How to treat the heart with heart failure. Complete characteristics of heart failure

Heart failure is a dangerous disease that can lead to death if first aid is not provided. With the development of this pathology, the heart is not able to maintain a sufficient rhythm of contractions, since its work is negatively affected by hypertension, valve defects, and ischemia. When pumping function decreases, the flow of oxygen and nutrients to organs and tissues slows down.

Many people believe that when heart failure develops, heart damage comes to the fore. In fact, the symptoms of pulmonary edema appear. This pathology is formed as a result of insufficient work of the heart muscle. Blood pumping slows down, it stagnates in the veins, and does not reach organs and tissues in a timely manner. The pressure in the cardiovascular system gradually increases, and fluid penetrates the tissues, in particular the lungs.

Main signs of heart failure:

1. Constantly increasing shortness of breath. It is noteworthy that this phenomenon is characterized by an increase in intensity in short time.
2. The patient will feel a little better if he sits instead of lying down.
3. A sharp pallor of the skin, a decrease in the temperature of the extremities, and a bluish tint to the skin is also possible.
4. Cough with sputum Pink colour. Possible admixture of foam.
5. Rapid increase in blood pressure. After this, it is possible to urgently reduce it to minimum values.
6. Tachycardia, the patient is forced to frequently make breathing movements, since the full volume of the lungs is not used.

How to provide first aid?

Emergency care for heart failure is necessary when developing acute stage pathology. The range of actions taken to restore the functioning of the heart muscle depends on the location of the disorders.

Help with left ventricular heart failure

If pulmonary edema occurs, therapeutic actions should be performed immediately. If negative symptoms occur, call an ambulance. Ask the person to move to a sitting position with their legs down. To normalize the condition, it is enough to put Nitroglycerin or ISO-MIK under the tongue. Make sure there is a sufficient supply of fresh air. If the patient's condition worsens, tourniquets should be applied to the thigh area.

First health care for acute heart failure includes the following steps:

1. If there is a possibility of developing severe breathing pathologies, upon admission of the patient to the hospital, he is prescribed narcotic analgesics.
2. It is necessary to eliminate congestion in the pulmonary circulation and speed up the work of the left ventricle. When fixing the fact of increased blood pressure, drugs are used that promote vasodilation. Diuretics are used in conjunction with other things and measures. If the pressure does not increase, the patient receives diuretics and nitrates. When blood pressure drops, it is necessary to use dobutamine and dopamine.

Help with right ventricular failure

If you notice negative symptoms, you must immediately call for medical help. Before the arrival of a specialized team, move the patient to bed, prepare a platform of pillows or other soft materials to support the torso and head. If available, give a nitroglycerin tablet. It should be absorbed under the tongue. Make sure there is enough fresh air in the room.

First aid for heart failure and left ventricular pathologies is provided using the following methods:

1. Oxygen therapy.
2. Painkillers medicines. If standard treatment measures do not help, doctors recommend using narcotic analgesics.
3. Anticoagulants.
4. Diuretics. If blood clots are detected, even if there is fluid retention in the body, diuretics are not used.
5. Nitrates, which unload the heart, stabilize the function of the left ventricle.
6. Cardiac glycosides are used in minimal dosages; it is advisable to combine them with a polarizing mixture.

Actions for cardiogenic shock

First aid for heart failure complicated by cardiogenic shock involves the use of therapeutic methods. Cardiogenic shock is possible when heart failure is combined with other disorders: cardiomyopathy, pericarditis and pneumothorax.

The following symptoms appear:

1. Severe pain that is practically not relieved by standard means.
2. A strong decrease in blood pressure, the value may decrease to 0.
3. Pallor of the skin.
4. The pulse accelerates, but is practically not palpable.
5. Cardiogenic shock often causes pulmonary edema and the development of renal failure.

First aid for heart failure complicated by cardiogenic shock includes the following measures:

1. Ensure uninterrupted supply of fresh air to the room.
2. Move the patient to a horizontal position. This action can only be carried out if the ventricle does not suffer.
3. Use of analgesics before doctors arrive.

First aid for acute heart failure combined with cardiogenic shock includes the following measures:

1. Use of narcotic analgesics.
2. Psychotropic substances. Their introduction is justified when a vasomotor disorder is detected.
3. Infusion therapy is used, and the patient does not have sudden surges in blood pressure.
4. Cardiotonic drugs are used to normalize cardiac output.
5. If the patient's condition is serious, it is necessary to administer adrenaline.
6. Anticoagulants help restore microcirculation.

Resuscitation of the patient

Emergency care for heart failure can be provided at home before doctors arrive. To do this, you should perform a number of activities:

1. Move the patient to a horizontal position, for example, put him on a bed with a hard mattress. It is advisable to use a cushion rather than a pillow, placing it under your head.
2. Turn the patient's palms down and move his hands to the sternum area. Make jerking movements in the sternum area, dive up to 5 centimeters. These actions are performed approximately 60 times per minute.
3. Together with the activation of the heart muscle, it is recommended to perform artificial respiration.
4. If a person performs resuscitation measures independently, it is necessary to carry out several pushes, then perform approximately 3 approaches of artificial respiration.
5. If resuscitation efforts are carried out by two people, responsibilities can be divided. In this case, one performs artificial respiration, the other makes pushes to the sternum.

30 seconds after the start of emergency recovery measures, it is necessary to assess the patient’s condition. Find out how effective resuscitation measures are. If the patient feels better, this can be seen by his appearance. The pupils dilate, a pinkish tint to the skin appears, and pulsation in the area of ​​the carotid artery becomes noticeable. If blood pressure increases, the patient begins to make breathing movements on his own. If resuscitation efforts are ineffective, they should be continued until the ambulance arrives.

When performing indirect cardiac massage and artificial respiration, it is possible to maintain the vital functions of the body for a long time. As a result, it is possible to eliminate the risk of irreversible consequences in the body.

What to do if you have a stroke?

When heart failure occurs in acute form disturbances occur in all organs, and sufficient oxygen does not reach the tissues. First of all, the function of the nervous system is disrupted. The risk of stroke increases. To avoid these consequences, it is necessary to promptly maintain the pumping function of the heart. In case of insufficient oxygen supply over a long period of time, negative symptoms increase.

To provide the necessary assistance to a person with heart failure combined with a stroke, it is necessary to help him take a comfortable position. Also completely eliminate the possibility of irritants such as loud sounds and bright lights. In order to achieve positive results During primary treatment, it is necessary to eliminate the symptoms of heart failure. If timely first aid is provided correctly, the risk of many irreversible consequences can be mitigated, as well as the person can be saved.

In order to properly provide first aid for heart failure, it is necessary to detect this disease in a timely manner and carry out the necessary resuscitation measures. For the patient’s recovery, take care of his timely transfer to the hospital for maintenance and rehabilitation therapy.

Heart failure– a condition in which the cardiovascular system is unable to provide sufficient blood circulation. Disorders develop due to the fact that the heart does not contract strongly enough and pushes less blood into the arteries than is necessary to meet the body's needs.

Signs of heart failure: increased fatigue, intolerance physical activity, shortness of breath, swelling. People live with this disease for decades, but without proper treatment, heart failure can lead to life-threatening consequences: pulmonary edema and cardiogenic shock.

Causes of heart failure associated with prolonged heart overload and cardiovascular diseases: coronary heart disease, hypertension, heart defects.

Prevalence. Heart failure is one of the most common pathologies. In this regard, it competes with the most common infectious diseases. Of the entire population, 2-3% suffer from chronic heart failure, and among people over 65 years of age this figure reaches 6-10%. The cost of treating heart failure is twice that of treating all forms of cancer.

