This disease is both acute and chronic and entails a significant decrease in the quality of human life.

It is noteworthy that the causes of such a condition as pulmonary heart failure can be associated with both individual and joint disorders in the work of the heart and lungs.

Causes

The main causes of the disease are as follows:

• cardiac asthma and pulmonary edema;
• pneumosclerosis;
• pulmonary vasculitis;
• emphysema;
• thromboembolism;
• bronchial asthma or COPD;
• pulmonary stenosis.

Also, a similar disease can occur with deformation of the chest or ordinary scoliosis.

Symptoms

Insufficiency of cardiopulmonary origin has pronounced symptoms that cannot be overlooked.

1. Symptoms of shortness of breath appear already at the initial stage of the disease. In most cases, shortness of breath occurs with any physical exertion.
2. Symptoms of cyanosis (cyanosis) also become noticeable immediately. This is due to a lack of oxygen in the arterial blood. Because of this, in a sick person, the skin becomes ash-gray.
3. Symptoms of a compensatory reaction occur after the onset of cyanosis. Blood deprived of the necessary oxygen begins increased production of hemoglobin and red blood cells. Therefore, when taking tests, the patient has increased these blood components.
4. Symptoms of pain in the right hypochondrium also indicate insufficiency of the cardiopulmonary nature, as this is a sign of insufficiency of the right heart.
5. Symptoms of sudden hypotension can also be signs of this disease. Sometimes a person feels a sharp weakness and headache, darkening in the eyes.

Sometimes the symptoms described above can be signs of another disease.

Diagnostics

In order to identify the presence of heart failure in a person and choose the necessary treatment, it is necessary to conduct certain studies. This disease is detected using several types of instrumental research.

Radiography of the heart and lungs

X-ray shows changes in the size and shape of the shadow of the heart, as well as its ventricles. There are typical radiological signs of cardiopulmonary insufficiency. One of the indicators in this examination is the presence of fluid in the pleura and changes in the shadows of the pulmonary veins. If they are enlarged, then there is edema - respectively, a disease.

echocardiography

Echocardiography is an important ultrasound method for studying the state of all parts of the heart, the valvular apparatus, as well as myocardial contractility, the speed and volume of blood that is ejected from the atria of the heart into the ventricles and further into the aorta and pulmonary artery. There are strict criteria that indicate the presence or absence of right or left ventricular heart failure.

Electrocardiography

Electrocardiography shows the electrical fields generated by the heart. Incorrect work of any part of the heart, rhythm disturbances, ischemia and hypertrophy are clearly visible on a conventional ECG. Sometimes long-term ECG research methods are used, such as Holter monitoring and stress testing - Bicycle ergometry. Cardiac arrhythmias often cause insufficiency of cardiopulmonary insufficiency.

Electrokymography

Electrokymography reveals possible changes in the cardiovascular system, in particular, violations of the movements of the heart.

Cardiac catheterization

Catheterization of the pulmonary artery and right cavities of the heart determines the blood pressure in these organs and thereby reveals a possible disease.

Methods of treatment

Currently, the treatment of cardiopulmonary insufficiency is carried out:

• diuretic drugs;
• cardiac glycosides
• beta blockers;
• surgical intervention;
• bloodletting;
• folk medicine.

Diuretic drugs

Treatment with diuretics helps to eliminate excess fluid that accumulates in the body, as a result of a decrease in the contractility of the heart. Hydrochlorothiazide is an effective and inexpensive diuretic. It stabilizes pressure and removes excess fluid.

An immediate and stronger drug is furosemide. It is usually taken in the morning on an empty stomach with regular monitoring of the electrolyte-salt balance. Since important trace elements are excreted from the body along with the liquid. The effect of the drug lasts 6 hours. It is possible to use it even with weak kidney function. Furosemide helps to quickly remove puffiness and removes excess fluid well. Another effective diuretic drug, thanks to which you can get rid of edema and remove excess fluid, is ethacrynic acid.

Beta blockers

Treatment of the disease with beta-blockers improves the functioning of the left ventricle of the heart, normalizes blood circulation, and helps relieve swelling.

The most effective beta-blockers are propranolol and timolol. They have adreno-selective properties and eliminate almost all the symptoms of this disease. Treatment with metoprolol is also considered effective. Since it has maximum cardioselectivity and eliminates all signs of the disease.

