Cardiac asthma

Cardiac asthma is a severe clinical syndrome, which is the appearance of sudden attacks of suffocation. The main reason for an attack of cardiac asthma is a violation of the functioning of the left side of the heart( acute left ventricular failure), which occurs most often against the background of the course of diseases of the circulatory system.

Cardiac asthma is characterized by a decrease in the performance of the myocardium and, as a consequence, stagnant conditions in the small circle of the circulation. The latter cause acute disorders in the respiratory and circulatory systems. The risk group includes people over 60, but the appearance of seizures at a young age is possible, as recently there has been a trend towards an increase in the incidence of cardiovascular diseases among young people.

Cardiac asthma causes

The determining causes for this syndrome are acute left ventricular failure, mitral stenosis( narrowing of the mitral valve), aortic insufficiency. Deterioration of the left ventricle leads to interstitial edema of the lungs, which causes disturbances in the process of gas exchange in the lungs. There is shortness of breath, there are cases of reflex bronchospasm, which also aggravate the process of breathing. Disturbances in the work of the left heart can be caused by the presence of an atrial thrombus or myxoma( intracavitary heart tumor).

These pathological processes usually occur at any disease of the circulatory system: myocarditis, acute coronary syndrome, aortic heart defects, postpartum cardiomyopathy, hypertension, arrhythmia, Cardiosclerosis, heart aneurysm, etc. Dangerous paroxysmal ups of blood pressure( BP) with a large load. On the myocardium of the left ventricle( hence its overstrain, for example, in the case of pheochromocytoma).Risk detection

cardiac asthma attack has with increasing circulatory volume( fever, physical load), the circulating blood volume( delivery into the human body of a large amount of fluid during pregnancy), when the patient in a prone position, a strong emotional disorder. In all cases, the flow of blood to the lungs increases. Before the attack, patients often feel discomfort in the chest area in the form of constriction, palpitation is felt, a cough is possible.

in the development of cardiac asthma guilty and some extracardiac causes: infections( pneumonia, septitsiemii), acute circulatory disorder in the brain, acute glomerulonephritis( a kidney disease), heavy dependence on psychoactive substances, bronchial asthma, etc. An attack may occur as a post-operative complication..Cardiac

asthma symptoms

main signs of cardiac asthma during wakefulness are breathlessness, cough, chest tightness sensation during low physical activity, during mental stress or overeating, adopting a horizontal position.

However, in most cases, an attack of cardiac asthma catches a person by surprise at night, because during admission the adrenergic regulation is weakened and the flow of blood to the lungs increases. The patient wakes up from lack of air, dyspnea increases, which becomes choking. There is a dry cough with the separation of a later clear sputum or sputum of a pinkish stain with blood veins. The respiratory rate increases - the number of respiratory movements is 40-60 / min. At a rate of about 20 / min.

In a fit of cardiac asthma a person is forced to take a vertical position, sitting on the bed, as a result of this action is decreased shortness of breath( orthopnea), that brings some relief to the person. Breathing a patient through the mouth, speech is difficult. The lungs are heard whistling dry rales( in the case of bronchospasm), finely crackles( while listening to the chuck area, wheezing on both sides or only on the right side).

Auscultation of the heart becomes a time-consuming process, as when listening there are noises and rales. Nevertheless, when listening you can find out the deafness in the heart tones, single rattles or wheezing of a diffuse species. It is possible to identify the signs of a leading disease( failure of valvular valves, aortic valves, a violation of the rhythm of the heart).X-ray examination of the chest will detect signs of stagnant blood in the veins and excess blood in the small circle of the circulation. The pulmonary fields are transparent, the roots of the lungs can be enlarged and blurred on the roentgenogram.

A sudden awakening due to an attack causes the patient to be agitated, anxious, panicking, growing into a fear of death. Therefore, often patients with cardiac asthma are characterized by inadequate behavior, which complicates the process of providing them with first aid. Examination of the patient allows you to detect cyanosis in the nasolabial triangle, cyanosis of finger phalanges, an increase in diastolic blood pressure, and tachycardia.

An attack of cardiac asthma usually lasts a few minutes or it can take up to 2-3 hours. The frequency of attacks and their feature depends on the flow of the main disease:

- in case of mitral stenosis seizures are rarely observed due to the presence Reflex Kitaeva( reflex narrowing of pulmonary alveoli, which hinders the occurrence of stagnation in the capillaries, the venous line)

- seizures in acute right heart failureCan completely pass.

Long attacks of cardiac asthma cause the appearance of "gray" cyanosis, cold sweating, cervical veins swell. There is a threadlike pulse and a drop in blood pressure, the patient feels a breakdown.

Cardiac treatment When asthma

cardiac asthma due to increased permeability of the capillaries is extensive plasma flow in lung tissue, particularly in perivascular, peribronchial space. In connection with this, interstitial pulmonary edema develops. The result of this process is a violation of ventilation of the lungs and normal gas exchange between the lung alveoli and blood.

