Heart cough – how to distinguish from normal, how to treat a disease

Cough caused by cardiological pathologies differs from that of infectious diseases of the respiratory tract. It has a number of features that facilitate diagnosis:

  • With a heart cough, sputum or pus does not separate, it is always dry, it is chronic. Discharges with an admixture of blood occur in an acute attack.
  • Blueness (cyanosis) appears in the region of the nasolabial triangle. Cyanosis affects the lips, earlobes, fingertips.
  • During physical exertion, a debilitating cough with shortness of breath occurs. As the disease progresses, even a long conversation can cause a similar reaction. Manifested tachycardia.
  • Due to excess blood in the heart, pain occurs.
  • The cause of fainting or a condition preceding it is increased pressure in the chest, decreased blood supply to the heart.
  • With a coughing fit, veins in the neck swell strongly.
  • In the horizontal position, the left ventricle is overloaded, which provokes a coughing fit.
  • At the initial stage of the development of pathology, before the coughing attack, the patient experiences dizziness, weakness, and sweating. In the evening, there is swelling of the ankle. With the further development of the disease, it becomes more dense and does not pass during the night’s sleep.

The disease begins with a mild cough, later turning into a pronounced dry cough. At the stage of alveolar edema, moist small bubbling rales are present, which are audible from a distance without using a phonendoscope. White or pinkish foam is released. Its color is due to the presence of red blood cells in the proliferate, sweating through the vascular wall with permeability changed as a result of overextension.

Shortness of breath with cardiac asthma is often inspiratory, difficulty breathing. Mixed options are possible. The patient complains of a feeling of suffocation, lack of air. The pain is characteristic of seizures that develop against the background of acute ischemic myocardial damage, including heart attack. Painless forms are noted with cardiosclerosis.

  • Hypoxia (diffuse cyanosis, tachycardia, inclusion of auxiliary muscles in the respiratory process).
  • Heart failure (edema of the legs, bluish tinge of the nasolabial triangle, earlobes, lips).
  • The situation is forced, half-sitting, with the emphasis on the bed. This placement of the body in space allows you to deposit a certain amount of blood in the lower limbs and partially relieve the small circle.
  • Heart sounds are muffled due to the large number of wet rales, IIt accent appears over the pulmonary artery.
  • Blood pressure initially rises, then follows its drop up to shock figures.

Differential diagnosis in the later stages of the disease is not difficult. The patient reveals a typical clinical picture corresponding to pulmonary edema. Recognize a heart cough immediately after its appearance by the presence of the following symptoms:

  • Heartache.
  • Available cardiological history (AMI, congenital malformation).
  • Acceptance by the patient of a forced sitting position with legs down.
  • The absence of signs of inflammation of the upper respiratory tract.

Debut on the background of physical activity, psycho-emotional arousal, stress. Symptoms of general intoxication are not detected. At a young age and in children, the disease is rare.

With an infectious lesion of the respiratory system, a connection with the load is not traced. In the recent past, there has been an episode of hypothermia or drafts. There are other relevant symptoms:

  • Hyperthermia.
  • Myalgia
  • Detachable from the nasal passages.
  • Sore throat.
  • Hyperemia of the mucous membranes.

It is diagnosed with the same frequency in adult patients, adolescents, preschoolers. Rarely accompanied by shortness of breath. Classical asthma occurs after contact with an allergen or non-biological trigger (frosty air, pungent odors). Expiratory dyspnea, due to bronchospasm, exhalation is difficult. Wheezing wheezing, audible from a distance, dry. Sputum clears its throat in a small amount, has a vitreous consistency. Foaming does not occur.

To decide how to treat heart cough, you need to know the disease that causes it. Treatment is based on the nature and form of the disease, and can be:

  1. medication;
  2. surgical;
  3. using folk remedies.

Each type of treatment has its advantages and disadvantages, than a doctor will prescribe a cough for heart cough in your case. He will draw up a treatment plan and help to choose the necessary drugs or prescribe procedures that promote recovery.

You can cure heart cough only after the complete elimination of the disease that causes it. Often, treatment is prescribed not to eliminate side symptoms, but to restore normal blood circulation.

This form of treatment is considered the most effective in the case of CVD (cardiovascular system) disease. Drugs are prescribed as directed by the doctor after the examination and analysis: ultrasound, cardiogram, tomography and blood test. Medications help normalize heart function, relieve muscle cramps and improve blood circulation. The heart independently pumps out stagnant blood from the lungs and restores the breathing process.

People who suffer from heart disease are always wondering how to distinguish bronchial asthma from heart cough. These two diseases are very similar to each other and can mislead both the patient and the doctor. To correctly identify and distinguish cardiac cough from other ailments, you need to monitor the clinical picture. The disease manifests itself in the following symptoms:

  • dry cough – sputum does not stand out;
  • blue shade of lips, nasolabial triangle, earlobes and fingers;
  • frequent and labored breathing;
  • dyspnea;
  • pain in the heart;
  • dizziness;
  • fainting or loss of consciousness;
  • bloating of veins on the neck;
  • the phenomenon progresses in a horizontal position;
  • weakness;
  • strong sweating;
  • swelling of the ankle region in the evening.

If the symptom manifests itself from infectious and inflammatory pathologies of the respiratory organs, then it is characterized by a strong increase in temperature, which leads to sore throat, runny nose and other signs of a cold. First, the cough appears dry, and then goes wet with the separation of yellowish sputum.

It is possible to recognize a heart cough from the use of nicotine in the morning. It is after sleep that the symptom manifests itself best. The patient is diagnosed with white or gray sputum.

During heart failure therapy, a person often consumes ACE inhibitors. Based on the use of the drug, a dry cough may develop.

Symptoms in each patient may be of varying severity. Manifestations depend directly on the formed cardiological ailment.

With the manifestation of such an unpleasant indicator, a person is immediately concerned about the question of how to treat heart cough. However, doctors argue that in the treatment of ailment, the emphasis should not be on eliminating the cough, but on the very cause of the development of the pathology. It is for this that the diagnosis of the disease and the identification of the very source of manifestation are carried out.

When determining the ailment, it is important to differentiate the cardiac from bronchial cough and prescribe the correct treatment. As for folk remedies, they differ significantly in their components for two ailments – cardiac and bronchial cough. Therefore, their use is generally undesirable.