Anatomy of the heart

Heart is a hollow four-chamber organ that consists of 2 atria and 2 ventricles. The atria (upper chambers of the heart) are separated from the ventricles by septa with valves (bicuspid and tricuspid) that allow blood to flow into the ventricles and close, preventing it from flowing back.

The right half is tightly separated from the left, so venous and arterial blood do not mix.

Functions of the heart:

• Contractility. The heart muscle contracts, the cavities decrease in volume, pushing blood into the arteries. The heart pumps blood throughout the body, acting as a pump.
• Automatism. The heart is capable of independently producing electrical impulses that cause it to contract. This function is provided by the sinus node.
• Conductivity. Along special paths, impulses from the sinus node are conducted to the contractile myocardium.
• Excitability– the ability of the heart muscle to be excited under the influence of impulses.

Circulation circles.

The heart pumps blood through two circulation circles: large and small.

• Systemic circulation– from the left ventricle, blood flows into the aorta, and from it through the arteries to all tissues and organs. Here it releases oxygen and nutrients, after which it returns through the veins to the right half of the heart - the right atrium.
• Pulmonary circulation- blood flows from the right ventricle to the lungs. Here, in the small capillaries that encircle the pulmonary alveoli, the blood loses carbon dioxide and is again saturated with oxygen. After this, it returns through the pulmonary veins to the heart, to left atrium.

Structure of the heart.

The heart consists of three membranes and a pericardial sac.

• Pericardium - pericardium. The outer fibrous layer of the pericardial sac loosely surrounds the heart. It is attached to the diaphragm and sternum and anchors the heart in chest.
• The outer layer is the epicardium. This is a thin transparent film of connective tissue, which is tightly fused with the muscular layer. Together with the pericardial sac, it ensures unhindered glide of the heart during expansion.
• The muscular layer is the myocardium. The powerful cardiac muscle occupies most of the heart wall. The atria have two layers: deep and superficial. The muscular lining of the stomach has 3 layers: deep, middle and outer. Thinning or proliferation and hardening of the myocardium causes heart failure.
• The inner lining is the endocardium. It consists of collagen and elastic fibers that ensure the smoothness of the cavities of the heart. This is necessary for blood to slide inside the chambers, otherwise wall thrombi may form.

Mechanism of development of heart failure

Develops slowly over several weeks or months. There are several phases in the development of chronic heart failure:

1. Myocardial damage develops as a result of heart disease or prolonged overload.


2. Contractile dysfunction left ventricle. It contracts weakly and sends insufficient blood to the arteries.


3. Compensation stage. Compensation mechanisms are activated to ensure normal heart function under the current conditions. The muscle layer of the left ventricle hypertrophies due to an increase in the size of viable cardiomyocytes. The release of adrenaline increases, which causes the heart to beat stronger and more often. The pituitary gland secretes antidiuretic hormone, which increases the water content in the blood. Thus, the volume of pumped blood increases.


4. Depletion of reserves. The heart exhausts its ability to supply cardiomyocytes with oxygen and nutrients. They experience a lack of oxygen and energy.


5. Stage of decompensation– circulatory disorders can no longer be compensated. The muscle layer of the heart is unable to function normally. Contractions and relaxations become weak and slow.


6. Heart failure develops. The heart contracts weaker and slower. All organs and tissues receive insufficient oxygen and nutrients.

Acute heart failure develops within a few minutes and does not go through the stages characteristic of CHF. Heart attack, acute myocarditis or severe arrhythmias cause heart contractions to become sluggish. At the same time, the volume of blood entering the arterial system drops sharply.

Types of heart failure

Chronic heart failure– a consequence of the heart vascular diseases. It develops gradually and progresses slowly. The wall of the heart thickens due to the growth of the muscle layer. The formation of capillaries that provide nutrition to the heart lags behind the increase muscle mass. The nutrition of the heart muscle is disrupted, and it becomes stiff and less elastic. The heart cannot cope with pumping blood.

Severity of the disease. The mortality rate for people with chronic heart failure is 4-8 times higher than for their peers. Without proper and timely treatment in the stage of decompensation, the one-year survival rate is 50%, which is comparable to some cancer diseases.

Mechanism of development of CHF:

• The throughput (pumping) capacity of the heart decreases - the first symptoms of the disease appear: exercise intolerance, shortness of breath.
• Compensatory mechanisms are activated aimed at maintaining normal heart function: strengthening the heart muscle, increasing adrenaline levels, increasing blood volume due to fluid retention.
• Malnutrition of the heart: there are many more muscle cells, and the number of blood vessels has increased slightly.
• Compensatory mechanisms are exhausted. The work of the heart deteriorates significantly - with each beat it does not push out enough blood.

Types of chronic heart failure

Depending on the phase of cardiac contraction in which the disorder occurs:

• Systolic heart failure (systole - contraction of the heart). The chambers of the heart contract weakly.
• Diastolic heart failure (diastole – the phase of relaxation of the heart) the heart muscle is not elastic, it does not relax and stretch well. Therefore, during diastole, the ventricles are not sufficiently filled with blood.

Depending on the cause of the disease:

• Myocardial heart failure – heart diseases weaken the muscle layer of the heart: myocarditis, heart defects, coronary artery disease.
• Reloading heart failure - the myocardium is weakened as a result of overload: increased blood viscosity, mechanical obstacles to the outflow of blood from the heart, hypertension.

Acute heart failure (AHF)– a life-threatening condition associated with rapid and progressive impairment of the pumping function of the heart.

Development mechanism of OSN:

• The myocardium does not contract strongly enough.
• The amount of blood released into the arteries decreases sharply.
• Slow passage of blood through body tissues.
• Increased blood pressure in the capillaries of the lungs.
• Stagnation of blood and development of edema in tissues.

Severity of the disease. Any manifestation of acute heart failure is life-threatening and can quickly lead to death.

There are two types of OSN:

1. Right ventricular failure.

   Develops when the right ventricle is damaged as a result of blockage of the terminal branches of the pulmonary artery (pulmonary embolism) and infarction of the right half of the heart. This reduces the volume of blood pumped by the right ventricle from the vena cava, which carries blood from the organs to the lungs.

2. Left ventricular failure caused by impaired blood flow in the coronary vessels of the left ventricle.

   Mechanism of development: the right ventricle continues to pump blood into the vessels of the lungs, the outflow of which is impaired. The pulmonary vessels become overfilled. In this case, the left atrium is not able to accept the increased volume of blood and stagnation develops in the pulmonary circulation.

Variants of the course of acute heart failure:

• Cardiogenic shock– significant decrease in cardiac output, systolic pressure less than 90 mm. Hg Art, cold skin, lethargy, lethargy.
• Pulmonary edema– filling of the alveoli with liquid that has leaked through the walls of the capillaries is accompanied by severe respiratory failure.
• Hypertensive crisis– against the background of high blood pressure, pulmonary edema develops; right ventricular function is preserved.
• Heart failure with high cardiac output– warm skin, tachycardia, blood congestion in the lungs, sometimes high pressure(for sepsis).
• Acute decompensation of chronic heart failure – AHF symptoms are moderate.

Causes of heart failure

Causes of chronic heart failure

• Heart valve diseases– lead to the flow of excessive blood into the ventricles and their hemodynamic overload.
• Arterial hypertension(hypertension) - the outflow of blood from the heart is disrupted, the volume of blood in it increases. Working in an intense mode leads to overwork of the heart and stretching of its chambers.
• Aortic stenosis– narrowing of the aortic lumen leads to blood accumulating in the left ventricle. The pressure in it increases, the ventricle stretches, and its myocardium weakens.
• Dilated cardiomyopathy– a heart disease characterized by stretching of the heart wall without thickening. In this case, the ejection of blood from the heart into the arteries is reduced by half.
• Myocarditis– inflammation of the heart muscle. They are accompanied by impaired conductivity and contractility of the heart, as well as stretching of its walls.
• Coronary heart disease, previous myocardial infarction– these diseases lead to disruption of the blood supply to the myocardium.
• Tachyarrhythmias– the filling of the heart with blood during diastole is disrupted.
• Hypertrophic cardiomyopathy– the walls of the ventricles thicken, their internal volume decreases.
• Pericarditis– inflammation of the pericardium creates mechanical obstacles to filling the atria and ventricles.
• Graves' disease- contained in the blood a large number of hormones thyroid gland which have a toxic effect on the heart.

