The heart muscle is the main organ in the human body. It is responsible for supplying blood to soft tissues. In the event of a failure, the body quickly dies due to a lack of oxygen and nutrients. One of the most severe cardiac disorders is considered to be cardiac asthma.
It is characterized by stagnation of blood in a small circle, as a result of which the lungs begin to experience a lack of nutrients. On the other hand, against the background of blood accumulation in the capillaries of the respiratory organs, their edema occurs. As a result, the person suffers from asthma attacks. In such a situation, the immediate assistance of medical professionals is required.
Medical certificate
Cardiac asthma is a pathology accompanied by attacks of shortness of breath and suffocation of varying degrees of intensity. Its development is preceded by stagnant processes in the pulmonary circulation. Due to the influence of provoking factors and against the background of a deterioration in the work of the heart, there is an insufficient functioning of the left sections of the heart muscle. At the same time, the activity of the right departments is fully preserved.
Due to the resulting dissonance in the left atriumthe pressure increases. The same indicator increases in the vessels of the small circle. At the same time, pressure increases in the capillaries, arteries and veins of the lung tissues. With a further increase in the listed parameters, a compensatory mechanism is activated - the so-called Kitaev reflex. This condition is characterized by spasm of the vessels of the pulmonary system as a response to an increase in pressure in the left side of the heart. A vicious circle begins.
Subsequently, there is sweating and extravasation of blood cells, first into the interstitial space, and then into the cavity of the alveoli. This stage is alveolar edema. The sweating substance contains plasma, an increased amount of protein and red blood cells. Air flows are mixed with transudate in the cavity of the alveoli, which is accompanied by the release of pinkish foamy sputum. The progression of the pathological process inevitably leads to hypoxemia and hypoxia.
Main reasons
The main cause of cardiac asthma is acute heart failure affecting the left side of the body's main muscle. This disease, in turn, can develop against the background of the following reasons:
- diffuse cardiosclerosis;
- myocarditis;
- Left ventricular and atrial aneurysms;
- IHD;
- previous myocardial infarction;
- acquired heart valve defects (e.g. stenosis);
- presence of large blood clots in the muscle.
The following factors increase the risk of developing cardiac asthma: unbalanceddiet, smoking, alcohol abuse and frequent stress. Modern man experiences their impact daily.
Clinical picture
Manifestations of bronchial asthma and cardiac asthma are similar in many ways. The most characteristic symptom is increasing shortness of breath. It can appear suddenly or after intense physical activity. Nervous strain should also be included among the provoking factors.
Approximately 2-3 days before the upcoming attack, the so-called harbingers appear. These disorders include the following disorders: cough after a change in body position, shortness of breath, discomfort in the chest area.
The attack of cardiac asthma itself usually occurs at night, when the whole body is resting, and the elements of the pulmonary circulation are filled to the maximum. During the day, it can be provoked by physical or emotional overstrain. A sudden feeling of lack of oxygen and shortness of breath appearing at the same time make you wake up. A person cannot lie down and intuitively takes a comfortable position in which he feels better.
It is hard for the patient to speak, he is forced to breathe only through his mouth. The following symptoms of cardiac asthma are sometimes added to the above signs:
- Feeling afraid and afraid to die.
- Changing the skin color of the nasolabial triangle to cyanotic.
- Tachycardia.
- Increase in blood pressure.
- Small bubbling dry rales in the lungs.
The appearance of these symptoms of cardiac asthma requires immediate medical attention. If the patient every timewill postpone a visit to the doctor, the clinical picture may worsen. Usually it is supplemented by a deterioration in the general condition, a drop in blood pressure, a change in skin color. Moreover, each time the attack increases in duration. The appearance of foamy sputum with blood impurities indicates the transition of the disease to pulmonary edema.
Cardiac and bronchial asthma: differences
Many due to insufficient medical knowledge often confuse bronchial asthma with heart disease. Such errors are due to a similar clinical picture. In both cases, the patient experiences shortness of breath and asthma attacks. However, the main difference is in the cause of shortness of breath. In the first case, bronchospasm and pulmonary edema act as factors provoking the disorder. Cardiac asthma is a consequence of the failure of the pumping function of the heart. The bronchial variant requires direct contact with irritating elements, a history of allergic ailments. This is an independent disease. Heart disease is always one of the manifestations of heart failure.
Differential diagnosis of both ailments is extremely important for the appointment of competent treatment. The primary role in this matter is played by the patient's history, the study of his complaints, ECG data.
First Aid
With cardiac asthma, emergency care should be provided to the patient immediately. First of all, it is recommended to call a team of medical workers, and secondly, to perform a number of specific actions to alleviate the person's condition.
- The patient must be seated on the bed so that the legs are lowered down.
- Open a window to ventilate the room.
- It is recommended to remove all squeezing clothes, loosen the tie, unfasten the belt. In this way, normal blood flow can be restored.
- The limbs should be bandaged or bandaged. This will fill the venous bed, relieve the load on the heart muscle.