To successfully rid a person of coughing, you need to normalize the regime of the day and balance your diet. Failure to comply with these nuances can also provoke significant disturbances in the functioning of the heart and other systems in the patient’s body.

Patients with cough are prescribed medications. Medicines are considered the main and most effective treatment for the disease. They help strengthen the heart muscle and improve its functionality. After restoration of the heart, the organ itself begins to pump out excess blood from the lungs, which means that blood circulation throughout the body gradually returns to normal and the cough is eliminated.

You can cure heart cough with the following drugs:

It is undesirable to use these medications on your own. First, the cardiologist needs to establish an accurate diagnosis and, after the examination, prescribe certain drugs that are suitable for the characteristics of the patient’s body.

In addition to medicines, the attending doctor advises to follow these simple rules:

  • observe the regime of the day – normalize the time of work and rest;
  • do exercises in the morning;
  • to walk outside;
  • Stress away
  • eat right and fresh foods – do not eat a lot of salt, coffee, black tea, fatty and spicy foods;
  • eliminate negative habits.

The cause of its appearance is heart failure (HF), which leads to stagnation of blood in the lungs. In patients with left ventricular failure, a symptom is almost always recorded. In a number of sources, there is another name for the condition – “cardiac bronchitis.”

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Symptoms and signs

Many patients, faced with an unconditioned reflex, do not rush to the doctor, but begin to independently treat themselves for colds or allergies. This leads to loss of time and worsening of the patient’s condition. There are concomitant symptoms that make it possible to differentiate cardiac cough. If any such manifestation occurs, you should immediately contact a specialist.

Table 1. Concomitant Symptoms of Cardiac Cough

Type of coughIn case of insufficiency, an unproductive reflex occurs (without secretion of the tracheobronchial secretion), intensifying when taking a horizontal position
DyspneaIt can occur both against the background of physical activity, and at rest
Heart rhythm disturbanceThe patient has tachycardia
Decreased performanceIt becomes difficult for a person to do the usual things, he quickly gets tired, experiences drowsiness and muscle weakness
SwellingWith heart failure, peripheral edema is detected
HemoptysisThe appearance of foamy sputum with an admixture of blood
Arterial hypertensionThe patient experiences a regular increase in pressure.

Symptoms of cardiac cough in women and men also include cyanosis (cyanotic coloration of the skin), the appearance of moist rales in the lungs, dilatation of the left ventricle, etc.

Causes

Congestion in the lungs associated with the inability of the heart to fully pump blood provokes coughing fits. They are caused by acute and chronic cardiovascular pathologies:

  • myocarditis (lesions of the muscle layer of the heart associated with inflammatory processes);
  • cardiomyopathy (damage to the muscle tissue of the heart of unknown origin, organ enlargement, development of heart failure, impaired heart rate, impulse conduction);
  • cardiosclerosis (a pathology of the heart, which is characterized by proliferation of connective tissue in the muscle layer, valve deformity);
  • arterial hypertension;
  • myocardial infarction;
  • heart attack;
  • cardiac ischemia;
  • congenital heart defects;
  • arrhythmias;
  • aortic lesions;
  • lesions of the heart valves of an acquired nature;
  • diseases of the mediastinal organs (anatomical space between the sternum and spine, the middle sections of the chest cavity).

Cough with heart diseases occurs against the background of pathologies of the endocrine system, with severe forms of anemia. Coughing attacks provokes:

  • alcohol abuse;
  • smoking;
  • constant stress;
  • taking certain medications to treat heart and vascular diseases.

With many acute and chronic heart diseases, heart failure develops, which results in a reflex cough.

The main causes of heart cough in an adult are:

  • disruption of the heart valves;
  • arterial hypertension;
  • cardiomyopathy;
  • myocarditis;
  • arrhythmias;
  • CHD (coronary heart disease);
  • myocardial infarction;
  • heart attack;
  • cardiosclerosis;
  • vices;
  • aortic diseases (mesortitis, aneurysm);
  • lesions of the mediastinum.

Heart cough may also occur in the background:

  • endocrine disorders;
  • anemia (usually in severe form);
  • alcohol abuse and smoking;
  • frequent or severe mental disorders, stress;
  • the use of certain medications (coughing may be an adverse reaction).

Treatment

Symptoms and signs

That is why disturbances in blood circulation can affect the work of the respiratory organs, and a person will have a heart cough. This symptom of many diseases of the cardiovascular system can appear before or because of their treatment.

Heart cough resembles cough with ordinary bronchitis, but is not accompanied by sputum production. In severe cases, streaks of blood may appear in the cough.

In this article, we will consider the main causes of the appearance, the development mechanism, symptoms and methods of treating heart cough. This knowledge will help you to suspect the onset of the disease in time and take the necessary measures to eliminate it, which will prevent the development of formidable complications.

Causes

Also, causes of heart cough can be diseases of the endocrine system, alcohol abuse, smoking, severe forms of anemia, taking certain medications to treat cardiovascular pathologies, frequent and severe stresses.

Blood supply to the lungs is provided by the pulmonary circulation, and its effectiveness largely depends on the full functioning of the left ventricle and atrium. The development of heart cough goes through several stages. The mechanism of inhibition of respiratory function is as follows:

  1. Pathological processes occurring in the left ventricle cause a decrease in its contractile ability, and it cannot effectively pump blood from the pulmonary arteries into the aorta. Such changes in the work of the heart lead to an increase in pressure in the lungs and a slowdown in blood microcirculation.
  2. Slowed blood flow causes an increase in venous pressure and oxygen starvation of tissues.
  3. Due to hypoxia, collagen fibers, which cause the development of pneumosclerosis, are deposited on the interalveolar septa and walls of small vessels.
  4. Small vessels of the lungs are gradually sclerosed and completely obliterated (overgrown with connective tissue). Such pathological processes lead to a decrease in blood flow in the lungs and an even greater increase in pressure in the pulmonary vessels.
  5. Increased pressure in the pulmonary artery leads to an increase in the load on the left ventricle, and it hypertrophies.
  6. Then there is a dilatation (expansion of borders) of the right half of the heart, which causes stagnation of a large circle of blood circulation. The liquid part of the blood seeps into the lung tissue and irritates the bronchial receptors. The patient develops a cardiac cough, which proceeds chronically, appears when trying to occupy a horizontal position, and worsens in the evening or at night.
  7. With a serious complication of the pathological process in the heart (for example, the development of a new attack of a heart attack, arrhythmia, ventricular fibrillation, etc.), acute left ventricular failure develops, and its rapid progression can cause attacks of cardiac asthma or pulmonary edema.
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Symptoms

After collecting complete information about the nature of the cough, the doctor determines the tactics for further examination of the patient.