These diseases weaken the heart and lead to the activation of compensation mechanisms that are aimed at restoring normal blood circulation. Blood circulation improves for a while, but soon the reserve capacity ends and symptoms of heart failure appear with new strength.

Causes of acute heart failure

Heart problems:

• Complication of chronic heart failure under severe psycho-emotional and physical stress.
• Pulmonary embolism(its small branches). Increased pressure in the pulmonary vessels leads to excessive load on the right ventricle.
• Hypertensive crisis. A sharp increase in pressure leads to spasm of the small arteries that supply the heart - ischemia develops. At the same time, the number of heart contractions increases sharply and the heart becomes overloaded.
• Acute heart rhythm disturbances– an accelerated heartbeat causes overload of the heart.
• Acute disruption of blood flow inside the heart can be caused by damage to the valve, rupture of the chord that restrains the valve leaflets, perforation of the valve leaflets, infarction of the interventricular septum, separation of the papillary muscle responsible for the operation of the valve.
• Acute severe myocarditis– inflammation of the myocardium leads to the fact that the pumping function sharply decreases, heart rhythm and conductivity are disrupted.
• Cardiac tamponade- accumulation of fluid between the heart and the pericardial sac. In this case, the cavities of the heart are compressed, and it cannot fully contract.
• Acute arrhythmia(tachycardia and bradycardia). Severe rhythm disturbances impair myocardial contractility.
• Myocardial infarction is an acute circulatory disorder in the heart, which leads to the death of myocardial cells.
• Aortic dissection– disrupts the outflow of blood from the left ventricle and the activity of the heart in general.

Non-cardiac causes of acute heart failure:

• Severe stroke. The brain carries out neurohumoral regulation of the activity of the heart; during a stroke, these mechanisms go astray.
• Alcohol abuse disrupts conduction in the myocardium and leads to severe rhythm disturbances - atrial flutter.
• Attack bronchial asthma nervous excitement and acute lack of oxygen lead to rhythm disturbances.
• Poisoning by bacterial toxins, which have a toxic effect on heart cells and inhibit its activity. The most common causes: pneumonia, septicemia, sepsis.
• Incorrect treatment heart disease or self-medication abuse.

Risk factors for developing heart failure:

• smoking, alcohol abuse
• diseases of the pituitary gland and thyroid gland, accompanied by increased blood pressure
• any heart disease
• taking medications: antitumor drugs, tricyclic antidepressants, glucocorticoid hormones, calcium antagonists.

Symptoms of right ventricular acute heart failure are caused by stagnation of blood in the veins of the systemic circulation:

• Increased heart rate- the result of deterioration of blood circulation in the coronary vessels of the heart. Patients experience increasing tachycardia, which is accompanied by dizziness, shortness of breath and heaviness in the chest.
• Swelling of the neck veins, which intensifies with inspiration, is explained by an increase in intrathoracic pressure and difficulty in blood flow to the heart.
• Edema. A number of factors contribute to their appearance: slower blood circulation, increased permeability of capillary walls, interstitial fluid retention, and impaired water-salt metabolism. As a result, fluid accumulates in cavities and limbs.
• Lower blood pressure associated with a decrease in cardiac output. Manifestations: weakness, pallor, increased sweating.
• There is no congestion in the lungs

Symptoms of left ventricular acute heart failure associated with stagnation of blood in the pulmonary circulation - in the vessels of the lungs. Manifested by cardiac asthma and pulmonary edema:

• Cardiac asthma attack occurs at night or after exercise, when blood stagnation in the lungs increases. There is a feeling of acute lack of air, shortness of breath quickly increases. The patient breathes through the mouth to ensure greater air flow.
• Forced sitting position(with legs down) in which the outflow of blood from the vessels of the lungs improves. Excess blood flows into the lower extremities.
• Cough at first dry, later with pinkish sputum. The discharge of sputum does not bring relief.
• Development of pulmonary edema. Increased pressure in the pulmonary capillaries causes fluid and blood cells to leak into the alveoli and the space around the lungs. This impairs gas exchange and the blood is not sufficiently saturated with oxygen. Moist coarse bubbling rales appear over the entire surface of the lungs. You can hear bubbling breathing from the side. The number of breaths increases to 30-40 per minute. Breathing is difficult, the respiratory muscles (diaphragm and intercostal muscles) are noticeably tense.
• Foam formation in the lungs. With each breath, the fluid that has leaked into the alveoli foams, further impairing the stretching of the lungs. A cough with foamy sputum appears, foaming from the nose and mouth.
• Confusion and mental agitation. Left ventricular failure leads to cerebrovascular accident. Dizziness, fear of death, fainting are signs of oxygen starvation of the brain.
• Heartache . Pain is felt behind the sternum. It can radiate to the shoulder blade, neck, elbow.

• Dyspnea- This is a manifestation of oxygen starvation of the brain. It appears during physical activity, and in advanced cases, at rest.
• Exercise intolerance. During exercise, the body needs active blood circulation, but the heart is not able to provide this. Therefore, when exerting yourself, weakness, shortness of breath, and chest pain quickly occur.
• Cyanosis. The skin is pale with a bluish tint due to lack of oxygen in the blood. Cyanosis is most pronounced on the tips of the fingers, nose, and earlobes.
• Edema. First of all, swelling of the legs occurs. They are caused by congestion of the veins and the release of fluid into the intercellular space. Later, fluid accumulates in the cavities: abdominal and pleural.
• Stagnation of blood in the vessels of internal organs causes a malfunction in their operation:
  • Digestive organs. Feeling of pulsation in the epigastric region, stomach pain, nausea, vomiting, constipation.
  • Liver. Rapid enlargement and pain of the liver are associated with stagnation of blood in the organ. The liver enlarges and stretches the capsule. When moving and palpating, a person experiences pain in the right hypochondrium. Gradually, connective tissue develops in the liver.
  • Kidneys. Reducing the amount of urine excreted, increasing its density. Casts, proteins, and blood cells are found in the urine.
  • Central nervous system. Dizziness, emotional agitation, sleep disturbance, irritability, increased fatigue.

Diagnosis of heart failure

Inspection. Upon examination, cyanosis is revealed (pallor of the lips, tip of the nose and areas distant from the heart). Pulse is frequent and weak. Blood pressure during acute insufficiency decreases by 20-30 mmHg. compared to a worker. However, heart failure can occur against a background of high blood pressure.

