Diastolic dysfunction of the left ventricle types signs of treatment

Ventricular dysfunction is more often an age-related disorder and occurs mainly in older people. Women are especially susceptible to this pathology. Diastolic dysfunction of the left ventricle causes hemodynamic disturbances and atrophic changes in the structure of the myocardium. The period of diastole is characterized by muscle relaxation and the filling of the ventricle with arterial blood. The process of filling the heart chamber consists of several stages:

  • relaxation of the heart muscle;
  • under the influence of the pressure difference from the atrium, the blood passively flows into the ventricle;
  • with atrial contraction, the remaining blood is abruptly expelled into the ventricle.

In case of violation of one of the stages, insufficient blood flow is observed, which contributes to the development of left ventricular failure.

Ventricular dysfunction is more often an age-related disorder and occurs mainly in older people. Women are especially susceptible to this pathology.

Diastolic dysfunction of the left ventricle causes hemodynamic disturbances and atrophic changes in the structure of the myocardium. The period of diastole is characterized by muscle relaxation and the filling of the ventricle with arterial blood.

The process of filling the heart chamber consists of several stages:

  • relaxation of the heart muscle;
  • under the influence of the pressure difference from the atrium, the blood passively flows into the ventricle;
  • with atrial contraction, the remaining blood is abruptly expelled into the ventricle.

Diastolic ventricular dysfunction can be caused by certain diseases that can significantly disrupt the hemodynamics of the heart:

  • Diastolic dysfunction of the left ventricle is a consequence of thickening of the heart muscle tissue (myocardial hypertrophy). As a rule, hypertrophy develops in people with hypertension, aortic stenosis and hypertrophic cardiomyopathy.
  • It can develop under the influence of pericarditis, due to which the thickened walls of the pericardium compress the chambers of the heart.
  • With pathological changes in the coronary vessels that cause coronary heart disease due to coarsening of the heart tissue and the appearance of scars.
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Especially often, the disease develops in people with diabetes or obesity. In this case, the pressure on the heart chambers increases, the organ cannot fully function and ventricular dysfunction develops.

Diastolic dysfunction of the left ventricle over time may practically not bother the patient. However, this pathology is accompanied by certain symptoms:

  • cardiopalmus;
  • cough, manifested more often in a horizontal position;
  • fatigue with habitual physical exertion;
  • shortness of breath at first accompanies only during physical exertion, then sharply arises even at rest;
  • heart rhythm disturbances, manifested by atrial fibrillation;
  • difficulty breathing (dyspnea) at night. 73b01e804bfae8141c17316a4956c48c - Diastolic dysfunction of the left ventricle types signs of treatment

If such symptoms are found, it is necessary to seek medical help and undergo an examination to identify the cause of the discomfort and eliminate the disease at the initial stage.

Since the disease gradually worsens the hemodynamics of the heart, several stages are distinguished:

  • Stage 1 is characterized by minor hemodynamic disturbances. Diastolic dysfunction of the left ventricle of type 1 causes a slowed down process of the transition of chambers from systole to diastole, the main volume of blood enters the ventricle during relaxation of its chambers.
  • 2nd stage – the filling of the ventricle is carried out due to the pressure difference, since at this stage the pressure rises reflexively in the left atrium.
  • Stage 3 – the pressure in the left atrium remains high, while the left ventricle becomes stiff, losing the elasticity of the fibers. fa082ff9a9ce10af651b7f732dd3d1d5 - Diastolic dysfunction of the left ventricle types signs of treatment

Diastolic dysfunction of the left ventricle type 1 is treatable, while subsequent stages of the disease cause irreversible changes in the work and physiological state of the organ. That is why it is necessary to consult a doctor at the first manifestation of the symptoms of the disease.

To identify physiological changes and disorders of the hemodynamics of the heart, it is necessary to conduct a full examination, which includes several diagnostics:

  • Echocardiography with additional dopplerography is the most accessible and informative method for examining the cardiovascular system. Using it, you can quickly />

Using the above methods, the types of diastolic dysfunction of the left ventricle are also determined.

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Treatment of the disease

To eliminate violations of the hemodynamic process and prevent the development of irreversible changes, it is necessary to prescribe drugs that help maintain optimal heart performance (blood pressure, heart rate). Normalization of water-salt metabolism will reduce the load on the heart. The elimination of left ventricular hypertrophy is also required.

After the examination, the attending physician will select a suitable complex of drugs that can maintain normal all indicators. Heart failure also plays an important role, the treatment of which requires compliance with a large number of medical recommendations.

Diastolic dysfunction of the left ventricle, the treatment of which requires high professionalism of the doctor and strict adherence to all his prescriptions, is rare in young active people. That is why, with age, it is important to maintain activity and periodically take vitamin complexes that help to saturate the body with the necessary trace elements.

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Diastolic myocardial dysfunction of the left ventricle, which is detected in time, will not do much harm to human health and will not cause serious atrophic changes in the heart tissue.