Heart cough has a number of characteristic features that distinguish it from a cold or bronchial cough:

  1. Heart cough is dry. During coughing, the patient does not separate sputum, mucus or pus. During acute attacks, bloody discharge may appear.
  2. The cough is accompanied by cyanosis (blueing) of the lips, nasolabial triangle, earlobes or fingertips.
  3. During coughing, the patient has rapid breathing. At first, shortness of breath and coughing appear only during physical exertion, but with the progression of the disease, even a long conversation can cause a suffocating dry cough and rapid breathing.
  4. The cough is accompanied by pains in the heart and palpitations, which are caused by overloading the heart with blood.
  5. A cough may be accompanied by fainting conditions or dysfunctions, which are provoked by an increase in chest pressure and a decrease in the volume of blood entering the heart.
  6. During coughing attacks, the veins in the neck are inflated.
  7. A cough appears or intensifies when trying to lie down, because in this position of the body the left ventricle is even more overloaded. Some patients even have to sleep in a half-sitting position. The same symptom can be observed with bronchial asthma, and therefore this condition of the patient requires differential diagnosis.
  8. At the onset of the disease, coughing is accompanied by severe weakness, sweating, and dizziness. Further, the patient develops ankle edema in the evening. In the later stages, edema becomes more dense, stable and does not disappear in the morning.

The above features of cardiac cough may occur in varying degrees. Their severity depends on the cause of the cough and the severity of the underlying heart disease.

Heart cough may be:

  • irritating and dry – in the initial stages of the disease, when stagnation in the pulmonary circulation has not yet developed;
  • sharp, short and dry, combined with pain in the heart – often observed with rheumatism, which was complicated by pericarditis;
  • dry and paroxysmal, accompanied by difficulty breathing – often observed with mitral stenosis;
  • evening or night, loud and exhausting, appearing in a prone position or when trying to take a horizontal position – characteristic of chronic left ventricular failure;
  • cough with hemoptysis – appears with severe congestion in the lungs due to atrial fibrillation and right ventricular failure, may indicate the development of thromboembolism.

When the first episodes of cardiac cough appear, the patient must consult a doctor and undergo an examination that will identify the cause of the deviations in the activity of the heart. Timely treatment of the detected disease will allow you to quickly get rid of cough and inhibit the progression of the underlying ailment.

Diagnostics

A chest radiography survey allows the doctor to identify congestive changes in the lungs and conduct differential diagnosis with various diseases that are accompanied by a cough.

Symptoms of heart cough may be similar to the signs of many diseases of the heart and respiratory system. For an accurate diagnosis, the patient is prescribed the following diagnostic methods:

  • ECG – to detect ischemia and myocardial hypertrophy;
  • Echo-KG – to study and evaluate the contractility of the ventricles and a more detailed study of the structures of the heart;
  • radiography – to detect congestion in the lungs;
  • tomography – for a detailed study of the state of the myocardium.

Treatment

To eliminate cardiac cough, the patient is prescribed a course of treatment for the underlying disease that caused it. Self-medication of this unpleasant symptom is unacceptable, because

attempts to suppress it can lead to undesirable consequences. During cardiac cough, the bronchi are cleared, and inhibition of these processes will cause an accumulation of discharge from the lungs.

That is why the course of therapy should be prescribed only by a cardiologist.

To get rid of heart cough, in addition to treating the underlying disease, the doctor will recommend a range of measures.

Daily regime

Compliance with the regime of work and rest with pathologies of the cardiovascular system allows you to avoid overload and has a beneficial effect on the work of the heart. Such patients are recommended to sleep at least 8 hours a day.

Smoking and alcohol have a serious burden on the heart, and quitting should occur as soon as possible.

Stressful situations pose a serious threat to people with heart pathologies, and the patient should learn to resist them properly and not get upset over trifles. If necessary, the doctor may recommend taking sedatives.

With heart cough, oxygen starvation of tissues is observed, and walks in the fresh air will contribute to their saturation with oxygen. Such oxygen therapy will not only help eliminate heartbeats and shortness of breath, but also normalizes mood and sleep.

Healthy eating

For diseases of the cardiovascular system, the doctor may prescribe a special diet or recommend reducing the amount of salt consumed and refuse harmful products (fatty meat, fast food, smoked meats, pickles, soda, strong tea and coffee). All patients are advised not to overeat and monitor their weight, because

Sufficient physical activity contributes to the normalization of blood circulation and the elimination of congestion. Their intensity should be individual and is determined only by the general condition of the patient. Initially, they should be minimal, and with improvement, gradually increase.

Knowing the symptoms of the disease, you can make a proper diagnosis and begin timely and effective treatment. Specialists distinguish the following symptoms of cough with heart failure:

  • cough is manifested by sharp and painful attacks, lasting from 2 minutes to half an hour;
  • it is dry, resembles a dog barking;
  • most often attacks occur in the evening and at night, while staying in a horizontal position;
  • during attacks, the patient’s temperature rises, sweating increases, the heart rate increases;
  • after the attack, the patient has practically no strength;
  • after a prolonged attack, hemoptysis may occur;
  • often with a debilitating cough, a sharp pain in the heart occurs.
  1. Diuretics Due to their ability to remove fluid from the body, the functioning of the circulatory system is facilitated.
  2. Preparations for vasodilatation.
  3. Anesthetic or expectorant drugs.
  1. Diuretics. And although these drugs are presented in a wide range, doctors most often prescribe the following options:
    • Indapamide. This is a long-acting diuretic.

      When using it, it is possible to prevent the penetration of sodium, chlorine, and hydrogen ions into the lymph. It has a slight vasoconstrictor effect. With heart pathologies, the drug is taken for 2-3 months in the morning at 1,25 mg.

      Veroshpiron. It is a hormonal and potassium-sparing diuretic.

      Its task is to stimulate the removal of sodium and water from the body, reduce and wash potassium ions, and reduce the level of acidity of urine. For a cough heart attack, apply it at 100 mg per day for 15 days.

