Heart failure : causes, symptoms , diagnosis, treatment
Cardiovascular Diseases / / August 12, 2017
Heart failure video
The heart is a muscular organ that works like a pump, to pump blood to all parts of the body, and to supply the organs and tissues with oxygen and essential nutrients.
case of violation of the heart's ability to pump blood develop heart failure.
cardiac cycle consists of diastole and systole.During diastole, the ventricles - of the heart chamber, relax and fill with blood coming from the atria.During systole the ventricles are expelled, they contain blood in the pulmonary trunk and aorta.If it is impossible to throw out the required amount of blood ventricular systolic heart failure develops.In that case, if the ventricle is unable to relax, in order to completely fill with blood, there is diastolic heart failure.
Cardiac involvement may be a right-hand - right-sided heart failure is associated with right ventricular overload;left-handed - left-sided heart failure - is a result of left ventricular overload.
The left ventricle is the major pumping chamber, and the occurr
pumping function of the myocardium, the fluid may accumulate in the lungs, liver, gastrointestinal tract, hands and feet.This is called congestive heart failure.
distinguish chronic and acute heart failure.
Chronic heart failure occurs as a result of cardiovascular disease has a long course and progresses over time.Damaged tissue change their density and structure, so that the heart is unable to cope fully with the function of pumping blood.
Acute heart failure usually develops suddenly in a short period of time is enhanced shortness of breath, breathing becomes rapid and whistling, the skin turns blue, blood pressure jumps, pinkish frothy sputum may appear on the lips.This condition poses a serious threat to the life of the patient and requires immediate hospitalization in the intensive care unit.
cause of congestive heart failure are factors such as heart attack, blood clot in the lungs, allergic reactions and severe infection, etc ..
Pathological processes that damage the heart muscle, as a rule, are irreversible, but a healthy lifestyle, drug therapy, permanentfollow-up, a cardiologist can control the physical condition, improve its performance and maintain full quality of life.
Signs and symptoms of heart failure
Symptoms of heart failure are not immediate.Initially, they may assert itself only during exercise, over time, you may find breathing problems and other symptoms, even in a period of rest.
Symptoms of chronic heart failure:
- swelling in the legs, ankles, sometimes on the abdomen; Weight gain due to fluid retention;
- Shortness of breath and cough;
- Heart palpitations;
- Urging to urinate during the night;
- Fatigue, weakness, dizziness;
- Loss of appetite;
- Shortness of breath during physical activity or after you go to;
- Increase in liver;
- nighttime awakenings due to shortness of breath;
- Reduction of health;
- Difficulty concentrating.
During prolonged heart failure manifests a greater number of symptoms, and they tend to be more pronounced.
Causes of heart failure
to heart failure can cause any heart disease.Damaged tissue becomes more rigid and sealed, and the heart is unable to cope fully with the function of pumping blood.
Common causes of heart failure:
- Coronary artery disease, narrowing of the small blood vessels that supply blood and oxygen to the heart muscle;
- High blood pressure that is not controlled;
- Congenital heart disease;
- Heart attack;
- valvular heart disease;
- Infections that weaken the heart muscle;
- Severe anemia;
- The high content of iron in the body;
- Diseases of the thyroid gland;
- Cardiomyopathy (heart muscle damage caused by infections, diseases such as rheumatoid arthritis or lupus, as well as abuse of alcohol or drugs)
- Myocarditis (inflammation of the heart caused by a viral infection).
Risk Factors heart failure
There is a high risk of developing heart failure if you:
- Hypertensive heart disease;
- there are any heart disease, and you have had a heart attack;
- taking certain medications;
- abuse alcohol, smoking or taking drugs.
Diagnostics heart failure
Diagnosis of the disease involves a comprehensive approach.
