In this case, it is rather difficult to establish a diagnosis, since the clinical picture indicates other diseases. For example, for bronchial asthma. At the same time, there may simply not be time for diagnostics.
If possible, then after a personal examination and clarification of the anamnesis, the patient is sent for diagnosis. The standard program includes such studies:
- Ultrasound of the heart and chest;
- duplex scanning;
- X-ray in 3 projections.
If these research methods are not enough for an accurate diagnosis, then differential diagnosis is used. No self-medication in this case is unacceptable.
The following are required to determine how to treat cardiac asthma.
When listening to the lungs, scattered or single rales can be determined, stagnation and plethora in a small circle are visible on the x-ray, on the ECG during cardiac asthma there is a decrease in the amplitude of the teeth and the ST interval,
, signs of coronary insufficiency.
The effectiveness of medical care will depend on the correctness of the diagnosis. The specialist will have to differentiate cardiac asthma from the following pathological conditions:
- mediastinal syndrome;
- laryngeal stenosis;
- fit of hysteria;
- shortness of breath with uremia (autointoxication syndrome);
- bronchial asthma.
According to generally accepted protocols, the diagnosis is made on the basis of the results of instrumental examination and examination. In the case of cardiac asthma, their basis is auscultation (listening with a phonendoscope), electrocardiography (ECG) and radiography. You can familiarize yourself with the features of these tests below:
- During auscultation, the doctor will hear a gallop rhythm characteristic of cardiac asthma, a frequent but weakened pulse, arrhythmias, and muffled heart sounds. Dry wheezing in the lungs is clearly distinguished.
- An x-ray of the thoracic region will allow you to see stagnant processes, reduced transparency of the pulmonary fields, the formation of Curly lines.
- Electrocardiography performed during an attack will show a decrease in the amplitude of the teeth and a reduction in the ST interval. Sometimes various failures in the heartbeat and manifestations of coronary insufficiency are recorded.
Bronchial asthma, in contrast to cardiac asthma, manifests itself for the first time at an early age, which is considered one of the main criteria for differential diagnosis. It is also characterized by the presence of allergic reactions and pathologies of the respiratory system against the background of the absence of ailments of the heart and blood vessels. Based on the above facts, the doctor will be able to make the correct diagnosis.
Prior to the examination, nursing assistance will be required. Patients usually arrive in serious condition, so it is important not to disturb their psycho-emotional background even more. The nurse will have to answer all questions and talk about the treatment procedures scheduled for the near future.
The diagnosis of cardiac asthma should be especially thorough, since it is important to distinguish this syndrome from bronchial asthma, from uremia, laryngeal stenosis, hysterical seizure and mediastinal syndrome. The doctor, in addition to a thorough examination and examination, should study the patient’s history, send him for an ECG and chest x-ray.
During an attack, listening to heart sounds is difficult, but you can determine their muffledness. Heart rhythm disturbances (gallop rhythm) are also heard, the second tone is accented above the pulmonary trunk. The pulse during the attack is weak, sometimes threadlike. Pressure first rises and then drops. In this case, single or scattered dry rales are heard in the lungs. The occurrence of single wet rales is possible.
An X-ray examination of the chest allows you to determine the presence of signs of stagnation of venous blood in the pulmonary circulation, the pulmonary fields will be less transparent, the roots of the lungs dilated, their necrosis is possible. The fact that there is interstitial edema will be indicated by the Curly line.
An electrocardiogram will detect arrhythmia, coronary insufficiency, a decrease in the amplitude of the teeth.
In order to make a differential diagnosis with asthma, it is first necessary to pay attention to when the first symptoms of the disease arose. So, cardiac asthma is most often manifested in old age. Moreover, the patient does not have an allergic history, there are no diseases of the respiratory system, but there is a cardiovascular pathology.
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In medicine, it is customary to distinguish three stages of the development of an ailment:
- the first is a harbinger of an attack. 2-3 days before the attack, the patient may complain of shortness of breath, symptoms may worsen with physical activity;
- the second is the attack itself;
- the third is pulmonary edema.
If you pay attention to the state of health in the first stage in a timely manner, then you can stop the attack and not be afraid for life. The last stage poses a serious threat to human life. This is due to the fact that the patient’s lungs are filled with liquid and it is almost impossible to breathe.