      Vasodilators This group of drugs should include the following:

        Losartan. Its task is to lower pressure in the pulmonary circulation with cardiac pathology.

      Does not allow sodium and water to linger in the body. Reception lead for 6 weeks.

    • Atakand. This drug lowers blood pressure, inhibits the action of the hormone angiotensin. Take 8 mg once a day for 2-3 months.
  2. Mucolytics In order to accelerate the process of eliminating sputum and reduce the intensity of coughing, it is necessary to use the following medicines:
    • Codeine. It has a narcotic effect, but it quickly stops the irritation of the cough center.

      With its use, pain is reduced. But it must be used with extreme caution, since drug dependence may occur. Apply the drug at 15-60 mg. The duration of the course can only be determined by a doctor.

      Glaucin. It has a local analgesic effect, effectively treats heart cough, has a calming effect on the autonomic nervous system, and reduces blood pressure.

      Reception lead for a week at 50 g 3 times a day.

      Diagnosis of heart cough

      Heart rate analysis, identification of its disorders

      Echocardiography (ultrasound examination of the heart)

      Examination of the basic structures of the heart, identification of the causes of heart failure

      In-depth study of heart structures, detection of intracardiac blood clots, clarification of the cause of heart failure

      It is used to confirm the diagnosis of coronary atherosclerosis.

      Symptoms can develop in both older people and young people. The age category of the disease is slightly limited, therefore, an examination of the cardiovascular system must be carried out for all people. If any of the aforementioned symptoms are detected or if a cough is already present, the patient should urgently consult a doctor.

      To accurately diagnose an ailment, the patient takes such measures:

      These methods of examining the condition of the body allow you to fully analyze the functionality of the myocardium and determine congestion in the lungs. After carrying out all diagnostic measures, the doctor can prescribe therapy to the patient.

      The determination of pathology at the stage of pulmonary edema is carried out by the presence of appropriate symptoms. There is usually no time left for additional examinations. The initial stage allows the use of hardware and laboratory methods. The main method is electrocardiography. On the film, cicatricial changes in the myocardium, conduction blockade, AMI (depression or ST elevation) are detected.

      A non-specific type of laboratory examination is a general clinical blood test. It allows you to differentiate cardiac cough from infectious. With colds in the internal environment, characteristic changes occur (growth of ESR, leukocytosis). And also determine the concentration of natriuretic hormones – specific peptides, the production of which increases with an increase in hemodynamic load and organic damage to the heart.

      Diagnosing with severe manifestations of heart failure accompanied by a cough is not difficult. But to detect the disease in the early stages, a number of examinations are carried out:

      • Electrocardiography – shows the physical condition of the heart, reveals coronary disease, myocardial hypertrophy;
      • Ultrasound of the heart (Echo-KG) – allows you to see how the heart works in real time, shows the volume of the heart cavities and wall thickness;
      • Radiography – reveals signs of infections and tumors in the chest;
      • Tomography – gives a detailed view of the state of the heart muscle.

      Cough in heart disease differs from any other in the absence of sputum. And if with bronchitis or colds, the treatment will be aimed at expectoration, i.e. an increase in the amount of sputum and its dilution; then with a cough caused by heart failure, such a treatment can be not only useless, but also harmful.

      How to treat heart cough

      To improve the condition when a cough appears with heart failure, it is important to follow simple rules:

      1. Unload the cardiovascular system as much as possible, eliminate the use of alcohol, quit smoking.
      2. Include moderate physical activity, walking in the daily regimen.
      3. Provide a full night’s sleep (at least 8 hours).
      4. Limit the use of salt, this will help reduce puffiness.
      5. Exclude from the diet fast food, smoked meats, marinades, fatty meats, fizzy drinks.
      6. Include enough fresh vegetables and fruits on the menu.
      7. Increase stress resistance, master relaxation techniques.
      8. Monitor body weight, get rid of excess weight.

      In addition to pharmacological preparations, cough for heart diseases is treated with herbal preparations, special herbal preparations. To achieve the therapeutic effect of phyto-remedies, it is necessary to take it regularly. Before starting treatment, it is necessary to take into account the sensitivity of the body to the components of the drug, consult with your doctor.

      Traditional medicine is replete with recipes to maintain healthy heart and blood vessels. Some of them are quite affordable and easy to prepare:

      1. 15 g of elecampane roots pour 200 ml of water, bring to a boil, keep on fire for 30 minutes. Strain. Use in a warm form for 1 tablespoon 3 times a day.
      2. 15 g of lingonberry leaves pour 200 ml of cold water, heat, boil for 10 minutes. Insist 1 hour, strain. Take 0,5 cup 2 times a day.
      3. 1 teaspoon of blue cornflower inflorescences pour 250 ml of water, boil for 4-5 minutes. Insist 1 hour, strain. Take 2 tablespoons 3 times a day.

      The action of pharmacological agents for heart failure is aimed at expanding blood vessels, normalizing blood pressure and heart rate, preventing blood clots, relieving edema, and improving microcirculation in heart tissues. For this purpose, drugs of different groups are prescribed:

      • Antitussive with anesthetic effect. Assigned, if necessary, to dilute and remove sputum. For example, Codeine, Tusuprex.
      • Diuretics (diuretics) relieve stress on the cardiovascular system by eliminating edema. Among them are Indapamide, Veroshpiron, Tryphas.
      • Angiotensin 2 receptor blockers reduce blood vessel spasm. In this group, Kandekor, Eprosartan, Atakand, Losartan.
      • Beta-blockers have a vasodilating effect (vasodilators). Concor, Obzidan belong to him.
      • Glycosides increase the strength and speed of heart contractions without increasing myocardial oxygen demand, increase the efficiency of the heart muscle. For example, Adoniside, Neriolin.

      One of the methods to eliminate the root cause of heart failure is surgery. In certain cases, it is more effective than conservative treatment. Before surgery, it is necessary to assess the risks and complications, especially for elderly patients. Surgical intervention is advisable with the following pathologies:

      • heart valve failure;
      • atherosclerosis, coronary thrombosis;
      • cardiomyopathy.

      The therapy is primarily aimed at unloading the pulmonary circulation, relieving spasm of the coronary arteries, if any, lung dehydration, reducing preload on the heart, then the patient is transported to ICU. Treatment in the elderly, adults and pediatric patients differs only in the dosage of the drugs. Planned recovery and secondary prevention of attacks is determined by the underlying disease that caused cardiac asthma.