Surgical intervention

Cardinal treatment is applicable if the disease is severe. The most commonly used atrial septostomy, thromboendarterectomy or organ transplantation.

An atrial septomy is necessary to reduce pressure in the right atrium and pulmonary artery. A thromboendarterectomy is used to remove blood clots from the lungs. Transplantation is used if other methods of treatment have not given the desired effect.

bloodletting

This treatment consists in removing a certain amount of blood from the bloodstream. Up to 400 ml of blood is emitted from the body of the sufferer. With this method of salvation from the disease, the patient's pressure decreases, excess fluid is eliminated, and swelling disappears.

Glycosides

The most effective glycoside that is common in Russia is digoxin. Glycosides are positive inotropic agents that improve the quality of life of patients suffering from pulmonary heart failure.

Glycosides are prescribed in small doses. Using cardiac glycosides, patients are less likely to seek hospitalization.

Folk remedies

Treatment with folk remedies should be carried out only after consultation and doctor's prescriptions. Because this disease is very serious and dangerous.

The main remedy for this disease is a simple wormwood. It normalizes blood circulation, eliminates pain, removes excess fluid. From wormwood you need to prepare a decoction and take it before meals every day for three quarters of a glass.

Another no less effective remedy is a decoction of nettle. This decoction should be used to make hand baths. Timed treatment lasts 10 minutes every day

Pumpkin juice is also an excellent remedy for this disease.

It must always be remembered that folk recipes alone are indispensable in the treatment of diseases of the heart and lungs, moreover, some drugs cannot be used simultaneously with herbal preparations due to the possible increase in side effects.

Cardiopulmonary failure is a pathology that provokes disorders in the respiratory and cardiovascular systems. Appears due to the development of hypertension in the pulmonary circulation. This phenomenon provokes the release of blood into the pulmonary artery, due to which myocardial hypertrophy occurs.

In the case of destruction of the heart muscle, its contractility decreases, which affects the total amount of pumped blood.

Failures in the work of the heart lead to the following pathologies:

1. Hypoxia of various organs due to a reduced amount of oxygen obtained from the blood.
2. Congestion in the lungs, which does not allow the patient to use their full volume when breathing.
3. Pathologies associated with stagnation of fluid in the lungs, which are combined with heart failure. The syndrome includes several dangerous disorders.

The following symptoms appear:

1. Dizziness that starts for no apparent reason, even at rest.
2. Shortness of breath with little exertion.
3. Decrease in working capacity, inability to perform habitual actions that did not seem difficult before the onset of pathology.
4. Paleness of the skin in the region of the nasolabial triangle and fingers of the upper extremities.

Causes

Acute cardiopulmonary insufficiency is considered a dangerous disease in which prompt medical intervention is required to prescribe treatment. Reasons for this condition:

1. Asthma during exacerbation.
2. Persistent spasms, pulmonary thrombosis.
3. Pneumonia.
4. Stagnation in the chest due to the accumulation of a significant amount of fluid, air.
5. Injury in the sternum.

Factors affecting the occurrence of the disease from the cardiovascular system:

1. Vasculitis in the lungs.
2. Formations of a tumor nature in the mediastinum.
3. The development of aneurysms, which, with an increase in the pathological process, compress the parts of the heart located on the right side.

The causes of the disease from the bronchi:

1. Pneumonia treatment.
2. Chronic infectious processes in the lungs: bronchitis, tuberculosis.
3. Emphysema in the lungs.
4. Bronchitis with asthmatic component.

Symptoms

Sometimes cardiopulmonary insufficiency appears without predisposing factors, while a clear clinical picture is noticeable. If the disease is acute, first aid must be provided immediately. Usually the patient is transferred to the intensive care unit. The disease is manifested by the following symptoms:

1. Thrombosis of the pulmonary artery.
2. Pneumonia.
3. Exacerbation of asthma.
4. Mitral valve dysfunction.
5. Failure of a previously transplanted prosthetic valve.
6. In the case of the development of many adverse factors, signs of severe circulatory failure are possible.

The following symptoms appear:

1. Breathing is accelerated, it is impossible to take a deep breath.
2. A sharp drop in pressure. If timely assistance is not provided, there is a risk of collapse.
3. Dyspnea.
4. Decreased limb temperature.
5. Blueish skin tone.
6. Profuse sweating.
7. Pain syndrome in the chest.

