The most common symptoms of acute heart failure are

Heart failure is an acute or chronic condition in which contractile muscle manipulations weaken and stagnant processes develop in the blood circulation circles.

At the same time, a person with minor exertion and at rest feels short of breath, gets tired quickly, suffers from bluish nails and the area of ​​the nasolabial triangle.

In acute heart failure, pulmonary edema, cardiogenic shock develops. The chronic form of the disease is dangerous by the appearance of oxygen starvation of organs and tissues. This disease is the most common cause of death.

Pathology worries as a result of defects, cardiomyopathy, ischemia, hypertension and other ailments.

Timely care can save a patient’s life. For this reason, it is necessary to know the main signs of the disease.

These include shortness of breath, general weakness and rapid fatigue of a person, even with small loads. There is also confusion, a threadlike pulse, drowsiness, fluctuations in blood pressure, swelling of the lower extremities.

Signs of left ventricular acute heart failure:

  • wet cough with frothy sputum;
  • wheezing in the bronchi and lungs;
  • dyspnea;
  • attacks of suffocation at night;
  • pain behind the sternum, transmitted under the scapula;
  • persistent dizziness.

The patient is almost always in a comfortable position for him – a sitting position. Quite often, fainting conditions are observed. During the course of the disease, cardiogenic shock, pulmonary edema and cardiac asthma develop.

Signs of right ventricular pathology:

  • uncomfortable sensation in the sternum;
  • dyspnea;
  • dizziness;
  • increased heart rate;
  • swelling of the extremities;
  • pallor of the skin;
  • swelling of veins located in the neck;
  • weakness;
  • ascites;
  • acrocyanosis;
  • hyperhidrosis;
  • gelatomegaly.

The disease is characterized by stagnation of blood in a large circle of blood circulation.

In the early stages of the development of the disease, the symptoms will be minor. During exercise, shortness of breath may occur. The patient often ignores it, due to age-related changes in the body. A cough appears due to increased pressure in the vessels of the lungs. There is a rapid heartbeat after physical exertion or eating. The patient complains of fatigue and general weakness.

Quite often, the patient decreases the amount of urine. This is due to circulatory disorders in the pelvis. Swelling appears on the lower extremities. The tip of the nose, as well as the skin of the feet and hands acquire a bluish tint.

As the disease develops, blood circulation in the brain occurs. The main symptoms at this stage are irritability, fatigue after mental exertion, a constant state of depression. There is a sleep disturbance. If measures are not taken in a timely manner, the pathology will lead to death.

Acute heart failure and its symptoms before death:

  • unbearable pain in the region of the heart and under the scapula;
  • drowsiness;
  • general weakness of the body;
  • noisy breathing, which then slows down, becomes convulsive;
  • dilated pupils;
  • change in the shade of the skin (pallor);
  • the pulse on the carotid arteries is not palpable;
  • lack of pupil and corneal reflexes;
  • faint state

A person can die in minutes. As a rule, fatal outcomes are observed outside stationary conditions. Death can occur as a result of nervous shocks or significant physical exertion. Mortality cases are frequent at rest. It all depends on the stage of development of the disease.

Chronic heart failure is a syndrome that is expressed in a decrease in systolic and diastolic function of the heart and chronic hyperactivation of neurohormonal systems. It occurs as a result of various cardiovascular diseases.

Today in the world there is a significant number of people with chronic heart failure. Of those who go to the clinic, patients with this diagnosis are only 1-2%, however, in older age groups, the incidence of the disease rises to 10%. Almost every second patient (49%) with a disease in the stage of decompensation is subject to hospitalization in the cardiology department of the hospital. [1] Thanks to successes in the development of cardiology, the detection of heart failure among the population has increased so much that it looks like a real epidemic. If timely treated for heart attacks and other diseases, you can significantly increase the life expectancy of patients.