      Medications

      A decrease in blood flow from peripheral vessels into the small circle is achieved by the introduction of vasodilators. Sublingual or parenteral forms of nitroglycerin are used. Tablets are taken in 1 piece, under the tongue. An injection of 1% solution was diluted with 0.9% sodium chloride to obtain a 0.01% concentration. The rate of infusion is selected individually.

      To reduce the volume of circulating blood and lower the degree of hydration of the lungs, loop diuretics are prescribed to the patient. The drug of choice is Furosemide or Lasix in a dose of 60–90 mg. It is administered intravenously, in a jet. The diuretic effect with such use is achieved within 2–5 minutes after infusion. An effective drug for the relief of edema is Morphine (1-2 ml of a 1% solution).

      Drug administration is best done fractionally. Part of the drug is injected intravenously, the remainder is administered intramuscularly or subcutaneously. This reduces the risk of respiratory arrest and makes the effect of Morphine softer, stretched over time.

      As antifoam for alveolar pulmonary edema, oxygen is used, which is passed through 70–80% ethyl alcohol. Higher concentrations can cause burns to the mucous membrane of the respiratory tract. For administration, an O2 KRI-1 reducer-inhaler is used, which is present in the list of standard equipment for SMP machines. In order to increase the contractility of the heart, cardiotonics (Dopamine) are introduced through a syringe pump or infusion system.

      With a successful relief of cardiac cough, wheezing subsides, an increase in saturation, and normalization of the color of the skin are noted. After stabilization, the patient is hospitalized for examination and maintenance therapy. In a planned manner, patients are prescribed medications:

      • Angiotensin-converting enzyme inhibitors (Enalapril, Captopril, Fosinopril).
      • Potassium-sparing diuretics (Spironolactone, Veroshpiron).
      • Angiotensin II antagonists (candesartan, losartan).
      • Neprilizin inhibitors (Sakubitril).
      • Beta-adrenergic receptor blockers (Nebivolol, Carvedilol, Bisoprolol).
      • Combined funds (Uperio).

      Treatment in older people is carried out taking into account their general condition and the presence of contraindications for taking this or that remedy. With a decrease in the function of excretion systems (kidneys, liver), dosage dosages may need to be adjusted. Therapy is carried out for life, under the control of the state of the cardiovascular system.

      Surgical recovery of the heart is required in severe cases when the drug exposure does not allow to stabilize the patient’s condition. Intervention is carried out in a specialized clinic, under general anesthesia, usually in a planned manner. The list of indications includes a severe course of the following pathological conditions:

      • Angina pectoris.
      • Cardiomyopathy
      • Coronary aneurysm.
      • Congenital or acquired lesions of the valvular apparatus.
      • AMI

      A radical method of surgical treatment is a heart transplant. It is produced in decompensated or critically acute CH IIB-III stages. Contraindication to the intervention is age ≥ 65 years, impaired liver and kidney function, severe atherosclerosis, acute viral infections, cancer with a poor prognosis for life.

      Folk remedies

      Medicines from the arsenal of alternative medicine can be used both in an adult patient and in a child. It should be remembered that such techniques are auxiliary and benefit only in the chronic course of the disease, in combination with basic drug support. Before starting to take herbal substances, you should consult your doctor.

      Traditional medicine is drunk in the form of water decoctions and infusions. Herbs such as St. John’s wort, immortelle, nettle, hawthorn, thyme, and dog rose are used as raw materials. They allow you to reduce the degree of atherosclerotic lesions of vascular intima, increase throughput and elasticity of the circulatory system.

      Patients with chronic heart failure should limit the calorie intake (to normalize body weight with its excess). The amount of salt should not exceed 5-6 grams per day. It should be considered not only a pure product, but also the amount of NaCl, which is part of the dishes. The daily volume of fluid should be kept within 1.5–2 liters.

      • Limit the use of spicy, fatty, fried, overly acidic foods, alcohol.
      • Eat fractionally, 5-6 times a day, in small portions.

      Signs of coughing

      It can be determined by the following criteria:

        No discharge. With this type of cough, there is no sputum. It is dry and suffocating.

      In the acute form, spotting may appear., Which are a consequence of the fact that the blood does not completely pump out of the lungs.

    • Heart palpitations.
    • Shortness of breath. Heart cough is accompanied by shortness of breath. Breathing becomes hoarse and intermittent.

      In the initial stages of heart failure, respiratory problems occur with physical exertion, with the further development of the disease, even a prolonged conversation or climbing stairs can cause shortness of breath.

    • Chest pain.
    • Veins on the neck swell.
    • Possible fainting. This can occur due to increased pressure in the chest and a decrease in the volume of blood approaching the heart.
    • In some cases, the skin becomes cyanotic.
    • There is a feeling of weakness, increased sweating, dizziness. With the further development of the disease, swelling of the ankle is possible.

If coughing attacks suddenly cause suffocation, which is accompanied by a strong feeling of tightness in the chest, you must call an ambulance and wait for her to arrive in a sitting position.

Let’s look at what a heart cough is, and what is its difference from the more widely known, associated with the respiratory system. It is not an independent disease, but only one of the manifestations of the pathology of the circulatory system. The basis of its development is edema of the mucous membrane of the bronchial tree in response to overload of the pulmonary circle of blood circulation.

Possible reasons

Various pathologies of the cardiovascular system, in the absence of effective treatment, can so disrupt the normal circulation of blood that it will begin to stagnate in the pulmonary vessels.

That is, a sufficient quantity will be supplied, but the heart will no longer be able to fully cope with pumping.

The difference between income and consumption will begin to accumulate in the vasculature, which will launch a multistage pathological mechanism consisting of the following steps:

  1. Increased pressure in the pulmonary circulatory network.
  2. The passage of fluid from the vessels into the intercellular space.
  3. Isolation of the protein fraction of the plasma into the lumen of the alveoli.
  4. Seepage from blood vessels into the alveoli of blood cells.

With each step, gas exchange in the lungs drops lower. The cough appears at the stage of impregnation of the walls of the alveoli with liquid, gradually intensifying. Further, protein fractions will provoke the appearance of foam, and penetrating blood cells will cause it to stain pink.