Symptoms

  1. Dyspnea. Appears at first only with intense physical activity, later at rest.
  2. Weakness, fatigue, decreased exercise tolerance.
  3. Violation of the heart rhythm, more often its acceleration or atrial fibrillation.
  4. Lack of air, compression in the chest area.
  5. Heart cough, worse when lying down.
  6. Swelling of the ankles.

At the initial stages of diastolic dysfunction, the patient is unaware of the impaired heart function, and the weakness and shortness of breath are attributed to banal fatigue. The duration of this asymptomatic period is different for each person. A visit to a doctor occurs only when tangible clinical signs appear, for example, shortness of breath at rest, leg swelling, affecting a person’s quality of life.

Diastolic myocardial dysfunction is not considered an independent disease. As a rule, this in itself is a sign of an already developing disease. This pathology leads to heart failure and is manifested by the following symptoms:

  • swelling of the legs;
  • high fatigue;
  • the appearance of shortness of breath even with little physical exertion. If manifested in a state of rest, then the disease has already passed into a serious form;
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Coughing can also be attributed to one of the symptoms of heart failure. Most often, he appears at night, indicating a congestion in the lungs.

Sazykina Oksana Yuryevna, cardiologist

In order for each cell of the human body to receive blood with vital oxygen, the heart must work correctly. The pumping function of the heart is carried out with the help of alternate relaxation and contraction of the heart muscle – myocardium.

If any of these processes are disturbed, dysfunction of the ventricles of the heart develops, and the ability of the heart to push blood into the aorta gradually decreases, which affects the blood supply to vital organs.

Developed dysfunction, or myocardial dysfunction.

Izuchenie narushenij diastolicheskoj raboty serdca javljaetsja aktualnoj zadachej - Diastolic dysfunction of the left ventricle types signs of treatment

Ventricular dysfunction is a violation of the ability of the heart muscle to contract with the systolic type to expel blood into the vessels, and relax with diastolic to take blood from the atria. In any case, these processes cause a violation of normal intracardiac hemodynamics (movement of blood through the heart chambers) and stagnation of blood in the lungs and other organs.

Both types of dysfunction are associated with chronic heart failure – the more ventricular function is impaired, the higher the severity of heart failure.

If heart failure can be without heart dysfunction, then dysfunction, on the contrary, does not occur without heart failure, that is, in every patient with ventricular dysfunction, there is chronic heart failure of the initial or severe stage, depending on the symptoms. This is important for the patient to consider if he considers medication to be optional.

You also need to understand that if a patient is diagnosed with myocardial dysfunction, this is the first signal that some processes are going on in the heart that need to be identified and treated.

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Diastolic dysfunction is a relatively new diagnosis. Until recently, even cardiologists rarely exhibited it. However, diastolic dysfunction is currently one of the most commonly detected heart problems with echocardiography.

Recently, cardiologists and therapists are increasingly setting their patients a “new” diagnosis – diastolic dysfunction. In severe cases of the disease, diastolic heart failure (HF) can occur.

Currently, diastolic dysfunction is detected quite often, especially in older women, most of whom are surprised to learn that they have heart problems.

Often, patients diagnosed with diastolic dysfunction may develop diastolic heart failure.

Neither diastolic dysfunction, nor diastolic heart failure are actually “new” diseases – they have always affected the human cardiovascular system. But only in the last decades, these two diseases began to be detected frequently. This is due to the widespread use of ultrasound methods (echocardiography) in the diagnosis of heart problems.

It is believed that almost half of patients admitted to the emergency department with acute heart failure actually have diastolic heart failure.

But to establish the correct diagnosis can be difficult, because after stabilizing the condition of such a patient, the heart may look completely normal during echocardiography, if the specialist purposefully does not look for signs of diastolic dysfunction. Therefore, inattentive and unguarded doctors often miss this disease.

The heart cycle is divided into two phases – systole and diastole. During the first ventricle (the main chambers of the heart), they contract, throwing blood from the heart into the arteries, and then relax. During relaxation, they are re-filled with blood to prepare for the next contraction. This phase of relaxation is called diastole.

The heart cycle consists of systole (contraction of the heart) and diastole (relaxation of the myocardium), during which the heart fills with blood

However, sometimes, due to various diseases, the ventricles become relatively “stiff.” In this case, they cannot completely relax during diastole. As a result, the ventricles are not completely filled with blood, but it stagnates in other parts of the body (in the lungs).

The pathological tightening of the walls of the ventricles and the resulting insufficient blood filling during diastole is called diastolic dysfunction. When diastolic dysfunction is so pronounced that it causes congestion in the lungs (that is, the accumulation of blood in them), it is considered that this is already diastolic heart failure.