Chronic heart failure occurs mainly due to atherosclerosis, coronary heart disease, and hypertension. Diabetes mellitus often leads to chronic heart failure in older people. In Russia, chronic obstructive pulmonary disease (13%) and an acute history of cerebrovascular accident (10,3%) also lead to the disease. [6] Many other diseases of the cardiovascular system that lead to chronic heart failure (heart disease, cardiomyopathy, myocarditis, cardiac arrhythmias) in total make up no more than 5%, since they are successfully treated. [2] In case of rejection of timely proposed surgical treatment, there may be irreversible consequences for life and health.

In Russia, chronic heart failure is more often registered in the female part of the population, and throughout the world it can often be found in men. Perhaps this is due to the closer attention of women to their health issues.

Forms of left ventricular dysfunction in chronic heart failure:

  1. Chronic heart failure with impaired systolic function – when the ejection fraction of the left ventricle decreases in 75% of cases.
  2. Chronic heart failure with impaired diastolic function – the ejection fraction of the left ventricle is not reduced, but a violation of its filling is determined, as a result of which pressure in the pulmonary veins increases in 25% of patients.

305 s - The most common symptoms of acute heart failure are

If you find similar symptoms, consult your doctor. Do not self-medicate – it is dangerous for your health!

Symptoms

Symptoms of acute heart failure are associated with impaired functions of the left or right ventricles.

The development of left ventricular failure is observed with pathologies that increase the load on the left heart. This is possible if a person suffers from hypertension, aortic defect, suffered myocardial infarction.

If the left ventricle cannot perform its functions, then there is an increase in pressure in large and small vessels of the lungs, their permeability increases, due to which the liquid part of the blood flows through their walls. Interstitial, and gradually alveolar edema develops.

ostraya serdechnaya nedostatochnost1 - The most common symptoms of acute heart failure are

The clinical picture of this condition is represented by cardiac asthma and alveolar pulmonary edema. An attack occurs if a person is subjected to physical or emotional stress. Patients usually suffer from sudden asphyxiation at night, which causes them to wake up.

Cardiac asthma is characterized by the appearance of a feeling of lack of air, palpitations, cough with sputum, severe weakness, cold sweat. An attack forces a person to crouch and lower their legs.

With the development of stagnation in the pulmonary circulation, pulmonary edema progresses. During a sharp asphyxiation, the patient begins to cough and foamy pink sputum is released, this is due to the appearance of blood impurities in it.

The patient breathes like a boiling samovar, is in a sitting position with his legs down, his face turns blue, the neck veins swell, the skin is covered with cold sweat.

In the presence of pulmonary edema, it is necessary to urgently deliver the patient to the intensive care unit and provide medical care, since the likelihood of a fatal outcome is very high.

ostraya serdechnaya nedostatochnost5 - The most common symptoms of acute heart failure are

Left atrial insufficiency is found in mitral stenosis. Clinical manifestations are similar to left ventricular pathology.

The development of right ventricular failure occurs in connection with a thrombus blockage of large branches of the pulmonary artery.

Stagnation develops in a large circle of blood circulation, due to which the lower extremities swell, it hurts on the right under the ribs, the veins in the neck are bursting and pulsating, shortness of breath occurs, the surface of the skin turns blue, pressing pains appear in the heart area.

There is also a weakening of the peripheral pulse, a sharp decrease in blood pressure.

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If the right ventricular pathology develops in the stage of decompensation, then the signs appear earlier than in acute left ventricular failure. This is due to the fact that the latter has a large set of compensatory capabilities, as it is the most powerful part of the heart.

At the beginning of the disease, symptoms of heart failure are noted exclusively during physical exertion. The appearance of shortness of breath is observed (frequent and deep breathing that does not correspond to the level of load), with an increase in pressure in the pulmonary vessels, a cough occurs, sometimes with blood. As a result of physical activity, taking a large amount of food and in a supine position – an increased heartbeat. The patient complains of excessive fatigue and weakness. Over time, there is an increase in symptoms that are now worrying not only with physical activity, but also at rest.