Edema is the main cause of coughing, as it irritates receptors located in the lungs. In response, the corresponding protective reflex is triggered. However, it is ineffective and does not bring relief. At the very beginning of the process, the cough is dry, then wet.

Distinguishing it from other varieties will help the characteristic signs of heart cough and accompanying conditions:

  • fainting;
  • tachycardia;
  • angina pectoris;
  • more often observed at night;
  • it is mostly dry, only with acute circulatory failure, bloody foamy sputum is observed;
  • before the attack there is a feeling of lack of air, shortness of breath, the nature of breathing changes, it becomes intermittent and hoarse;
  • the appearance of a cough shock at the beginning of the process only during hard physical work, and then, as the pathology that causes the heart damage progresses, the provoking loads fall before climbing the stairs, walking quickly, talking.

Heart cough can not be described as some kind of the same phenomenon. It manifests itself in different ways, depending on the reasons underlying the occurrence of heart failure. That is, there is a specific relationship between the features of cough and the disease that provoked it:

  • the initial phase of circulatory failure due to coronary disease causes attacks of dry irritating cough;
  • rheumatic pericarditis provokes a brief dry cough in combination with pain localized in the projection of the heart or spilled throughout the chest;
  • mitral valve stenosis leads to difficulty breathing, bouts of dry cough, sometimes accompanied by hemoptysis, increased sweating, low-grade fever and weakness;
  • thromboembolic syndrome caused by severe congestion in the lungs, which developed against a background of interruptions in the work of the heart as a blinking arrhythmia, provokes a cough with hemoptysis;
  • ischemic changes that led to chronic left ventricular circulatory failure, cause repeated nightly attacks of suffocation, as well as a loud exhausting cough that develops in a lying position, up to the addition of “rusty” sputum with brown or black inclusions.

Knowing these features of heart cough, it is possible to distinguish it from a cold and other types caused by lung pathology with a high degree of probability.

If there are suspicions that a cough that worries from time to time is associated not with the common cold or more significant diseases of the bronchopulmonary system, but with the heart, I would recommend that you first contact a general practitioner or family doctor.

Here is a list of examinations required for patients with suspected heart cough:

  • ECG;
  • Ultrasound of the heart;
  • coronary angiography;
  • general blood analysis;
  • transesophageal echocardiography;
  • X-ray examination of the lungs;
  • thyroid hormone panel;
  • blood test for serum creatinine.

You will also need to take urine for analysis, provided there is hypertension. After examining it, the doctor will conclude whether it is caused by kidney disease.

The occurrence of cardiac cough most often occurs against the background of the following pathologies:

  • myocarditis;
  • pericarditis;
  • hypertension of the pulmonary artery;
  • chronic arterial hypertension;
  • hypertrophy of the muscular membrane of the left ventricle;
  • stenosis of heart valves: one or several;
  • IHD, during which there is an atherosclerotic lesion of the blood vessels of the heart;
  • cardiosclerosis with a significant drop in the contractility of the heart muscle;
  • congenital heart defects – a defect in the septum separating the left and right ventricles;
  • cardiac amyloidosis – currently an incurable rare disease characterized by high mortality;
  • various cardiomyopathies: primarily dilated, in which the heart cavities are stretched;
  • acquired valvular defects: mainly the mitral valve, which regulates the direction of blood flow from the left atrium to the left ventricle.

In addition to chronic diseases, the appearance of a cough can be triggered by acute pathologies of the heart, such as myocardial infarction.

The patient M. M. (female, age 1 year and 1 month) was taken to a pediatric hospital.

Diagnosis at admission: pneumonia of a protracted course, subacute form of carditis.

The disease began with a low-grade fever and a rare dry cough, which, as it worsened, became more and more obsessive.

Parents decided to seek medical help after the child experienced a sharp deterioration: his breathing became moaning, shortness of breath appeared, the cough became moist, appeared in the form of prolonged painful attacks.

At the same time, cyanosis of the skin, a sharp decrease in the daily volume of urine and the restless state of the child were noted.

Before entering this department, the patient had already managed to be treated for pneumonia in three other hospitals. Everywhere she was prescribed taking various antibiotics:

  • semisynthetic penicillins;
  • cephalosporins of various generations;
  • aminoglycosides.

Treatment anywhere did not bring any expected effect, except, perhaps, for a short-term insignificant decrease in the symptoms of both pathologies.

A child in very serious condition with a temperature of 39,4 ° C entered pediatrics. The patient is restless, constantly groans, is in a forced position – half-sitting. The skin is earthy gray, has a marbled tint. Fingers and nasolabial triangle are cyanotic, face with cyanotic blush.

Painful coughing episodes are noted against the background of severe shortness of breath with a respiratory rate of up to 75 per minute, while auxiliary muscles are involved.

Marked expansion of the heart borders. During auscultation of the heart, muffled tones are heard, as well as a rough noise in systole (Botkin’s point, top). Pronounced tachycardia is observed – up to 170 contractions per minute.

A cardiogram was taken. On the film: sinus tachycardia, both ventricles are hypertrophied, both atria are overloaded, the electric axis is deflected to the right.

  • Echocardiography was also performed, which showed that both ventricles are dilated, the contractility of the heart muscle is greatly reduced.
  • A chest x-ray showed thymomegaly, cardiomegaly, the presence of infiltrates in both lungs, increased bronchial and vascular patterns.
  • Finally, they carried out a mycological examination of blood and smears from the throat!

As expected, found a huge number of fungi. Representatives of the genus Paecilomyce, belonging to the species viridis, were sown.

Based on the examinations, the following clinical diagnosis was established: subacute sepsis of fungal etiology with septicemia in the midst of a fever. Subacute non-rheumatic fungal carditis in severe form. Total heart failure.

The stepwise therapy of pecilomycosis sepsis with Diflucan was carried out. They also treated carditis, heart failure, and corrected the deficiency of immunity. Prescribed vitamin therapy.

After the treatment, a significant improvement in the condition of the child was observed:

  • normalization of respiratory rate and heart rate;
  • the beginning of resorption of infiltrates in the lungs;
  • decrease in the content of fungi Paecilomyces;
  • improved myocardial contractility;
  • decreased severity of cyanosis;
  • normalization of body temperature.

Cough and hypertension

There is also heart cough in older people, the treatment of which can be difficult, due to the fact that they have been taking the same drugs for years, and categorically refuse to change them for others. It is worth convincing such a patient, to explain that replacing the medicine will relieve the unpleasant symptom.