Listening to the heart. In acute heart failure, listening to the heart is difficult due to wheezing and breath sounds. However, it is possible to identify:

• weakening of the first tone (the sound of ventricular contraction) due to weakening of their walls and damage to the heart valves
• splitting (bifurcation) of the second tone on the pulmonary artery indicates later closure of the pulmonary valve
• IV heart sound is detected during contraction of the hypertrophied right ventricle
• diastolic murmur - the sound of blood filling during the relaxation phase - blood leaks through the pulmonary valve due to its dilation
• heart rhythm disturbances (slowness or acceleration)

Electrocardiography (ECG) It is mandatory for all cardiac dysfunctions. However, these signs are not specific to heart failure. They can also occur with other diseases:

• signs of scarring of the heart
• signs of myocardial thickening
• heart rhythm disturbances
• cardiac conduction disorder

ECHO-CG with Dopplerography (ultrasound of the heart + Doppler) is the most informative method for diagnosing heart failure:

• reduction in the amount of blood ejected from the ventricles is reduced by 50%
• thickening of the walls of the ventricles (the thickness of the anterior wall exceeds 5 mm)
• increase in the volume of the heart chambers (the transverse size of the ventricles exceeds 30 mm)
• decreased ventricular contractility
• pulmonary aorta dilated
• heart valve dysfunction
• insufficient collapse of the inferior vena cava during inspiration (less than 50%) indicates stagnation of blood in the veins of the systemic circulation
• increased pulmonary artery pressure

X-ray examination confirms an increase in the right side of the heart and an increase in blood pressure in the vessels of the lungs:

• bulging of the trunk and expansion of the branches of the pulmonary artery
• unclear outlines of large pulmonary vessels
• increase in heart size
• areas of increased density associated with swelling
• the first swelling appears around the bronchi. A characteristic “bat silhouette” is formed

Study of the level of natriuretic peptides in blood plasma– determination of the level of hormones secreted by myocardial cells.

Normal levels:

• NT-proBNP – 200 pg/ml
• BNP –25 pg/ml

The greater the deviation from the norm, the more severe the stage of the disease and the worse the prognosis. Normal levels of these hormones indicate the absence of heart failure.
Treatment of acute heart failure

Is hospitalization necessary?

If symptoms of acute heart failure appear, you must call an ambulance. If the diagnosis is confirmed, the patient must be hospitalized in the intensive care unit (for pulmonary edema) or intensive care and emergency care.

Stages of care for a patient with acute heart failure

The main goals of therapy for acute heart failure:

• rapid restoration of blood circulation in vital organs
• easing symptoms of the disease
• normalization of heart rate
• restoration of blood flow in the vessels supplying the heart

Depending on the type of acute heart failure and its manifestations, drugs are administered that improve heart function and normalize blood circulation. After the attack has been stopped, treatment of the underlying disease begins.

Procedures that help stop an attack of acute heart failure:

1. Bloodletting indicated for urgent unloading of pulmonary vessels, lowering blood pressure, eliminating venous stagnation. Using a lancet, the doctor opens a large vein (usually on the extremities). 350-500 ml of blood is removed from it.
2. Application of tourniquets to limbs. If there are no vascular pathologies or other contraindications, then venous stasis is artificially created in the periphery. Tourniquets are applied to the limbs below the groin and armpit for 15-30 minutes. Thus, it is possible to reduce the volume of circulating blood, unloading the heart and blood vessels of the lungs. Hot water can be used for the same purpose. foot bath.
3. Breathing pure oxygen to eliminate hypoxia of tissues and organs. To do this, use an oxygen mask with high speed gas supply. In severe cases, a ventilator may be needed.
4. Oxygen vapor inhalation ethyl alcohol used to extinguish protein foam formed during pulmonary edema. Before inhalation, it is necessary to clear the upper respiratory tract of foam, otherwise the patient faces suffocation. For these purposes, mechanical or electrical suction is used. Inhalation is carried out using nasal catheters or a mask.
5. Defibrillation necessary for heart failure with severe arrhythmia. Electropulse therapy depolarizes the entire myocardium (deprives it of isolated pathological impulses) and restarts the sinus node, which is responsible for the heart rhythm.

Treatment of chronic heart failure

Treatment of CHF is a long process. It requires patience and significant financial investment. Mostly, treatment is carried out at home. However, there is often a need for hospitalization.

Goals of therapy for chronic heart failure:

• minimizing the manifestations of the disease: shortness of breath, swelling, fatigue
• protection of internal organs that suffer from insufficient blood circulation
• reducing the risk of developing acute heart failure

Is hospitalization necessary to treat chronic heart failure?

Chronic heart failure is the most common reason hospitalization of elderly people.

Indications for hospitalization:

• ineffectiveness of outpatient treatment
• low cardiac output requiring treatment with inotropes
• severe edema that requires intramuscular administration of diuretics
• deterioration of condition
• heart rhythm disturbances
  

  Treatment of pathology with medications

  Group	A drug	Mechanism of therapeutic action	How is it prescribed?
  Beta blockers	Metoprolol	Eliminates heart pain and arrhythmia, reduces heart rate, and makes the myocardium less susceptible to oxygen deficiency.	Take 50-200 mg orally per day in 2-3 doses. Dose adjustment is made individually.
  	Bisoprolol	Has an anti-ischemic effect and lowers blood pressure. Reduces cardiac output and heart rate.	Take 0.005-0.01 g orally once a day during breakfast.
  Cardiac glycosides	Digoxin	Eliminates atrial fibrillation (uncoordinated contraction muscle fibers). Has a vasodilator and diuretic effect.	On the first day, 1 tablet 4-5 times a day. In the future, 1-3 tablets per day.
  Angiotensin II receptor blockers	Atakand	Relaxes blood vessels and helps reduce pressure in the capillaries of the lungs.	Take 8 mg once a day with food. If necessary, the dose can be increased to 32 mg.
  Diuretics - aldosterone antagonists	Spironolactone	Removes excess water from the body, preserving potassium and magnesium.	100-200 mg for 5 days. With prolonged use, the dose is reduced to 25 mg.
  Sympathomimetic agents	Dopamine	Increases heart tone and pulse pressure. Dilates blood vessels that feed the heart. Has a diuretic effect.	Used only in a hospital, intravenous drip at 100-250 mcg/min.
  Nitrates	Nitroglycerine Glyceryl trinitrate	Prescribed for left ventricular failure. Expands the coronary vessels that supply the myocardium, redistributes blood flow to the heart in favor of areas affected by ischemia. Improves metabolic processes in the heart muscle.	Solution, drops, capsules for resorption under the tongue. In the hospital, 0.10 to 0.20 mcg/kg/min is administered intravenously.

  Nutrition and daily routine for heart failure.

  Treatment of acute and chronic heart failure is carried out individually. The selection of drugs depends on the stage of the disease, the severity of symptoms, and the characteristics of heart damage. Self-medication can lead to worsening and progression of the disease. Nutrition for heart failure has its own characteristics. Diet No. 10 is recommended for patients, and 10a for the second and third degrees of circulatory disorders.

  Basic principles therapeutic nutrition for heart failure:

  • Liquid intake norms are 600 ml - 1.5 liters per day.
  • In case of obesity and overweight (>25 kg/m²), it is necessary to limit the calorie intake to 1900-2500 kcal. Avoid fatty, fried foods and confectionery products with cream.
  • Fats 50-70 g per day (25% vegetable oils)
  • Carbohydrates 300-400 g (80-90 g in the form of sugar and other confectionery products)
  • Limiting table salt, which causes water retention in the body, increases the load on the heart and the appearance of edema. The salt intake is reduced to 1-3 g per day. In case of severe heart failure, salt is completely turned off.
  • The diet includes foods rich in potassium, the deficiency of which leads to myocardial dystrophy: dried apricots, raisins, seaweed.
  • Ingredients that have an alkaline reaction, since metabolic disorders in heart failure lead to acidosis (acidification of the body). Recommended: milk, wholemeal bread, cabbage, bananas, beets.
  • For pathological loss of body weight due to fat mass and muscles (>5 kg in 6 months), high-calorie meals are recommended 5 times a day in small portions. Since an overfilled stomach causes the diaphragm to rise and disrupt the functioning of the heart.
  • Food should be high in calories, easily digestible, rich in vitamins and proteins. Otherwise, the stage of decompensation develops.
  Dishes and foods that are prohibited for heart failure:
  • strong fish and meat broths
  • bean and mushroom dishes
  • fresh bread, butter and puff pastry products, pancakes
  • fatty meats: pork, lamb, goose, duck, liver, kidneys, sausages
  • fatty fish, smoked, salted and canned fish, canned food
  • fatty and salty cheeses
  • sorrel, radish, spinach, salted, pickled and pickled vegetables.
  • spicy seasonings: horseradish, mustard
  • animal and cooking fats
  • coffee, cocoa
  • alcoholic drinks
  Physical activity for heart failure:

  In acute heart failure, rest is indicated. Moreover, if the patient is in a supine position, the condition may worsen - pulmonary edema will intensify. Therefore, it is advisable to be in a sitting position on the floor with your legs down.