Emergency care for heart asthma
Although the attack can go away on its own, there is a high risk of developing pulmonary edema, so emergency first aid for cardiac asthma should be given to a person in place. It is important to suppress the excessive activity of the neuroreflective respiratory center, which is in an excited state, as soon as possible, to remove the emotional burden, and increase the outflow of blood from the pulmonary circulation.
Naturally, first of all, you need to call an ambulance, since such a condition poses a direct threat to the life of the patient.
Until the doctors arrived at the place of call, the person should be provided with maximum peace. To begin with, he should take an upright position, for this it is best to put him in a comfortable chair. Feet should be lowered. If there is such an opportunity, then you need to put the lower limbs in hot water. On the throat and on the body should not be objects that restrict breathing.
Nitroglycerin can alleviate the condition. To do this, put 2-3 tablets of the drug under the tongue, or pour 5-6 drops of this drug into the same place. Repeat administration of Nitroglycerin is allowed after 10 minutes. You can replace Nitroglycerin with one Corinfar tablet. In parallel, you need to control blood pressure. If neither one nor the other was at hand, then you can replace them with Validol.
Another effective first aid measure for a heart attack is the application of a venous tourniquet. This should be done 10 minutes after the person has taken an upright position. Replace the tourniquet can nylon pantyhose, elastic bandage, any bandage. Harnesses are placed on both legs and on the arm. The distance from the inguinal fold to the place of application of the tourniquet should be 15 cm on the leg, and on the arm – 10 cm from the shoulder.
Naturally, the sooner a person is hospitalized, the better. This is done even if the attack was stopped. In the future, treatment of the cause that this attack provoked is sure to be required.
Emergency care for cardiac asthma can save a person’s life, since not all attacks pass without complications. To know the generally accepted algorithm of actions for their relief should not only asthmatic, but also close people included in his environment. Rules for the provision of prehospital care:
- call an ambulance;
- ask the patient to crouch, hanging his legs down;
- open the windows so that the room is well ventilated;
- remove clothing tightening the chest and neck;
- measure heart rate and blood pressure;
- for pain in the heart, give the Nitroglycerin tablet;
- if possible, make a warm foot bath.
Giving “Nitroglycerin” sublingually (under the tongue) is necessary under strict control of blood pressure. If it falls below 90/60 mm Hg. Art., the drug is contraindicated. It is recommended to apply tourniquets to the lower limbs. They should be localized 15 cm below the inguinal fold. The severity of blood stagnation will decrease due to its slowdown in this area.
The ambulance team includes a driver, a doctor and 1-2 paramedics. They will have to support the life of a person before arriving at the clinic. Further actions are carried out in the intensive care unit.
With strong rapid breathing (excitation of the respiratory center) – subcutaneous or intramuscular administration of narcotic analgesics (morphine, omnopon).
Drugs are contraindicated in chronic pulmonary heart, right ventricular failure, acute airway obstruction, cerebral edema, pregnancy.
In case of pain with a pronounced psychomotor agitation, a combination of narcotic analgesics with neuroleptanalgesia (droperidol or haloperidol) is highly effective.
A combination of the above products with the use of a 1% diphenhydramine solution or 2,5% pipolfen solution is acceptable.
Mandatory hospitalization – only after emergency care and the cessation of an attack of cardiac asthma.
Strict bed rest, half-sitting position, which improves lung excursion.
The imposition of venous tourniquets on the limbs or bandaging them to redistribute blood in the body (depositing blood in the venous bed, thereby facilitating the work of the heart).
Nitroglycerin in tablets (preferably aerosol) under the tongue repeatedly after 3 minutes. Blood pressure control.
Long repeated inhalation of oxygen through ethyl alcohol, which helps to reduce pulmonary edema (antifoam effect).
Upon arrival of the cardiological ambulance team, an urgent relief of pulmonary edema is performed, while bloodletting in the amount of 300-500 ml of blood is indicated; usually carried out with arterial hypertension and venous congestion, as well as intravenous jet administration of diuretics, hormonal drugs.