Please note: A cough associated with taking antihypertensive drugs is usually not accompanied by shortness of breath and chest pain, it occurs shortly after taking the pills and may remind yourself several times during the day. If an attack occurs, it does not last long.

Now, let’s consider other signs of heart cough in adult women and men who are not associated with medications, but indicate serious pathologies.

Symptoms are observed at different times of the day and have the following features:

  1. Frequent, dry, sharp cough. It gives the patient suffering, as it is accompanied by pain in the heart. The patient often clears his throat for a long time, the larynx is irritated, the tickling and itching in the throat are disturbing, which are difficult to cope with. A little relief comes after a sip of water, but after a while the cough returns again. This type of painful symptom is observed with rheumatic diseases of the myocardium, with pericarditis.
  2. Dry cough that appears in the evening and night hours. The attack begins as soon as the patient takes a horizontal position – when a person is sitting or standing, this symptom is absent. Such a cough indicates insufficiency in the pulmonary circulation and pathology of the left ventricle. The weak ventricle cannot fully push the blood out; a certain amount of it stagnates. Due to the fact that an insufficient amount of blood enters the pulmonary artery, the nutrition of the pulmonary and bronchial departments is disrupted. There is a cough that does not have the nature of an attack, but appears regularly, in the form of single coughs. Coughing up is not always possible, you have to change the position of the body. Often, such patients get used to sleeping half-sitting, otherwise the sensation of pain does not go away.
  3. Paroxysmal, excruciating, dry cough, complicated by shortness of breath. It occurs at any time of the day, several times. During an attack, the patient sweats, complains of a sharp weakness, sometimes there is a slight subfebrile condition, body temperature ranges from 37-38 degrees. This attack indicates mitral stenosis and hypertrophy of the left atrium. Bloody streaks may appear in the sputum during a prolonged attack. The question of how and how to treat heart cough at home in adults in this case has the only answer – strictly follow the recommendations of the cardiologist, not to allow omissions in taking medications. No antitussive drugs and folk remedies will help.
  4. A prolonged dry cough, which is present almost constantly during the day, suggests that cardiac pathology provoked stagnation and a large circle of blood circulation. The situation arises when the pulmonary circulation is no longer able to function compensated. With such a constant cough, blood in the sputum also appears periodically.
  5. Coughing up blood. A severe sign that is alarming regarding pulmonary embolism and severe right-sided myocardial pathologies.

Heart cough is not a rare sign of heart disease. Here is a list of diseases in which it is possible:

  • arterial hypertension;
  • all types of coronary heart disease, namely: angina pectoris, heart attacks, cardiosclerotic changes in the myocardium after a heart attack;
  • inflammatory myocardial diseases – pericarditis, myocarditis, endocarditis;
  • heart defects;
  • heart rhythm disturbances;
  • myocardial amyloidosis;
  • aortic disease.
  • metabolic diseases;
  • severe anemia;
  • chronic overwork and frequent stress;
  • mediastinal diseases;
  • neoplasms;
  • smoking and alcoholism.

Particular attention should be paid to congenital heart defects. If a woman has a pathological pregnancy, the baby is born with this disease. Modern diagnostics can recognize fetal pathologies at an early stage, and surgical treatment should be performed shortly after the baby is born. In the presence of congenital heart disease, a child may suffer.

Whatever the heart cough is triggered, the symptoms and treatment in adults and children vary widely. In children’s practice, this is most often the help of a cardiac surgeon, for adult patients, regular monitoring and treatment by a cardiologist.

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  1. The cough is worse if the person lies down.
  2. The attack is accompanied by chest pain.
  3. Heart palpitations (tachycardia).
  4. Sweating, weakness during an attack.
  5. Possible syncope after a coughing fit.
  6. Acrocyanosis.
  7. Severity with sputum removal, the use of bronchodilators is ineffective.
  8. Bloating veins on the neck.

If there is a patient with myocardial disease in the family, monitor his condition. A cough that occurs during the daytime is a troubling symptom. He warns of a possible deterioration by night. Therefore, it is better to show the person to the cardiologist right away.

Heart cough in children

Most often, cough is manifested in children with congenital heart disease. Although not every defect is the cause of the development of this symptom. The appearance of cough in heart diseases provokes pathologies of the left ventricle.

It’s important to know! If a child has a cardiac cough, it is necessary to treat the cardiovascular system, and not the cough! Such medication will help eliminate cough.

As for children in their teens, the first malaise with heart cough is periodic shortness of breath, even after light physical exertion. Compared with their peers, adolescents suffering from this symptom are less hardy.

They have a constant weakness of the body, as well as rapid fatigue. Therefore, if a teenager exhibits such ailments, an urgent examination is necessary.

Timely treatment at this age is quite productive and will help avoid chronic heart failure in the future.

Heart cough during pregnancy

If a woman already had a heart disease before conception, it is likely that it will worsen during pregnancy. The load on the body of a pregnant woman increases significantly, the load on the cardiovascular system also increases, so the likelihood of heart failure increases.

The most critical period is considered to be 26-28 weeks of pregnancy, when the volume of circulated blood increases as much as possible. Also, the birth itself and the postpartum period are considered a dangerous period. Often women with heart defects and other heart diseases are not allowed to give birth, but they do a planned cesarean section.

If a woman already has a heart cough, her condition should be constantly monitored and preferably in a hospital. The most dangerous are severe shortness of breath with coughing in the absence of exertion, as they can be harbingers of pulmonary edema.

Heart failure during pregnancy is dangerous not only for a woman, but also for a child, since in case of circulatory disturbance, fetal hypoxia begins, it lacks oxygen.

During pregnancy, most drugs are prohibited, especially in the first trimester. Heart failure during this period is treated with acceptable drugs: diuretics, beta-blockers, drugs to improve myocardial metabolism.

With severe coughing fits, safe antitussive drugs can be prescribed. A strong cough can be dangerous due to tension of the abdominal wall and increased tone of the uterus.

Folk remedies

You can cure heart cough with the help of alternative medicine. They can not be used independently, but only as an additional therapy. It is fashionable to consider such recipes as effective:

    Oatmeal broth that supports the work of the heart.

It is necessary to take raw materials in an amount of 100 g and pour 500 ml of water. To simmer on fire, and place 1/3 cup of the dried elecampane root in the cooled broth.