  In chronic heart failure, rest is contraindicated. Lack of movement increases congestion in the systemic and pulmonary circulation.

  Sample list of exercises:

  1. Lying on your back. The arms are extended along the body. As you inhale, raise your arms, and as you exhale, lower them.
  2. Lying on your back. Exercise "bicycle". Lying on your back, perform an imitation of riding a bicycle.
  3. Move to a sitting position from a lying position.
  4. Sitting on a chair. The arms are bent at the elbow joints, hands to the shoulders. Rotate your elbows 5-6 times in each direction.
  5. Sitting on a chair. As you inhale, lift your arms up and tilt your torso toward your knees. As you exhale, return to the starting position.
  6. Standing, holding a gymnastic stick. As you inhale, lift the stick and turn your torso to the side. As you exhale, return to the starting position.
  7. Walking in place. Gradually they switch to walking on their toes.
  All exercises are repeated 4-6 times. If dizziness, shortness of breath and chest pain occur during physical therapy, you must stop exercising. If, when performing exercises, the pulse accelerates by 25-30 beats, and after 2 minutes returns to normal, then the exercises have a positive effect. Gradually, the load must be increased, expanding the list of exercises.

  Contraindications to physical activity:

  • active myocarditis
  • narrowing of heart valves
  • severe heart rhythm disturbances
  • attacks of angina in patients with decreased blood output

Failure is a dysfunction of the heart when it is unable to provide adequate blood flow to organs and tissues. Body cells do not receive enough nutrients and experience oxygen starvation. Chronic heart failure is the outcome of almost all heart diseases.

Causes of chronic heart failure

The most common causes of heart failure are atherosclerosis, hypertension,. Due to the narrowing of blood vessels, the tension of the blood inside increases, and it becomes more and more difficult for the heart to push it through. Up to a certain point, this violation is compensated by an increase in the strength and frequency of heart contractions, but over time the heart ceases to cope with increased loads.

Heart failure can be caused by dysfunction of the heart itself due to myocarditis, myocardial dystrophy, heart valve defects, severe infections, poisoning, and autoimmune diseases. Many lung diseases are accompanied by increased blood pressure in the pulmonary vessels. As a result, the load on the heart increases, and this can also lead to heart failure. When kidney function is impaired, excess fluid is retained in the body, which increases the amount of blood and increases the load on the heart muscle.

Symptoms of heart failure

On initial stages Symptoms of heart failure occur only during exercise. Shortness of breath appears - breathing becomes too frequent and deep, does not correspond to the severity of work or physical exercise. If the pressure in the vessels of the lungs increases, the patient is worried, sometimes with blood impurities.

After physical exertion, heavy meals and in a lying position, increased heart rate occurs. The patient complains of increased fatigue and weakness.

Over time, these symptoms intensify and begin to bother you not only during physical work, but also at rest.

Many patients with heart failure have decreased urine output and go to the toilet mostly at night. In the evenings, swelling appears on the legs, at first only on the feet, and over time it “rises” higher. The skin of the feet, hands, earlobes and tip of the nose takes on a bluish tint. If heart failure is accompanied by stagnation of blood in the liver vessels, a feeling of heaviness and pain occurs under the right rib.

Over time, heart failure leads to poor circulation in the brain. The patient becomes irritable, quickly gets tired during mental stress, and often becomes depressed. He sleeps poorly at night and is constantly sleepy during the day.

What can you do?

If treatment is not carried out, heart failure constantly increases and leads to increasingly severe complications, the patient’s condition worsens. The functioning of all organs is disrupted, as they no longer receive the required amount of nutrients and oxygen. Ultimately, this leads to disability and death.

Patients suffering from heart failure must be registered with a therapist and cardiologist, regularly attend examinations and examinations, and periodically undergo treatment in a hospital.

What can a doctor do?

For heart failure, your doctor may order the following studies and tests:

Treatment of heart failure is carried out with medications. The patient receives appointments from a therapist and cardiologist at the clinic at his place of residence. Hospitalization to a hospital for examination and treatment is periodically required. Typically, recommendations and prescriptions for heart failure include:

• limiting physical activity;
• physical therapy;
• diet: you need to limit the consumption of salt, liquid, fatty foods;
• medications to lower blood pressure and relieve heart stress;
• drugs that increase heart contractions;
• drugs that help remove excess fluid from the body and restore water-salt balance;
• , microelements, vascular and other agents that help restore normal metabolism in the heart muscle;
• treatment of the underlying disease that led to the development of heart failure.

The prognosis for patients with heart failure depends on the underlying disease. If it can be cured, then the patient has a chance of recovery. Otherwise, the doctor can only slow down the further progression of the disease. At the initial stages, normal performance is maintained, but then it decreases, and in severe heart failure it is lost - the patient becomes disabled. If left untreated, heart failure ultimately leads to death.

Prevention

To prevent heart failure it is necessary proper nutrition, sufficient physical activity, refusal bad habits. All diseases of the cardiovascular system must be promptly identified and treated.

Heart failure is a companion to various diseases of the cardiovascular system. This disease develops over a long time and cannot be completely cured. However, a well-chosen treatment regimen can reduce the manifestations of heart failure to a minimum.

Intensive therapy for patients with heart failure is aimed at:

• elimination of symptoms of the disease (weakness, shortness of breath, swelling, tachycardia);
• prevention of organ damage;
• relief and prolongation of life.

Taking into account the heterogeneity of the patient population, an individual treatment regimen is used for heart failure, taking into account the causes and conditions of the development of the disease and its clinical picture.

A positive outcome in the treatment of heart failure is possible only by influencing the cause that was the trigger for the development of the pathology. Depending on this, therapy for heart failure can proceed in the following directions:

• restoration of blood pressure if the source of the disease is arterial hypertension;
• normalization of heart rhythms during bradyarrhythmia and tachyarrhythmia;
• prohibition of alcohol in case of its abuse;
• weight loss in case of obesity;
• surgical correction of congenital heart diseases;
• normalization of hormonal levels in case of thyrotoxicosis or myxedema;
• restoration of normal levels of red blood cells and hemoglobin in case of anemia;
• medicinal or surgery pericarditis;
• restoration of bronchial patency, anti-inflammatory measures if lung pathologies occur;
• antianginal therapy for coronary heart disease.

Treatment of the primary disease may be complicated for several reasons:

• non-compliance with the recommendations of the attending physician (violation of the combination, dosage and schedule of taking medications, violation individual diet and physical activity regimen);
• drinking alcohol;
• infectious diseases;
• acute myocardial infarction;
• pregnancy;
• blockage of the pulmonary artery by blood clots;
• thyroid disorders;
• taking a number of medications that are incompatible with treating the source of heart failure.

In this case, treatment is carried out in such a way that the manifestations of heart failure are reduced as much as possible. In addition, all are created possible conditions to return to the issue of treating the underlying disease.

Drug treatment of heart failure

HF therapy medications should be long-term, combined and based on evidence. Drugs for heart failure should improve the patient's condition, reduce the frequency of hospitalizations and the risk of death.