Symptoms of the disease

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Diastole dysfunction may be asymptomatic for a long time before it begins to manifest clinically. The following symptoms are characteristic of such patients:

  • shortness of breath that occurs during physical exertion, then at rest;
  • cough worse in horizontal position;
  • reduced exercise tolerance, fast fatigue;
  • palpitations
  • paroxysmal night dyspnea;
  • rhythm disturbances are often present (atrial fibrillation).
  • cardiopalmus;
  • cough, manifested more often in a horizontal position;
  • fatigue with habitual physical exertion;
  • shortness of breath at first accompanies only during physical exertion, then sharply arises even at rest;
  • heart rhythm disturbances, manifested by atrial fibrillation;
  • difficulty breathing (dyspnea) at night.

    914637 - Diastolic dysfunction of the left ventricle types signs of treatment

    The method of treatment of the disease

    Laboratory researchInstrumental studies
    General, clinical blood testECG
    Biochemical analysisHolter ECG monitoring – ECG throughout the day
    Ultrasound of the heart with vascular dopplerography

    Among the additional measures, it is not excluded the study of thyroid function (determining the level of hormones), chest x-ray, coronarography, etc.

    The main problem for the effective treatment of the disease remains the restoration of full contractility of the body. Diastolic LV myocardial dysfunction includes drug and surgical therapy. Therefore, treatment has several main areas:

    1. stabilization of normal heart rate to prevent the development of arrhythmias;
    2. treatment of coronary disease;
    3. stabilization of blood pressure.
    Blockersaimed at normalizing heart rate, lowering blood pressure, improve the procedure for feeding myocardial cells
    Inhibitors or sartansthey work on myocardial remodeling, improve its elasticity, reduce the load. Significantly improve the results of analyzes of patients with permanent heart failure
    Diureticsremove excess fluid, reducing asthmatic manifestations, and also allow you to control blood pressure. The drug is prescribed in small quantities, since it leads to a decrease in stroke volume
    Calcium antagonistscontribute to myocardial relaxation, lower blood pressure
    Nitratesonly additional drugs that can be prescribed for myocardial ischemia

    The treatment process takes place in a hospital, where the state of the patient is monitored by medical personnel.

    A patient with a ventricular dysfunction should always follow a diet. To do this, limit salt intake, monitor the fluid you drink – this will reduce the load on the circulatory system. It is worth eating rationally, adhering to the regimen, you need to divide the food 4-6 times. You need to abandon fatty, fried and spicy.

    The treatment is aimed at correcting hemodynamic disorders

    It is also important to adjust your lifestyle: get rid of bad habits, do not overwork, get enough sleep. Pay attention to physical activity. Loads should be rational, consistent with the capabilities of the body. You need to spend more time outdoors. If the disease is complicated, it is necessary to exclude the load or consult a doctor.

    Subject to the recommendations of the doctor and taking medications, the prognosis of the disease is favorable.

    Forecast

    Violation of the diastolic function of the left ventricle cannot be completely stopped, but with adequate medication correction of circulatory disorders, treatment of the underlying disease, proper nutrition, work and rest, patients with such a disorder live a full life for many years.

    Despite this, it is worth knowing that such a violation of the heart cycle is a dangerous pathology that cannot be ignored. With a poor course, it can lead to a heart attack, stagnation of blood in the heart and lungs, and edema of the latter. Complications are possible, especially with a severe degree of dysfunction: thrombosis, pulmonary embolism, ventricular fibrillation.

    In the absence of proper treatment, severe dysfunction with severe heart failure, the prognosis for recovery is poor. In most such cases, it all ends with the death of the patient.

    With regular proper treatment, nutrition adjustment with salt restriction, monitoring of the state and level of blood pressure and cholesterol, the patient can count on a favorable outcome, prolonging life, and moreover, active.

    Development mechanism

    Diastolic dysfunction of the left ventricle is a violation of the normal process of filling the ventricle with blood during the period of relaxation of the heart (diastole). This type of pathology, as a rule, develops in old age, more often in women.

    Normally, blood filling consists of several stages:

    • myocardial relaxation;
    • passive blood flow from the atrium to the ventricle due to pressure differences;
    • filling as a result of atrial contraction.

    Due to various factors, one of the three stages is violated. This leads to the fact that the incoming blood volume is not able to provide an adequate cardiac output – left ventricular failure develops.

    Diagnosis of diastolic heart failure

    Diagnosing the disease at an early stage will help to avoid irreversible changes.

    To establish a diagnosis, as a rule, three conditions are necessary:

    • the manifestation of symptoms and signs of heart failure;
    • systolic function of the drug is normal or slightly reduced;
    • with instrumental diagnostic methods, LV malfunctions are detected, its rigidity is increased.

    Diagnosis in the early stages helps to prevent irreversible changes in the heart

    The main instrumental diagnostic methods include:

    • two-dimensional echocardiography with dopplerography is one of the most effective methods for determining the diagnosis;
    • radionuclide ventriculography will determine the failure of the myocardial contractility function;
    • Echocardiography reveals signs of myocardial ischemia;
    • chest x-ray will determine pulmonary hypertension.

    To avoid the development of most cardiac pathologies, it is necessary to adhere to a healthy lifestyle. This concept includes regular healthy nutrition, sufficient physical activity, the absence of bad habits and regular body tests.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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