Again send to the stove, wait 2 hours, filter, add honey to improve the taste. Take 100 ml 3 times a day for 2 weeks.

Viburnum infusion. It treats heart pathologies and normalizes its work.

It is necessary to crush 20 g of ripe fruits, add 200 ml of boiling water. You can improve the taste of the medicine with honey. Consume 100 ml 2 times a day for a month.

A decoction of grass, which soothes hearts and improves its work.

You need to mix 3 parts of yarrow and 1 part of lemon balm. Then add 1 part of the rhizome of valerian. 20 g of raw materials account for 200 ml of boiling water. Wait 3 hours, filter and drink 200 ml throughout the day for 30 days.

  • The pulp from pumpkin perfectly stops swelling and serves as a preventive measure. Grind 0,5 kg of pumpkin pulp and consume. If there is heart failure, then you need to use this tool constantly.
  • Garlic and lemon syrup effectively coughs. Place 5 heads of garlic in a container, place 5 lemons and 500 g of honey. Cover the jar tightly, wait 10 days, and then apply 10 g 4 times a day.
  • Heart cough is a very dangerous symptom that can indicate various pathologies of the heart. It is very important to be able to recognize it in time in order to immediately begin treatment. Moreover, therapy should be comprehensive so as not only to stop coughing attacks, but also to normalize heart function.

    Herbal Fees

    1. Healing Elixir To treat a heart cough, prepare such a potion.

    Scale 10 large unpeeled lemons with boiling water and leave for 15 minutes. Squeeze juice from them, add 1 kg of linden honey and 10 chopped large heads (not cloves!) Of garlic.

    Mix thoroughly and pour into a jar. The medicine should be infused for 10 days in the refrigerator or in a cool, dark place. How to take: 1 teaspoon before meals 4 times a day.

    Such treatment should be used for several months until all the unpleasant symptoms go away. This drug relieves arrhythmias and other heart diseases at an early stage.

    Additionally, you can use other folk remedies.

    Herbal mixture with honey. A recipe created by Carpathian healers is also suitable for treating heart cough.

    A full glass of dill seeds should be ground in a coffee grinder and mixed with 2 tbsp. grated valerian root.

    Add 2 cups of liquid honey and mix again, pouring about 1 liter of boiling water into the product. Insist the medicine for several days. How to take: 1 tablespoon 3 times a day before meals.

    Continue treatment for 2-3 months. With arrhythmia, such a drug should be drunk for several years.

  • Herbal collection number 1. You can treat heart cough with the following herbal collection:
    • Inflorescences of Hawthorn – 50 g;
    • Melissa leaves – 50 g;
    • Crown grass broom – 50 g;
    • Yarrow herb – 50 g;
    • Valerian root – 50 g.

    How to use: 1 tablespoon of the mixture pour a glass of boiling water and insist for 20-30 minutes. Drink 3 times a day, 1 glass after a meal. Additionally, you can use other folk remedies to strengthen the heart.

  • Herbal collection No. 2 If you have a heart cough, try this treatment:
    • Melissa leaves – 50 g;
    • Goose cinquefoil grass – 50 g;
    • Motherwort grass – 50 g.

    How to use: 1 teaspoon of the mixture pour a glass of boiling water and insist for 20-30 minutes. The prepared drink should be drunk in small portions during the day.

    Continue treatment until complete recovery and normalization of the heart.

  • Herbal harvest number 3. You can treat an ailment with such an herbal potion:
    • Caraway seeds – 50 g;
    • Nettle leaves – 50 g;
    • Fucus vesiculus leaves – 50 g;
    • Horsetail grass – 50 g;
    • Knotweed grass – 50 g.

    How to use: 2 tablespoons of the collection pour 700 ml of boiling water and leave for 15 minutes, then strain. Drink the drink warm 3 times a day 15 minutes before meals.

  • Herbal harvest number 4. If you have a cough due to heart disease, treatment with the following collection will give excellent results:
    • Motherwort herb – 50 g;
    • Inflorescences of hawthorn – 50 g;
    • Hawthorn fruits – 50 g;
    • Grass lovage – 50 g;
    • Valerian root – 50 g;
    • Melissa leaves – 50 g;
    • Rosehips – 50 g;
    • Nettle leaves – 50 g;
    • Mistletoe herb – 50 g.

    1 tablespoon of the mixture pour a glass of boiling water, let it stand under the lid for 3 hours. Drink 3 times a day, 1 glass before meals.

    Prevention

    To improve your condition, listen to a few simple tips:

    1. Stop drinking and smoking to relieve the cardiovascular system.
    2. Use moderate physical activity (swimming, light running, aerobics) regularly.
    3. Walk outdoors more often.
    4. Try to sleep at least 8 hours a day.
    5. Reduce the amount of salt consumed (this helps relieve swelling in the chest area).
    6. Refuse harmful products – smoked meats, fatty meat, pickles, fast food, carbonated drinks.
    7. Learn relaxation techniques to reduce stress.
    8. Eat 1 clove of garlic every day (it is very useful for the cardiovascular system).

    Secondary prophylaxis of cardiac cough with diagnosed CHF consists in observing the medical and protective regimen. It is necessary to precisely follow the doctor’s prescriptions, regularly undergo medical examinations, adhere to the principles of dietary nutrition, and lead a moderately active lifestyle (daily walks, permissible physical exercises). Primary prevention coincides with the well-known requirements of healthy lifestyle:

    • Quitting smoking and drinking alcohol.
    • Hardening.
    • Regular classes in dynamic sports.
    • Fractional balanced nutrition.
    • Annual medical examinations as part of a general medical examination.

    Any child or adult with the slightest signs of malaise and a slight cough should immediately seek help from a doctor. In the early stages of the disease, it is always much easier to eliminate and prevent the development of complications.

    In order to prevent heart cough, doctors advise to follow the rules of a healthy lifestyle, give up bad habits and monitor their condition.

    Cough with heart failure manifests itself in case of non-compliance with the standard rules of a healthy lifestyle. To avoid cough disorders with heart disease, you need to follow simple recommendations:

    • regularly experience dosed physical activity;
    • to refuse from bad habits;
    • adhere to a proper diet;
    • normalize sleep patterns.

    It is enough to follow these tips and the chance of having heart problems will be reduced to a minimum.

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  • 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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