Angiotensin-converting enzyme (ACE) inhibitors

These drugs are considered leading drugs for the treatment of heart failure. Their ability to slow down the course of the disease and improve the prognosis in almost all patients has been proven.

The action of ACE inhibitors is aimed at blocking the protein angiotensin II, which has vasoconstrictor activity. The concentration in the blood of the peptide bradykinin, which dilates blood vessels, increases. The walls of the blood vessels relax. This leads to the following effects:

• blood pressure decreases;
• pressure in the capillaries of the lungs decreases;
• vascular resistance to blood flow decreases;
• blood overload of the heart decreases;
• minute volume of blood circulation increases;
• the production of the hormone aldosterone, which retains water and salt, decreases;
• myocardial tolerance to stress increases.

ACE inhibitors are classified according to the duration of exposure. Thus, the drug captopril is a short-term ACE inhibitor (acts for 5-6 hours), enalapril is a medium-term drug (12 hours), lisinopril is a long-term drug (24 hours).

The list of ACE inhibitors on the market is significant. There are ready-made combinations with diuretics and calcium antagonists.

Side effects of ACE inhibitors: dry cough, weakness, drowsiness, nausea, renal dysfunction. In general, the drugs were well tolerated. Side effects occur in less than 10% of patients.

ACE inhibitors are indicated for all patients with HF. First, small doses of drugs are prescribed, gradually increasing them to the maximum tolerated. After the first appointment, the patient is observed for several hours.

Angiotensin II receptor antagonists (blockers)

This is a relatively new group of drugs in the treatment of heart failure. The effect of their use is similar to ACE inhibitors, but it is achieved by influencing only the renin-angiotensin-aldosterone system without suppressing the hormone bradykinin.

Angiotensin II receptor blockers (losartan, valsartan, etc.) in the treatment of heart failure serve as an alternative to ACE inhibitors and are prescribed if the latter are intolerant.

Medicines for heart failure in this group are distinguished by the absence of side effects such as cough and bronchospasm.

Diuretics

These are diuretic drugs. Diuretics (hydrochlorothiazide, furosemide, spironolactone and others) are used as a symptomatic remedy at stages when the level of fluid in the body is exceeded. The activity of diuretic therapy depends on the severity of the edema syndrome. Treatment begins with small doses and is gradually increased to medium therapeutic doses.

According to the mechanism of action, diuretics are divided into thiazide, loop and potassium-sparing. If necessary, they are combined, increasing the total diuretic effect.

Cardiac glycosides

Cardiac glycosides (digitoxin, strophanthin) are herbal medicines. In therapeutic practice, derivatives of lily of the valley, foxglove, adonis, and strophantha are used.

Cardiac glycosides for the treatment of chronic heart failure are taken for poor myocardial contractility, arrhythmia, high heart rate, and left ventricular dysfunction. The drugs improve hemodynamic parameters, normalize the metabolism of the heart muscle, eliminate tachycardia and shortness of breath.

Beta blockers

Beta blockers (metoprolol, carvedilol and others) block the effects of adrenaline, thereby slowing the heart rate and lowering blood pressure.

Sedatives

Sedatives (Corvalol, Valocordin and others) are sedatives that have a beneficial effect on nervous system. Corvalol restores and slows down the heart rate, relieves vascular spasms, reduces the excitability of the central nervous system, and eliminates chest pain. Has a hypnotic effect.

Pacemakers

Pacemakers are installed in patients if drug treatment has insufficient positive effect. These devices, usually inserted under the skin of the chest, stimulate the heart using electrical impulses. The operation is performed under local anesthesia so that the patient can answer the cardiac surgeon's questions while setting up the device.

Main groups of pacemakers:

• simple. Intended for patients whose heart does not produce electrical impulses properly;
• biventricular (BVEKS). Installed in patients whose synchronicity of the left ventricle with other parts of the heart is disturbed;
• implantable cardioverter defibrillators (ICDs). They are introduced if there are arrhythmias with a high threat to life, for example, ventricular fibrillation, ventricular tachycardia;
• SRT-D. The device combines the functions of BVEX and ICD: at the same time it restores the synchrony and rhythm of the heart in patients who need it.

Surgery

A number of patients are shown surgical intervention. Modern technologies in cardiac surgery make it possible to operate safely and with a high degree of efficiency. For heart failure, the following types of operations are performed:

• restoration of heart valve functions. Indicated when HF is caused by heart defects;
• coronary artery bypass surgery. It is carried out if the source of HF is ischemic disease. The operation restores blood flow to the heart;
• installation of an artificial ventricle. This is an operation to insert an implant into the body that helps pump blood;
• A heart transplant is a complex operation to replace a diseased heart with a healthy donor one.

Treatment of acute heart failure

AHF is characterized by a high rate of development of pathology, is life-threatening and requires urgent intensive care.

For the diagnosis of AHF, the following signs are important: swollen veins of the neck; severe pain under the ribs; shortness of breath, suffocation; coughing fits with foam; pallor; sweating; marbled color of the skin.

When these signs appear, take the following actions:

• a medical team is called;
• the patient's upper body is raised;
• the patient should be reassured;
• the flow of oxygen is ensured, doors and windows open;
• take 1-2 tablets of nitroglycerin under the tongue every 10 minutes with blood pressure monitoring;
• furosemide is administered, it should begin to unload the myocardium within 5 minutes;
• in case of severe psychomotor agitation, a narcotic analgesic (morphine) is administered to relax the respiratory muscles;
• Nitroglycerin is administered intravenously under the control of blood pressure and heart rate;
• if it is not possible to carry out medication therapy, tourniquets are applied to the thighs.

Non-drug treatment of heart failure

With a diagnosis of heart failure, the patient continues to go to work, family life, rest. However, the disease changes lifestyle. To avoid complications of the disease and have good health, it is necessary to follow medical recommendations, carry out disease prevention, and participate in rehabilitation programs.

Diet

• reducing the consumption of table salt. The more pronounced the symptoms of the disease, the stricter this requirement. So, if patients with FC II are recommended to consume no more than 5 g of salt per day, then FC IV patients should completely exclude salt when preparing food;
• careful use of salt substitutes containing potassium. There is a risk of hyperkalemia when combined with ACE inhibitors;
• reducing water consumption to 1.5 liters per day. This includes liquid meals. In case of severe CHF, this volume still needs to be reduced;
• a complete ban on alcohol for patients with alcoholic cardiopathy. All other groups of patients should reduce its consumption as much as possible;
• body weight control. Excess weight worsens the prognosis and requires dieting. Measuring weight is necessary to adjust the dose of diuretic drugs;
• preference should be given to vegetables and fruits, lean meats, fish, cereals, and dairy products. Potassium-rich foods are recommended (cabbage, buckwheat, oatmeal, dried apricots, potatoes, bananas, nuts). Cheeses, animal fats, fatty meats, pickles, smoked meats and marinades, legumes, and spices should be excluded.

Physical activity

Exercise as a treatment for heart failure has only recently been recognized. Physical activity is recommended if chronic heart failure is stable. Exercise has a positive effect on the contractile function of the heart, skeletal muscles, respiratory and vascular systems.

The load regimen is determined based on the results of a 6-minute walk test. Patients who cannot walk 150 meters without discomfort, shortness of breath, and palpitations (FC III-IV), as well as patients with obvious lack of body weight, are excluded from physical education at the first stage. They are prescribed breathing exercises using special simulators (Frolov apparatus, Threshold and others). The exercise machines create resistance as you inhale and exhale, training your breathing muscles. On average, after a month of using breathing simulators, the course of the disease improves, and tolerance to physical activity appears.