- Physical examination. On physical examination, the patient is examined chest.You will hear a work of the heart and lungs.Your doctor will examine you for signs of heart failure:
- Fast breathing or trouble breathing;
- Swelling of the hands and feet;
- Varicose veins in the neck;
- specific sounds from the accumulation of fluid in the lungs;
- Accumulation of fluid in the abdominal cavity;
- Accumulation of fluid in the liver, which expressed her tenderness;
- Irregular or rapid heartbeat and unusual heart murmur.
- Research. diagnostic tests for heart failure:
- Blood tests to check kidney function and thyroid;
- Echocardiogram: allows you to determine the type of heart failure - systolic or diastolic heart failure;
- Determination of ejection fraction, to see how much blood your heart can pump out;
- Electrocardiogram (ECG) - reveals heart rhythm problems;
- tomography to determine the extent of damage to the heart muscle, and how well the heart is able to pump blood;
- Coronary angiography - reveals the narrowed artery.
- Chest X-ray to determine whether there is enlargement of the heart and fluid accumulation in the lungs - two factors that are often associated with heart failure.
Treatment of heart failure
Drug therapy can significantly ease the work of the heart: to expand the blood vessels, normalize heart rhythm, necessary to replenish potassium, reduce the risk of heart damage, rid the body of excess fluid and salt.
Medicinal preparations for the treatment of heart failure
purpose of drug therapy for heart failure is:
- to minimize the clinical symptoms, such as fatigue, arrhythmia, dyspnea, edema, etc .;
- protect blood vessels, heart, kidneys, brain damage;
- improve quality of life;
- reduce the number of hospitalizations and prolong life.
The main drugs used to treat heart failure include ACE inhibitors (ACEI), cardiac glycosides, b-blockers, diuretics, antianginal agents.
- ACE inhibitors. These drugs have contributed to increasing coronary blood flow, with prolonged use leads to a decrease in the severity of myocardial hypertrophy.They dilate blood vessels, reducing blood pressure, and heart work easier to pump blood.
ACE inhibitors include:
- Benazepril (Lotenzin);
- captopril (hood);
- fosinopril (Monopril);
- Lisinopril (Zestrill);
- enalapril (Vasotec).
- Antagonists of angiotensin II receptors. For patients who can not take ACE inhibitors, are a good alternative to an angiotensin II receptor antagonists (ARBs):
- irbesartan (Avapro);
- Candesartan (Atacand);
- Losartan (Cozaar);
- Valsartan (Diovan).
- Cardiac glycosides increases the strength of cardiac contractions, helping the heart to pump more blood, improves diuresis (mochevyvedeniya), help to better tolerate exercise, contribute to the improvement of clinical symptoms and slow the progression of the disease.They are very effective drugs, but they must be used with great caution and under medical supervision.
This group of drugs includes:
- b-blockers - help to reduce the heart rate, improve blood circulation, lower blood pressure.
- acebutolol (Sektral);
- Atenolol (tenormin);
- bisoprolol (Zebeta);
- Carvedilol (Roper);
- Propranolol (Inderal);
- metoprolol (Lopresor).
- Diuretics. diuretics or diuretics deduce the excess fluid from the body, thereby removing the swelling and reducing the load on the heart.There are different types of diuretics (loop, thiazide, thiazide).Diuretics negative feature is that they are other than water excrete potassium and magnesium, the lack of which may worsen the patient's condition.Therefore, the use of diuretics is necessary to compensate for the deficiency of micronutrients.
The most popupulyarnym diuretics include:
- Thiazides: chlorothiazide, chlorthalidone, indapamide, hydrochlorothiazide, metolazone.
- Loop diuretics: bumetanide, furosemide (Lasix), torasemide.
- Potassium-sparing diuretics: amiloride, spironolactone, triamterene.
Available as diuretics, which contain a combination of two or more drugs.
During reception of diuretics, it is necessary to check the kidneys and control the level of potassium.
Due to the increased frequency of urination, try not to take diuretics in the night.Take them every day at the same time.