In heart failure, as a rule, a decrease in the amount of urine occurs, patients go to the toilet mainly at night. By evening, edema of the lower extremities appears, begins with the feet, and then “rises” upward, fluid accumulates in the abdominal cavity – ascites, the chest – hydrothorax, and the pericardium – hydropericardium. [3] The skin of the feet, hands, earlobes and tip of the nose becomes cyanotic. Heart failure is accompanied by stagnation of blood in the vessels of the liver, contributing to a feeling of heaviness and pain under the right rib.

Over time, with heart failure, there is a violation of blood circulation throughout the body, leading to general irritation, rapid fatigue as a result of mental stress. Body weight decreases, motor activity decreases, shortness of breath and edema increase. Weakness increases, the patient no longer gets up in bed, sits or lies on pillows with a high headboard. Sometimes patients are in serious condition for how many months, after which death occurs.

Causes

The heart is the main link in the blood circulation chain. Violations in his work will cause destabilization in the functioning of all organs.

The main causes of acute heart failure:

  • heart disease (acute myocardial infarction, myocarditis);
  • pathology of the development and operation of the chambers of the heart and its valves;
  • myocardial hypertrophy;
  • decompensation of chronic deficiency;
  • hypertensive crisis;
  • tamponade of the heart – stagnation of fluid between the leaves of the pericardial sac;
  • pulmonary embolism – the formation of blood clots, which most often clog veins in the pelvis and lower extremities;
  • acute diseases of the lungs and bronchi.

These causes of acute heart failure are observed due to disturbances in the functioning of the main organ. There is insufficient blood supply to the vessels.

There are several other reasons for the development of the disease that are not related to the functioning of the heart muscle. These include: extensive surgical intervention in the human body (restoration of internal organs after injuries), respiratory infections, brain injuries, nervous shocks, excessive use of antidepressants, bronchial asthma, stroke, toxic effects on the myocardium.

The latter is extremely dangerous for the whole organism. It appears as a result of excessive consumption of alcoholic beverages, as well as smoking.

Heart failure pathogenesis

When the stroke volume of blood circulation decreases, compensation mechanisms start: the frequency and strength of heart contractions increases as a result of activation of cardiac and extracardiac factors (activation of the neurohumoral systems of the body – sympathoadrenyl, renin-angiotensin-aldosterone system, calicrekininin system, system of natriuretic peptides) Due to this, it is supported in the early stages minute volume of blood circulation due to an increase in myocardial metabolism, remodeling of the heart.

In the future, hyperactivation of neurohumoral systems occurs, as a result of which the myocardium is damaged, pre- and post-load increase, sodium and water are delayed, normal cardiomyocytes are replaced by collagen, cardiomyocyte necrosis occurs, arrhythmias occur and myocardial contractility decreases. [7]

Remodeling of the heart develops: structural and geometric changes in the left ventricle, as a result of which the myocardium hypertrophies and dilation (expansion) of the heart occurs. As a result, the geometry of the heart changes and systolic and diastolic functions are disrupted. They include both changes in individual cardiomyocytes, a decrease in their number, and changes in the geometry of the left ventricle: dilatation, spherical configuration, thinning of the wall, relative mitral regurgitation.

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Due to the above factors, myocardial contractility, the size of the minute volume decreases, the final diastolic pressure of the ventricle increases and blood stasis appears in the venous channel of the small or large circles of blood circulation.

Traditional treatment

With timely diagnosis, the patient can save a life. The treatment of acute heart failure requires an integrated approach. The main actions are aimed at reducing the symptoms of the disease.

The patient is prescribed vasodilators to reduce pressure in the venous vessels. This type of medication will help reduce the amount of blood entering the heart. This effect suppresses systolic stress on the myocardium.

With the help of special medicines, foamy sputum and progressive shortness of breath are eliminated. Pulmonary edema and cardiogenic shock are neutralized.

If blood stasis is formed in a small circle of circulation, bloodletting is necessary. This will help suppress the risk of pulmonary and respiratory edema. As a result of proper treatment, blood flow in the venous vessels decreases.

In severe cases of the disease, leeches are additionally used. They are installed on the sacral region. When localizing an attack in the right stomach, leeches are placed in the liver. If cardiac asthma is observed, bloodletting is performed by a radical method.