The foundation of training for CHF is aerobic exercise. This is walking, Nordic walking and swimming. Depending on the patient’s tolerance to cardio exercise, their duration ranges from 15 to 30 minutes 3-5 times a week. During one lesson, the intensity level of the load does not change and is 50-80% of the threshold heart rate. If this regimen is well tolerated, the duration and intensity of training increases. Physical activity doesn't have to be tiring.

Some studies show that interval training with variable intensity within one session is even more effective. Concerning strength training, it has not yet been established what the consequences of their influence on CHF are.

Smoking

Smoking is strictly contraindicated in patients with CHF. The risk of myocardial infarction and sudden cardiac arrest increases. Nicotine causes blood vessels to narrow and atherosclerosis develops. Persistent connection of red blood cells with carbon monoxide, which occurs during smoking, leads to a decrease in the number of red blood cells capable of transporting oxygen. Oxygen starvation occurs. This leads to disruption of all systems and affects the functioning of the heart. The contractile function of the myocardium is impaired, and the consequences of smoking may be irreversible.

Trips

Heart failure is not a reason to refuse travel if you feel well enough. However, you should not visit regions with a hot and humid climate or climb mountains. It is better if the climatic conditions are familiar to the patient.

Air travel can lead to dehydration, swelling and provoke thrombosis. Therefore, long hours of flights must be avoided. When traveling, you cannot remain motionless. It is recommended to get up periodically and do a light warm-up.

Rehabilitation programs

Rehabilitation programs for people with cardiovascular diseases are being created at public and private medical institutions. Experienced specialists conduct an examination and select individual program training, teach breathing exercises, and provide psychological support. Patients are told about lifestyle with heart disease and taught self-control skills.

Nursing

Caring for patients with heart failure involves constant monitoring of their condition, any physical assistance, as well as psychological support.

• Patients with severe HF are constantly in bed. It is important that it is as comfortable as possible. It is necessary to equip the bed with a headrest or other device so that it is possible to elevate the upper body.
• To avoid bedsores, the patient is often turned over and massaged. This also prevents the formation of blood clots.
• You should monitor the indoor air. It should be fresh, at a comfortable temperature and not dry.
• The skin condition of patients with heart failure worsens due to lack of nutrition and swelling. It dries, peels, and cracks may occur. To avoid suppuration, cracks are treated with iodine. Keep the skin clean by wiping it with a wet cloth twice a day. Bathing in the bath puts a strain on the heart, so it is only possible if the patient is in stable health.
• The patient should be weighed every morning after going to the toilet before breakfast. If the patient's condition is poor, weighing is carried out while sitting. The results are recorded to evaluate the dynamics. In this way, body weight is controlled and edema is detected in time. Swelling can also be checked by pressing a finger on the shin. You can talk about serious swelling if the finger mark does not go away for a long time. The abdominal girth is measured: up to several liters of water can accumulate in the abdominal area, which will put pressure on the internal organs. Hidden edema is determined by water balance: the amount of urine excreted is correlated with the amount of fluid consumed.
• The regularity of bowel movements is monitored. For constipation, with the doctor's permission, an enema or laxatives are taken.
• The patient's pulse is measured and assessed daily. Rhythm is judged by the intervals between shocks: with normal pulsation they should be equal. The number of pulse beats per minute is counted. Normally, this figure ranges from 60 to 90. To have an idea of ​​​​the stability of the pulse, it is assessed over time. The filling of the pulse is determined: a good pulse has clearly visible beats, which means that the artery is well filled with blood. Pulse examination is carried out on the radial artery and both arms. U healthy person it is the same on both sides.
• Blood pressure is measured in both arms. The procedure is carried out in a calm atmosphere. The patient should lean on the back of the chair and relax. The threshold value is 140/90 mmHg;
• If the patient experiences shortness of breath or attacks of suffocation, you should immediately call a doctor, place the patient in a sitting position, remove clothing and provide an influx of fresh air. If there are no contraindications, give a nitroglycerin tablet.
• When fainting, the patient is placed in a horizontal position, with the legs being higher than the head so that the blood flows to the head. You need to bring cotton wool soaked in ammonia to your nose and sprinkle water on your face.

When caring for a patient with heart failure, it is important to maintain stable emotional condition. To do this, you need to provide a calm environment, listen, support, and avoid unpleasant conversations in the presence of the patient.

Heart failure worsens a person's life and can be fatal. The disease is so serious that it requires continuous therapy throughout life. The success of treatment depends on how willing the patient is to take part in the process. Therefore, visiting a doctor and diagnosing the disease should become a regular and familiar ritual.

One of the common manifestations of almost all heart diseases is heart failure. The inability of the heart muscle to pump volumes of blood leads to serious health problems.

How to treat heart failure with medications?

A patient with this diagnosis does not have to take all medications recommended to treat the disease.

Causes

Heart failure often accompanies diseases such as atherosclerosis, arrhythmia, myocardial infarction and congenital heart defects. Taking into account the decrease in the functionality of one or another ventricle of the heart, several forms of the disease are distinguished:

• Left ventricular failure;
• Right ventricular failure;
• Biventricular failure (contractility of both ventricles is impaired).

In most cases, doctors attribute the occurrence of heart failure to an impairment in the ability to pump the required amount of blood or damage to the heart muscle itself. The main causes of this disease include high blood pressure (hypertension), coronary heart disease and defects. It is noteworthy that among women the cause of heart failure is more often arterial hypertension, while among men it is ischemia. Other factors that provoke the development of heart failure are:

• Diabetes;
• Heart rhythm disturbances;
• Myocarditis;
• Alcohol abuse and smoking.

If you do not consult a doctor in time with the question of how to treat heart failure, the disease can be complicated by cardiac asthma - very dangerous pathology, which is accompanied by attacks of suffocation and can threaten the patient’s life.

Symptoms

Depending on which part of the heart has stopped performing its functions, certain symptoms of heart failure appear. So, for example, when the left ventricle is malfunctioning, blood stagnation occurs in the lungs and pulmonary circulation, and when the right ventricle is dysfunctional, blood stagnation occurs in the systemic circulation. Characteristic symptoms heart failure are:

• Dyspnea. On initial stages it occurs after physical exertion. But as the disease progresses, shortness of breath begins to occur at rest;
• Difficulty in breathing. Night attacks of coughing and suffocation occur due to the redistribution of blood from the abdominal organs and lower limbs into the lungs when lying down;
• Decreased daily urine volume. Diuresis in in this case caused by a decrease in blood supply to the kidneys. Sometimes night diuresis increases, since when lying down, blood circulation is normalized;
• Cyanosis (blue discoloration of fingers, toes, lips);
• Swelling of the extremities;
• Pain in the right hypochondrium.

Increased fatigue and decreased performance are also significant symptoms of heart failure.

Treatment

The solution to the question of how to treat heart failure has long been found. In this case, various groups of drugs are widely used:

• Beta blockers. Reduce blood pressure and reduce heart rate, thereby preventing heart overload;
• Glycosides. Helps reduce the main symptoms of heart failure. To obtain a quick effect in the acute form of the disease, glycosides are administered intravenously;
• Diuretics. Eliminate the consequences of heart failure - in particular, edema, removing excess fluid from the body with urine.

Antiarrhythmic drugs, statins, anticoagulants and others are also used in the treatment of heart failure. However, there is no need to take them all.

The video below contains recipes folk remedies for the treatment of heart failure:

How to treat heart failure, which drugs should be taken and which should not, will be determined by the attending physician. Based on the existing symptoms, as well as the general health and lifestyle of the patient, the specialist will select the most effective medications.