A separate role in the occurrence of an attack in the neuroreflex links of the regulation of the breathing process, blood circulation in the brain. Stimulation of the respiratory center due to irregularities in its blood supply or rejection reflex character( response to pulses of stimulation foci) entails the development of the vegetative symptoms during cardiac asthma. In

with bronchial asthma the treatment of cardiac asthma is necessary to conduct the differential diagnosis of this disease( as well as with acute laryngeal stenosis, mediastinal syndrome, shortness of breath with uremia, hysterical seizure).It compares with cardiac asthma with other manifestations of allergy.

Asthma attacks occur with small changes in the respiratory rate, which is significantly hampered, and with an extended expiratory time. Sputum when coughing in consistency resembles a viscous mucus. At exhalation swelling of veins of a neck which during an inspiration decreases is marked. There are signs of emphysema of the lungs( percussion), dry wheezes( during auscultation).

effectively in the differential diagnosis of ECG at the time of carrying out the attack, the study of cardiac asthma clinic, collecting the patient's medical history, conduct physical examination and chest x-ray.

If it is not possible to provide emergency medical care in case of an attack, a paramedic, a nurse, is engaged in urgent therapy of cardiac asthma. Preliminary preparation of the patient is reduced to its convenient location( half-sitting) and release of the neck and abdomen to facilitate breathing.

After this, the following agents can be used:

- administration of Furosemide intravenously;

- use of narcotic analgesics( Pantopone, Morphine).Analgesics are administered in combination with Atropine, in the case of tachycardia - along with Pipolphen, Suprastin instead of Atropine;

- if bronchospasm, brain edema and other complications developed, a neuroleptanalgic( Droperidol) is used;

- if you need to reduce the load on a small circle of blood circulation is allowed to bleed to 0.5 liters of blood;

- application of harnesses( if there are no contraindications);

- inhalation of oxygen for a long time, which must be repeated( carrying out the procedure through ethyl alcohol with a mask, nasal catheters);

- adjustment AD( use of antihypertensive drugs, use of diuretics;.

- the use of cardiac glycosides( digoxin, Strophanthin)

attack results cardiac asthma is mainly determined, the flow of the underlying pathology, which leads to seizures

most cases, prediction of cardiac asthma. However, the prevention of recurrence of seizures is possible during complex treatment and strict adherence to the patient's medical prescriptions.alive the normal condition of the patient, remains in operation for several years.

Carrying out the treatment of chronic ischemic heart disease, arterial hypertension, inadmissibility of the development of infectious diseases, as well as following the water-salt regime are the basis for the prevention of cardiac asthma and its attacks.

Cardiac asthma emergency care

At the first sign of cardiac asthma, you should call an ambulance, and in anticipation of her arrival - to give the patient first aid.

To reduce the load on the heart, to facilitate breathing, the patient is given a semi-sitting position, it is also necessary to release the throat and the whole body from the compressing garments( unfasten the collar, loosen the belly belt, if any, etc.).The patient is best placed at the open window for fresh air. It is recommended to make a bath for the feet, which will have a calming effect on the patient.

Before the ambulance arrives, the blood pressure should be controlled all the time( if a person has had problems with the cardiovascular system before the case with an attack of cardiac asthma, then a tonometer with a high probability will be present in his house).It is recommended to give the patient nitroglycerin. The tablet is kept sublingually( that is, under the tongue) until it completely dissolves. After 5 minutes, the manipulation can be repeated, no more than 2 times. If you have a spray with nitroglycerin, you should give it preference. If the preparations containing Nitroglycerin are absent nearby, give the patient a tablet of Validol.

Effective with first aid is the application of venous tourniquets, after 5-10 minutes as a patient was brought into a semi-sitting condition. If a special tourniquet is missing, its role can be made by elastic bandage, kapron stocking. The bundles are superimposed simultaneously in the number of 3 pieces: on both feet and arm. When applying a tourniquet on the legs, it is placed 15 cm from the inguinal fold, on the arm the location of the harness is 10 cm from the shoulder joint. After 15 minutes, change the location of one bundle by placing it on a free limb. The application of harnesses is used to create stagnation of blood in the limbs, thereby reducing the burden on the heart, reducing the likelihood of pulmonary edema. Correct application of the harnesses is monitored by checking the pulsation of the arteries, on which the pulse should be perceptible when probing below the harness location. Finiteness after compression by a tourniquet in some minutes gets purple-cyanotic coloring.

A patient with an attack of cardiac asthma should be hospitalized in a hospital, despite the fact whether the attack was able to stop before the arrival of medical emergency workers. The main cause of the development of an attack of cardiac asthma will be found in the hospital, after which the doctor will prescribe the appropriate treatment.

Self-medication at home and access to traditional medicine are strictly prohibited. This can lead to complications of the disease or lead to a completely fatal outcome.