Methods of therapy
|Severe pain, worse shortness of breath||Prescribing drugs with a narcotic-based analgesic effect (Morphine, Pantopon). Usually they are combined with Atropine.|
|Heart palpitations||The use of Suprastin or Pipolfen.|
|Cerebral edema, bronchospasm, respiratory failure, pulmonary heart||Substitution of narcotic painkillers with Droperidol.|
|Pulmonary congestion, high blood pressure||Using a bloodletting method that allows you to unload the pulmonary vessels and stabilize the pressure. For 1 procedure should not be released more than 500 ml of blood. |
The application of tourniquets to reduce the severity of symptoms. Keep them recommended no more than 30 minutes. It is important that a pulse wave can be felt below the tourniquet.
Prescription of diuretics (Indapamide, Furasemide) in combination with other drugs with antihypertensive effect to lower blood pressure.
|Pulmonary edema||Use of an oxygen inhaler passed through alcohol. The procedure is performed using special masks and nasal catheters. |
Transfer to artificial ventilation of the lungs is carried out with pronounced edema and a clear violation of the respiratory function of the patient.
|An attack of cardiac or bronchial asthma due to narrowing of the opening of the mitral valve||Appointment “Eufilina” in the form of a solution for injection.|
|Severe palpitations||Performing a defibrillation procedure to restore the sinus rhythm of the heart.|
Combine the voiced methods of therapy and therapeutic agents with the use of cardiac glycosides (Digoskina, Strofantina). They are administered intravenously to restore normal functioning of the heart muscle.
With a successful relief of an attack of cardiac asthma, the patient will have to be in the hospital for some time. Doctors will closely monitor his condition. It is not possible to completely cure heart failure, but its severity can be reduced and the patient can be transferred to maintenance therapy. Before discharge, the doctor will give recommendations regarding the future lifestyle and schedule the next visit.
Successful relief of an attack does not mean that a person should forget about treatment. The further treatment regimen depends on the underlying pathological process. Folk remedies are not able to cure the patient, but can improve his condition. You can prepare yourself an effective medicine without leaving your home, following these recipes:
- 60 g of St. John’s wort pour 500 ml of boiling water. After cooling, add 1 tsp. honey. Take 500 per day.
- In case of heart disease, it is recommended to drink goat milk. It is saturated with useful substances necessary for the body and can reduce the frequency of attacks.
- Take in equal proportions dogrose and coltsfoot and mix in 1 container. 1 tbsp. l the resulting mixture pour 250 ml of boiling water. After cooling, drink ½ cup 3-4 times a day.
- Mix 30 g of yarrow, corn stigmas and cinquefoil seeds. Further cooking and method of application is similar to the previous recipe.
- When brewing tea, add 0,4 g of mummy to it and mix well. Take a drink after waking up for a long time (more than 1-2 months).
Cardiac Asthma Treatment
involves the following steps:
- first aid in case of an attack;
- medication for an acute attack (you can chew a nifedipine tablet or a capsule of nitroglycerin);
- oxygen inhalation;
- intravenous or subcutaneous administration of morphine or furosemide;
- administration of cardiac glucosides.
If the attack is recorded for the first time, the patient is sent to a hospital. In cardiac asthma with cardiac arrhythmias, electropulse therapy (defibrillation) is used.
How to cure cardiac asthma? The outcome of the disease largely depends on the underlying pathology, which leads to seizures. In most cases, the outcome of cardiac asthma is unfavorable, but comprehensive treatment of the problem and adherence to the recommendations of a specialist can prevent future attacks, maintaining the patient’s working capacity and satisfactory condition for several years.
1. Prepare a decoction: thoroughly grind and mix three grams of rosemary leaves, herbaceous centaury and arnica, galangal roots; pour the resulting mixture into 250 ml. boiling water and boil for 5 minutes. All broth drink fractionally during the day for one month. During the course of treatment of cardiac asthma, also take three drops of pharmacy tincture of valerian (or prepared at home) three times a day.
2. Prepare a decoction: one tablespoon of finely divided dry licorice root, pour half a liter of boiling water and simmer for 45 minutes. After cooling, strain and add half a gram of mummy to it. Drink one glass in the morning half an hour before breakfast with cardiac asthma.