- antianginal drugs - dilates blood vessels, help to reduce the heart's need for oxygen and at the same time increase its delivery, lead to a decrease in ventricular wall stress, cause a reduction in pressure in the pulmonary circulation, improve the systolic function of the heart.
- isosorbide dinitrate;
- hydralazine hydrochloride.
Medicines not recommended for use in heart failure
Medications that may worsen heart function:
- Ibuprofen (Advil, Motrin);
- naproxen ((Alevi, Naprosyn);
- Sildenafil (Viagra);
- Tadalafil (Cialis);
- Vardenafil (Levitra)
Surgical treatment of heart failure
- Coronary artery bypass grafting or angioplasty with stenting or.without - can improve blood flow to the damaged or weakened heart muscle
-. Surgery of heart valves
-. Pacemakers allow to maintain a stable heart rhythm
-. Defibrillator - a medical device, which by means of electrical pulses, eliminating life-threatening abnormal heart rhythms
. -. heart transplantation
End-stage heart failure
heart failure - a chronic condition that can worsen to develop severe heart failure, where the drug therapy, and others, including surgical techniques over time, some people already.are not effective.
Many patients are at risk of dying of the disease.At this stage typically requires a heart transplant.The waiting period
heart transplant, many patients require the use of special devices such as:
- implanted defibrillator to restore a normal heart rhythm;
-intraballonny pump (HAC), which supports heart function;
- artificial left ventricle - which allows to extend the patient's life and improve its quality.
Nutrition and dietary supplements heart failure
Selection of additional dietary supplements for patients with heart failure should be conducted jointly with the cardiologist, taking into account all the individual characteristics of the disease.
- Magnesium necessary to maintain heart health.This trace element is especially important for normal heart rhythm and is often used by physicians to treat irregular heartbeat (arrhythmias).Patients with heart failure often at risk of developing an arrhythmia.In addition, certain diuretics (diuretics) can lead to loss of magnesium.For this reason, the doctor may recommend supplements containing the trace element.
- Carnitine (500 mg 2 times a day) - Some early studies have shown that L-carnitine supplementation can reduce the likelihood of developing heart failure after a heart attack and to improve the condition during exercise if you already have heart disease.Carnitine - a substance that helps the body convert fatty acids into energy used for muscular work of the whole organism.
- Coenzyme Q10 (CoQ10, 100 - 200 mg per day) - CoQ10 levels may be low in people with heart failure.A number of studies have shown that CoQ10 supplements may help reduce swelling in the legs, improve breathing by reducing fluid in the lungs, and increase the body's exercise tolerance in people with heart failure.However, serious research in this area has been conducted, so for security purposes, consult with a specialist before you start taking this supplement.
- Creatine is an amino acid produced by the body.It contained mainly in muscles.According to the results of some studies in patients who received creatine in addition to the basic treatment, an improvement in muscle function and endurance.However, more research is needed on the effectiveness of creatine supplementation for patients with heart failure.
- Vitamin B1 (thiamine) Low levels of thiamine can contribute to the development of heart failure.Patients with severe heart failure can lose significant amounts of weight, including muscle (called cachexia) that is the cause of many nutrient deficiency, including thiamine.In addition to loss of thiamine can lead receiving diuretics.
- Amino Studies show that amino acids are useful for the normal operation of the heart, but research is needed on the effectiveness of their additional admission for heart failure:
- Arginine makes the body resilient to physical stress, increases levels of nitric oxide in the blood, improvingcirculation.
- Taurine improves the contractility of the heart, reduces the volume of the left ventricle.
Herbs used in heart failure
The use of herbs for the treatment of cardiovascular disease should be performed with caution, since the herbs can cause various side effects and interact with other herbs, supplements, and medications.For this reason, herbal treatments must be carried out only under the supervision of a doctor - a cardiologist.
- Hawthorn. flowers and berries are traditionally used for the treatment of cardiac arrhythmias, hypertension, chest pain, atherosclerosis (hardening of the arteries) and heart failure.