Quite often, they try to treat a patient with the help of alternative medicine or folk remedies. Self-medication can lead to negative consequences, as well as death.

Features of the disease

Acute heart failure is a disease that occurs not only in an adult, but also in a child. It is possible to diagnose such a disease in time by passing certain tests and undergoing ultrasound.

Acute heart failure in children can be left ventricular, right ventricular and total. The disease occurs as a complication after infections, in the presence of allergic diseases, as a result of exogenous poisoning. Quite often observed in children who are born with heart defects. A feature of the disease is its rapid course.

There are three stages of the development of the disease:

  • At the first, shortness of breath, tachycardia, muffled heart sounds, wet and dry rales are observed, the minute volume of blood decreases.
  • The second is characterized by the presence of signs of pulmonary edema, enlarged liver, wheezing during breathing, puffiness of the face.
  • In the third stage, pulmonary edema, fluctuations in blood pressure and oligoanuria are diagnosed.

The disease can be triggered by a violation of the heart rhythm as a result of excessive activity. Myocardial integrity also plays a large role. With its injuries, blood flows untimely to all organs.

Complications and prognosis

If the patient is not provided with medical care on time, then death occurs.

  1. sudden death (three times more often than in people without heart failure); [3]
  2. thromboembolism of the pulmonary artery, cerebral vessels, etc.
  3. heart attack;
  4. rhythm disturbances;
  5. acute heart failure, pulmonary edema.
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Heart failure diagnosis

  • electrocardiogram;
  • echocardiogram (echocardiography, ultrasound of the heart);
  • chest x-ray;
  • Holter monitoring;
  • general clinical tests: general analysis of blood, urine, biochemistry (creatinine, bilirubin, protein, cholesterol, etc.);
  • a blood test for brain natriuritic peptide (a hormone whose level rises even with minor heart failure). [3]

Main reasons

The development of the acute form occurs under the influence of:

  1. Diseases that reduce the contractility of the heart muscle, damaging or stunning it. This occurs with myocardial infarction, when a violation of the blood flow to the area of ​​the heart causes cell death, with inflammation of the heart muscle, as well as after surgical interventions on the heart or as a result of the use of a cardiopulmonary bypass.
  2. Decompensation of chronic insufficiency, as a result of which the heart can not provide organs with enough blood.
  3. Violations of the integrity of valves and chambers.
  4. Accumulation of fluid between the sheets of the pericardial sac, making normal heart contraction impossible due to compression of the heart cavities.
  5. Thickening of the walls of the heart muscle.
  6. Hypertensive crisis. In this case, blood pressure indicators significantly exceed the norm.
  7. Pathologies of the pulmonary circulation. Acute insufficiency can be caused by blockage of the pulmonary artery by blood clots, which usually form in the lower limbs or pelvis, acute lung pathologies such as bronchitis or pneumonia, acceleration or deceleration of the heart rhythm.

There are also extracardiac causes of the disease. Acute cardiovascular failure can be caused by:

  • infectious processes;
  • a developing circulatory disturbance in the brain, in which tissues are damaged, and organ functions are impaired;
  • extensive surgical interventions;
  • severe brain injuries;
  • toxic effects on the heart muscle with drugs or alcohol;
  • electric pulse therapy, injuries resulting from exposure to an electric current.

Forecast. Prevention

To avoid acute heart failure, you must:

  • visit a doctor at least twice a year, especially if there are chronic diseases of the cardiovascular system;
  • quit smoking and alcohol abuse;
  • avoid psycho-emotional stress;
  • maintain optimal body weight;
  • provide yourself with regular physical activity;
  • monitor blood pressure indicators;
  • eat rationally and balanced, consume foods that contain more fiber, refuse fried foods, hot and spicy;
  • monitor cholesterol.

Compliance with these recommendations will reduce the likelihood of developing acute heart failure.

50% of patients with heart failure live more than five years. The long-term prognosis depends on the severity of the disease, lifestyle, the effectiveness of the selected treatment, concomitant background, etc.