3. Prepare the infusion: pour two tablespoons of crushed dried cinnamon rosehips with one glass of boiling water and leave for 12 hours. Strain. Drink for patients with cardiac asthma 1/2 cup in the morning and evening before meals.
4. Prepare the infusion from a mixture of herbs: half a tablespoon of nettle leaves taken equally (1 tbsp) of quinoa leaves, young leaves of reeds; mix the resulting mixture thoroughly and pour one glass of boiling water, wrap the dishes and insist for two hours. Then add half a teaspoon of baking soda to the infusion and leave for another ten days in a warm place. Take 1 tsp. once a day for half an hour before eating for 30 days to patients with cardiac asthma.
5. It is recommended that a patient diagnosed with “cardiac asthma” instead of regular tea sold in a retail network use tea brewed on the grass of a hypericum hypericum: pour one teaspoon of dried medicinal herbs with a glass of boiling water, leave for ten minutes, strain and drink as much tea it will be pleasing to the soul, adding a little honey in each glass.
6. This recipe significantly strengthens the heart muscle: roll two heads of garlic and two lemons through a meat grinder, pour 1,2 liters of boiled chilled water and insist for three to four days at room temperature. Strain through one layer of gauze and add three tablespoons. l bee honey. Drink 50 ml each morning on an empty stomach. infusion.
7. Mix equally the roots of valerian, viburnum bark, marigold flowers and motherwort grass (chop the roots); pour two teaspoons of the collection with a glass of water and cook over low heat for 20 minutes, strain and drink all the medicine in sips throughout the day; and the next day – a fresh serving!
8. If you have shortness of breath, fill in a thermos with two tablespoons of dried hawthorn fruit in a half cup of boiling water. Insist two to three hours, strain. Drink small amounts of joe for twenty minutes during the day. The effectiveness of the recipe has been tried repeatedly – the result is positive.
The treatment of cardiac asthma is aimed at stopping the attack as soon as possible.
Medical assistance is reduced to the following activities:
Taking narcotic analgesics, for example, Morphine or Pantopon. They should be combined with Atropine. Drugs are used to eliminate severe shortness of breath and severe pain.
If there is tachycardia, then the patient should be prescribed Suprastin or Pipolfen.
Against the background of respiratory dysfunction, in the presence of bronchial spasm, and also if cerebral edema is observed, or a chronic pulmonary heart, then narcotic analgesics will be replaced with Droperidol.
It allows you to quickly unload a small circle of blood circulation against a background of high pressure and venous stasis such as bloodletting. The amount of blood should not exceed 500 ml.
Health workers can also apply harnesses. The exposure time on the limbs should not exceed half an hour. In this case, it is important that a pulse be felt below the tourniquet.
Oxygen inhalations passed through ethyl alcohol are very helpful. They are carried out using masks or nasal catheters and can reduce the swelling of the lung tissue.
Against the background of pulmonary edema, the patient urgently needs a transition to artificial lung ventilation.
To reduce blood pressure, you need to give the patient a diuretic drug, for example, Lasix or Furosemide, as well as specialized means to reduce blood pressure.
Cardiac glycosides such as Digoxin and Strofantin are administered intravenously with an attack of cardiac asthma almost always.
Eufillin is prescribed for bronchial and cardiac asthma, against the background of mitral stenosis.
Defibrillation is recommended for cardiac arrhythmias.
So, to cure cardiac asthma means to relieve an acute attack and prevent the development of alveolar pulmonary edema. Further therapy is carried out in a hospital and should be aimed at eliminating the underlying disease. Only in this way can an attack be prevented in the future.
As for the prognosis, it is primarily determined by what is the cause of the development of cardiac asthma. It is worth noting that in the vast majority of cases, cardiac asthma has a poor prognosis. Although competent treatment of the leading disease and compliance with all the doctor’s prescriptions allows a person to remain operational for several years.
Article author: Molchanov Sergey Nikolaevich | Cardiologist
Education: Diploma in “Cardiology” received at PSMU them. I.M.Sechenova (2015). Graduate school was passed here and a diploma “Cardiologist” was obtained.