Signs of chronic cardiopulmonary insufficiency appear as a result of hypertension in the pulmonary circulation. This process gradually intensifies, development occurs over a long amount of time. Patients live without the manifestation of negative symptoms for several months, years.

Periodically, patients notice the following symptoms:

1. Shortness of breath, which is aggravated by sports.
2. With physical activity, fatigue occurs within a few hours after the start of the work shift, stay at an important event.
3. The frequent appearance of a bluish tint of the skin in the area of ​​\u200b\u200bthe fingertips, the nasolabial triangle.
4. Rapid heart rate.
5. If pulmonary heart failure is accompanied by decompensation, negative manifestations gradually increase, leading to dangerous processes in the organs. You can notice the following signs of the disease:
6. Shortness of breath does not leave a person even at rest. It is possible to increase the attack if the patient moves to a horizontal position.
7. The pain syndrome increases as a result of the progression of ischemia.
8. Distention of the veins of the neck.
9. Decrease in pressure, development of tachycardia.
10. Blueish skin tone.
11. Enlarged liver, discomfort in the right hypochondrium.
12. Edema does not subside with the use of standard drugs, folk remedies.

In case of aggravation of the condition, inhibition of the functions of the brain and kidneys is possible. The person becomes sluggish, apathetic, manifestations of increased drowsiness are noticeable. The condition is dangerous due to a decrease in diuresis, other disorders in the organs that are difficult to restore when using medications. Hypoxia increases the amount of hemoglobin and red blood cells in the blood.

Treatment

If cardiopulmonary insufficiency appeared in an acute form, the patient moves to the intensive care unit. They use the technology of maintaining artificial respiration by introducing an oxygen mixture through a mask or using a nasal catheter. Thanks to this event, the vital functions of important organs are supported.

Treatment of cardiopulmonary failure includes intravenous administration of the following substances:

1. Thrombolysis is required to reduce the symptoms of pulmonary embolism. After its implementation, there is a dissolution of the thrombus, normalization of blood flow.
2. Atropine acts as a muscle relaxant, relaxes the muscles of the bronchi. As a result, it is possible to breathe independently.
3. Papaverine is necessary for excessively strong vascular tone. The action of this substance is to expand the vascular walls, normalize pressure.
4. Anticoagulants prevent thrombosis, protect the heart from the risks associated with blood diseases.
5. Eufillin restores the normal functioning of the myocardium, reduces the severity of respiratory disorders.

First aid for pulmonary edema

If the pathological process is growing minute by minute, it is necessary not only to call an ambulance, but also to carry out important activities on your own:

1. Move the patient to a sitting position.
2. Make sure the room is well ventilated.
3. 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.
4. 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.
5. 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.
6. 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.

Consequences

In the case of relief of the acute stage of cardiopulmonary insufficiency, with the onset of remission of the chronic form of the disease, the risk of developing complications remains:

1. Infection. If the patient has pulmonary edema, their inflammation, bronchitis, is possible. With a decrease in the functions of the immune system, the treatment of these diseases is complicated.
2. Chronic hypoxia of organs. Oxygen starvation manifests itself in vital organs, in particular, the brain and heart. It is necessary to start taking medications in a timely manner in order to prevent irreversible violations.
3. Ischemic tissue damage with insufficiently rapid removal of symptoms of hypoxia.
4. Atherosclerosis of the lungs. The formation of a site whose functioning is impaired due to fluid exposure.

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

This condition is characterized by the fact that the pressure of oxygen 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 of pathology is typical for lesions of the respiratory system and those pathologies in which the lung tissue is replaced by connective tissue.

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

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.

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 of the acute form of the disease manifest themselves in a few minutes or hours, less often - several 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 in full does not 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-fledged exchange of gases between the blood and the alveoli, but the process of gas exchange between the alveoli and the environment is disturbed.

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.

1. 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.
2. 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 of cerebral circulation, the use of drugs.
3. Rib cage. With scoliosis, accumulation of exudate in the pleural cavity, pneumothorax, these problems appear.
4. Oxygen delivery routes. The lesion develops with chronic obstructive pulmonary disease, laryngeal edema, the appearance of embolism in the bronchi.
5. Alveoli. Problems begin with pulmonary edema, pneumonia and other diseases that lead to the growth of connective tissue in the lungs.

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.

The characteristic symptoms indicate the appearance of problems. 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.

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 by painful sensations, then analgesics are given. 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.

It is difficult to avoid the negative consequences of the onset of acute respiratory failure. 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.

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