Successful treatment in the early stages can fully compensate for the condition of patients; in the third stage of heart failure, the prognosis is the saddest.

For the prevention of heart failure, it is necessary to minimize the influence of factors that contribute to its occurrence (IHD, hypertension, heart defects, etc.). [eleven]

To prevent heart failure from progressing, you must follow the recommended regimen of physical activity, take prescribed medications regularly and without omissions, and be constantly observed by a cardiologist.

Diagnosing

Signs of acute heart failure are an indication for urgent hospitalization. During the diagnosis:

  1. An anamnesis of the disease and assessment of patient complaints are analyzed.
  2. They analyze a life history. This will reveal the possible causes of the development of a pathological condition.
  3. Determine the presence of similar problems in the next of kin.
  4. Do a medical examination. The determination of wheezing in the lungs, heart murmurs, measurement of blood pressure, determination of hemodynamic stability (features of the movement of blood through the vessels). Maintain an adequate level of blood pressure and heart rate.
  5. Perform electrocardiography. During the study, an increase in the size of the left ventricle, signs of overload, and other specific features of a violation of blood flow to the heart muscle are revealed.
  6. Assign a general blood test. The procedure reveals the presence of an inflammatory process to increase the level of white blood cells, increase the erythrocyte sedimentation rate.
  7. A general blood test is performed. If protein, white blood cells and red blood cells appear in the urine, this indicates diseases that are a complication of heart failure.
  8. A biochemical blood test is performed to determine cholesterol, triglycerides, and glucose.
  9. Perform echocardiography. This is an ultrasound scan of the heart, which is used to evaluate and monitor local and general functions of the ventricles, valves, identify pathological processes in the pericardium, mechanical complications after myocardial infarction, neoplasms in the heart and other features.
  10. Determine the level of biomarkers that are specific signs of myocardial damage.
  11. Assign a chest x-ray. During the procedure, the size and clarity of the heart shadow, as well as the severity of congestive processes in the lungs, are assessed. X-ray allows you to confirm the diagnosis and evaluate the effectiveness of therapy.
  12. The gas composition of the blood is determined.
  13. Assign coronary angiography. This is a radiopaque technique for examining coronary vessels that provide blood to the heart. The procedure helps to identify in which place and how much the artery is narrowed.
  14. Perform multispiral computed tomography using a contrast agent. During the study, a contrast agent is introduced, which allows you to see the image of the heart and create its three-dimensional model. The method is necessary to identify possible defects in the walls of the heart, valves, check their work and identify the narrowing of the heart vessels.
  15. Pulmonary artery catheterization is performed to determine the acute form of heart failure.
  16. Assign magnetic resonance imaging to obtain an accurate image of the organ.
  17. The natriuretic peptide is determined. An increase in its level occurs depending on the degree of heart failure.

Therapies

Acute heart failure is a condition that threatens a person’s life.

Therapy of the disease after first aid depends on the main reason:

  1. If the violation is caused by arrhythmia, then in order to stabilize the patient’s condition and establish blood circulation, restore the normal frequency of contractions.
  2. In the presence of myocardial infarction, systemic thrombolysis is used to restore normal blood flow, that is, thrombi are dissolved with the help of thrombolytic drugs. Medicines are administered intravenously.
  3. If acute failure occurs due to injuries, rupture of the myocardium, damage to the valve, it is necessary to urgently hospitalize the patient and provide him with surgical care.

Acute congestive right ventricular failure is treated with the method of correction of the conditions that caused it, that is, they eliminate thromboembolism, asthmatic status.

Direct heart failure is eliminated:

  1. ostraya serdechnaya nedostatochnost6 - The most common symptoms of acute heart failure areOxygen therapy.
  2. Sedation. Medications cause sleep, from which the patient can be woken up at any time.
  3. Painkillers.
  4. Cardiac glucosides, which have a stimulating effect on the heart.
  5. Cardiotonic to increase contractility of the heart muscle.
  6. Diuretics to remove excess fluid from the body.
  7. Vasodilator drugs.
  8. Antiplatelet agents to reduce platelet adhesion.

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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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