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Cardiac asthma should only be treated permanently, in a clinic, under the supervision of a doctor. The main medical measures are aimed at implementing the following factors:
- stress relief;
- relief of the heart;
- elimination of violations in the work of the respiratory center;
- prevention of pulmonary edema.
As for drug therapy, the doctor may prescribe the following drugs:
- narcotic analgesics;
If the patient’s condition allows, then it is possible to use a physiotherapeutic procedure – oxygen inhalation.
Cardiac asthma treatment should only be prescribed by a doctor. The unauthorized use of drugs or traditional medicine is not appropriate here, since there is a high probability of death.
Prevention of folk remedies
Treatment of cardiac asthma with folk remedies is possible only on the recommendation of a doctor and if the patient’s life is not a direct threat. Folk remedies can soon be considered preventive for a person who has already suffered from cardiac asthma.
One of the best folk remedies for the prevention of this disease is to take a decoction of rose hips. You can drink it as tea, with a little sugar.
In addition, you can apply decoctions of such herbs:
- decoction of leaves of coltsfoot;
- harvest from licorice root, corn stigmas and yarrow.
But to treat such a dangerous disease only through traditional medicine is life-threatening.
It is almost impossible to completely exclude such attacks, so the prognosis a priori cannot be favorable. But if the patient adheres to the doctor’s recommendations, then there is the opportunity to significantly reduce such attacks. As practice shows, a person with cardiac asthma should adhere to special recommendations throughout his life.
Measures for the prevention of cardiac asthma include the following:
- rational drug therapy;
- prevention of high blood pressure;
- healthy lifestyle;
This article is posted for educational purposes only and is not scientific material or professional medical advice.
The prognosis with regards to people suffering from attacks of cardiac asthma depends on the underlying pathological process. For the most part, it is unfavorable, especially with late detection. Even with all the recommendations of specialists, it’s possible to reduce the frequency of seizures and restore to a certain extent disability only for a couple of years. The situation is more favorable with the early detection and preparation of an effective treatment regimen.
Prevention of cardiac asthma is the timely treatment of heart pathologies, especially ischemia, hypertension and heart failure. It is no less important to try to prevent the development of infectious diseases and maintain a water-salt balance.
Daily routine and diet
With this diagnosis, the patient should adhere not only to proper nutrition, but also to the regimen of the day.
Recommendations regarding the daily routine:
- a full healthy sleep, you need to go to bed and get up at the same time;
- moderate physical activity;
- excludes alcohol, smoking, nervous and stressful situations;
- daily walks in the fresh air;
- regular examination by a cardiologist.
As for nutrition, here should adhere to such recommendations:
- the basis should be light meals for the stomach;
- limited salt intake;
- drink no more than 1,5 liters of flu >
Follow these recommendations should the patient all the time.
The most likely complication of cardiac asthma is pulmonary edema. In second place is cardiogenic shock, which arose against the background of acute left ventricular failure. Both conditions are mostly fatal. An emergency call and the provision of first aid can change the situation.
Put your feet in hot water
- move the patient to a sitting position, legs should hang from the bed, chair and so on;
- put your feet in hot water, as this will ensure blood flow to the limbs;
- apply a tourniquet, but not longer than 20 minutes. The tourniquet should be 15 centimeters below the inguinal fold and always on top of the fabric.
Such help with cardiac asthma can save a person’s life and give doctors time to carry out the necessary medical measures.
At home, a person should not forget about the recommendations of a specialist, timely passing examinations and maintaining a healthy lifestyle. The rules will help with the latter:
- avoid stressful situations;
- sleep at least 7-8 hours;
- to refuse from bad habits;
- take breaks during operation every 1-2 hours;
- properly compose a diet;
- limit physical activity;
- take food 5-6 times a day in small portions;
- cook by boiling or steaming;
- reduce the consumption of fatty, fried and smoked foods;
- follow the treatment plan drawn up by the doctor;
- regularly examined.
Cardiac asthma is a manifestation of left ventricular failure resulting from stagnation of blood in the lungs. Many diseases and conditions associated with the heart and other organs affect the development of the pathological process. Treatment is carried out in a hospital under the strict supervision of doctors. After discharge, the patient will have to change his lifestyle and follow the rules of prevention.
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