Lifestyle

For patients diagnosed with heart failure, it is very important to take care healthy way life. It directly affects not only the progression of the disease, but also the healing process. To quickly get rid of dangerous symptoms heart failure, you must adhere to the following recommendations:

• Weight control. Excess body weight is one of the factors contributing to increased blood pressure, which, in turn, cannot but affect the functioning of the heart muscle;
• Dieting. First of all, patients with this diagnosis should avoid eating salt, marinades and pickles, which contributes to fluid retention and increases the load on the heart;
• Regular exercise. To avoid overload when choosing physical activities consult a specialist;
• To give up smoking;
• Limit alcohol consumption and, if possible, avoid strong alcoholic drinks.

Treatment of heart failure

How to treat heart failure?

As is known, acute and chronic heart failure are among the leading causes of mortality from cardiovascular diseases, which, due to the extreme prevalence of this type of pathology, makes the treatment of these two conditions a very serious problem. What is the treatment of heart failure, what is the role of the doctor, and what can the patient do? What are the chances of survival for a patient with heart failure? We devote this article to these and other issues related to the treatment of heart failure.

Is heart failure curable?

The first thing you need to understand when faced with the problem of heart failure (acute or chronic) is that this condition is by no means an independent disease, in the classical sense of the word, but only a set of symptoms and clinical signs that describe the state of cardiac dysfunction for one reason or another, or against the background of a particular disease (or diseases). That is, heart failure is always a consequence of other diseases. If we transfer these considerations to the field of treatment of heart failure, it becomes clear that on the one hand we need to deal with the symptoms of heart failure itself ( symptomatic treatment), and on the other hand, it is necessary to treat the underlying disease that undermines the work of the heart, that is, the cause of heart failure (see Causes of heart failure).

In light of the above, we can conclude that heart failure is curable to the extent that the cardiovascular disease that provoked it is curable.

Taking into account the fact that acute heart failure refers to emergency conditions medicine that requires urgent qualified intervention by cardiologists, we would like to focus in this article on the treatment of chronic heart failure, as well as methods of its prevention.

What are the main areas of treatment for heart failure?

Treatment of heart failure and the disease that provokes it is always a complex and time-consuming process. The main directions (goals) of treatment of heart failure are:

• Elimination of symptoms of the disease (symptomatic treatment);
• Protection of the organs most affected by heart failure (kidneys, brain, blood vessels);
• Improving the quality of life of patients and prolonging their life.

Achieving these goals becomes possible with the help various methods treatment carried out under the supervision of a specialist doctor observing the patient.

How do you start treating heart failure?

Treatment of chronic heart failure begins with the elimination of risk factors that worsen the prognosis of this disease. To achieve good results, it is important that a patient with heart failure:

• Quit smoking and alcohol;
• Followed the doctor's instructions for the treatment of arterial hypertension and other diseases of the cardiovascular system;
• Has taken measures to reduce body weight if he is obese;
• Reduced table salt consumption to a minimum;
• Followed a diet low in cholesterol and animal fats;
• I diversified my life as much as possible with physical activity.

Exercise for heart failure

Contrary to the deep-rooted belief that patients with heart failure should be protected as much as possible from all kinds of physical activity, there are currently a number of reports proving that moderate and balanced physical activity not only improves the general condition of the patient with heart failure, but also slows down the development of heart failure itself. diseases. On the contrary, a complete cessation of physical activity leads to a significant decrease in physical potential sick and actually makes him disabled. In case of heart failure, physical effort is contraindicated only if there are clear signs of an unfavorable course of the disease, severe edema (FC IV-III). For heart failure, walking, breathing exercises, and swimming are especially useful. It is important that physical activity does not tire the patient. If after “training” the patient complains of weakness and fatigue, then the level of stress must be reduced.

Diet for heart failure

Heart failure often occurs against the background of various metabolic disorders. For example, diabetes mellitus (impaired metabolism of carbohydrates and fats) is quite often combined with heart failure, and disturbances of water-salt metabolism (retention of water and salts in the body) can generally be considered an integral part of the heart failure syndrome. We also add that such metabolic disorders significantly complicate the course of heart failure. That is why in the treatment of heart failure much attention is paid to nutritional treatment. The principles of nutritional treatment of heart failure are:

1. Limiting the consumption of foods rich in cholesterol and animal fats;
2. Limiting the total calorie content of food (up to 1900-2500 kcal) and avoiding foods rich in easily digestible carbohydrates (sweets, flour products, sweet fruits, honey);
3. Limiting salt consumption (up to 5-6 g per day, including salt already contained in prepared dishes and products);
4. Limit fluid consumption to 1.5 liters. (including liquid dishes, tea, juices, etc.). A more severe restriction of fluid intake can only aggravate the patient's condition and is therefore not recommended.
5. Eating foods rich in potassium: raisins, dried apricots, bananas, potatoes, peaches, oatmeal, buckwheat).
6. Enrichment of food with foods high in polyunsaturated fatty acids: vegetable oils, olives, fatty fish.

Heart failure

DESCRIPTION

Heart failure is called arising as a result various reasons a condition in which the contractility of the heart muscle (myocardium) is weakened and the heart loses its ability to supply the body required quantity blood. Heart failure syndrome complicates many diseases of the cardiovascular system, and the disease develops especially often in people suffering from coronary heart disease and hypertension. Heart failure in many cases reduces a person's quality of life or can cause death.

CAUSES

The most common cause of heart failure is various diseases of the cardiovascular system.

A common cause of heart failure is narrowing of the arteries. supplying oxygen to the heart muscle. Vascular diseases develop in relatively at a young age, sometimes they are left unattended, and then elderly people often experience manifestations of congestive heart failure.

Chronic heart failure syndrome can complicate the course of almost all diseases of the cardiovascular system. But its main causes, accounting for more than half of all cases, are ischemic (coronary) heart disease and arterial hypertension, or a combination of these diseases. Often, cardiologists in their practice note the occurrence of heart failure syndrome during heart attacks and angina pectoris.

Other reasons causing the development of heart failure are changes in the structure of the heart valves, hormonal disorders(for example, hyperthyroidism - excessive function of the thyroid gland), infectious inflammation of the heart muscle (myocarditis). Myocarditis can manifest itself as a complication of almost any infectious disease: diphtheria, scarlet fever, polyarthritis, lacunar tonsillitis, pneumonia, polio, influenza, etc. It is this fact that serves as further confirmation that there are no “frivolous” viral infections, and each requires qualified treatment. Otherwise, they cause serious complications on the heart and blood vessels.

During pregnancy in women with various vascular or heart diseases, increased load on the heart can also trigger the development of heart failure.

Chronic heart failure can also be caused by alcohol and drug addiction, excessive physical activity, and even a sedentary lifestyle.

There is a high risk of heart failure syndrome in diabetes mellitus and diseases of the endocrine system in general.

In general, we can say that heart failure is provoked by diseases in which the heart muscle is overloaded with pressure (as in hypertension) or volume (heart valve insufficiency), as well as direct myocardial diseases (myocarditis, heart attack).

SYMPTOMS

The main and most noticeable manifestations of heart failure syndrome include shortness of breath, which sometimes occurs even at rest or with minimal physical activity. In addition, the possibility of the disease is indicated by increased heartbeat, increased fatigue, limited physical activity and excessive fluid retention in the body, causing swelling. Insufficient blood supply to the body is also the basis of such a clear sign of heart failure as blueness of the nails or nasolabial triangle (not in the cold, but at normal temperatures).

The inevitable result of heart failure is the appearance in the body of various abnormalities in blood circulation, which are either felt by the patient himself or determined by a cardiologist during examination.

TREATMENT

Limiting physical activity, diet rich in proteins and vitamins, potassium with limited sodium salts (table salt). Drug treatment includes taking peripheral vasodilators (nitrates, apressin, corinfar, prazosin, capoten), diuretics (furosemide, hypothiazide, triampur, uregit), veroshpiron, cardiac glycosides (strophanthin, digoxin, digitoxin, celanide, etc.).