- It is important to measure the pressure. If the blood pressure indicators are normal or slightly higher than this mark, the patient should be given a Nitroglycerin or Validol tablet. At low pressure, the combination of these drugs is prohibited. In this case, only "Validol" is allowed. After 10 minutes, the pressure should be measured again. If the indicators do not return to normal, you need to repeat the treatment. However, taking drugs is allowed no more than three times.
- After the patient sits in this position for about 10-15 minutes, it is recommended to lower the legs into a basin of warm water.
- In order to avoid the development of pulmonary edema, and only with full access to fresh air, you can let the victim breathe in ethyl alcohol vapor. For this purpose, a small piece of cotton cloth or a regular cotton pad is moistened in the solution and covered with nasal passages.
- Sedative drugs help with excessive stress and anxiety. They can be found in any person's first aid kit.
Asthma care is usually continued while the patient is being transported to a medical facility. When diagnosedexcitation of the respiratory center with rapid breathing, narcotic analgesics are used. Among the drugs from this group can be noted "Omnopon", "Morphine". However, these medications are categorically contraindicated in pregnancy, cerebral edema, airway blockage.
In case of severe psychomotor overexcitation, the above drugs are used in combination with neuroleptics ("Haloperidol", "Droperidol"). Medical emergency care is usually supplemented by the introduction of a solution of Dimedrol.
After stopping the attack, further treatment is carried out in a hospital. The therapy is aimed at reducing the excitability of the respiratory center, reducing the load on the pulmonary circulation. All drugs for this purpose, their dosage and duration of administration are selected individually.
Medical examination
Diagnosis of cardiac asthma is usually straightforward. First, the doctor conducts a survey of the patient, during which he may ask a number of clarifying questions. It is important for him to know when the initial symptoms of malaise occurred, what factors preceded them, how long each attack lasts. Then the specialist proceeds to a physical examination. At the same time, he should pay attention to the color of the skin, breathing, body position and general condition.
After that, the doctor proceeds to auscultatory diagnostic methods. Using a phonendoscope, he evaluates the functioning of the lungs, the functioning of the respiratory tract and the heart muscle.
Clear signscardiac asthma from the respiratory system are wheezing when breathing and coughing. This may be accompanied by the separation of sputum with blood impurities. During auscultation of the heart, muffling of its tones is often observed, which is typical for disruption of the myocardium, and noise may appear. Also, pathology is always accompanied by:
- expressed tachycardia, in which the heart rate is 110-150 beats;
- inspiratory dyspnea;
- tachypnea (rapid breathing).
If there are suspicions of cardiac pathology, the patient must be prescribed an ECG. This examination allows you to determine the state of acute myocardial infarction or previous pathology. In addition, it helps to identify hypertrophy of various parts of the heart, a violation of the processes of impulse transmission.
Additionally, chest X-ray, echocardiography with Doppler effect may be required. The listed diagnostic methods help to assess the clinical picture of the pathology, the work of the heart muscle, to find out the cause of the underlying disease.
Features of treatment
Night attacks of shortness of breath and suffocation in the initial stages can pass on their own. However, this fact does not allow the patient to ignore the symptoms of pathology. Due to the high likelihood of developing pulmonary edema and the occurrence of a threat to life during an attack of cardiac asthma, emergency care is simply necessary for the patient.
Therapeutic measures prescribed by doctors have several goals at once: to reduce the load on the small circleblood circulation, restore the emotional background of the patient, reduce the excitation of the respiratory center. Therapy for patients with severe shortness of breath and severe pain involves the use of narcotic analgesics ("Morphine", "Pantopon"). If there is a pronounced tachycardia, these drugs are taken simultaneously with "Suprastin" or "Pipolfen". In case of bronchospasm, cerebral edema or respiratory depression, they are replaced with Droperidol.
Treatment of cardiac asthma with venous congestion and arterial hypertension includes a bloodletting procedure in a volume of 300-500 ml. In the absence of serious contraindications to the patient, tourniquets are applied to the limbs, squeezing the veins and artificially creating venous congestion. The maximum duration of the entire procedure is 30 minutes. In this case, the doctor must constantly monitor the pulse. In case of urgent need or deterioration of the patient's condition, the procedure is immediately stopped.
In addition to the above measures, blood pressure is always corrected with the help of antihypertensive and diuretic drugs. In almost every case of an attack, it is considered appropriate to administer cardiac glycosides ("Digoxin", "Strophanthin"). The use of such a popular drug as "Eufillin" shows the greatest effectiveness in mixed pathology, when the patient is diagnosed with both bronchial and cardiac asthma. In the clinic, a patient with heart rhythm disturbances can be defibrillated.
After stopping the symptoms of an attack, they usually start treating the underlying disease to prevent it from recurring.appearance in the future.
Need to change diet
After discharge from the hospital, the patient must adhere to the doctor's prescriptions to prevent recurrent attacks. The focus is on eliminating factors that can trigger shortness of breath and cough. First of all, it is recommended to eradicate all addictions, adhere to a diet and a certain diet. It is extremely important to normalize the time of rest and wakefulness, to avoid psycho-emotional shocks.
Meals are usually based on the following rules:
- The number of meals per day should be 5-6 times. Many worry that with such a regimen, you can quickly recover. Actually it is not. Eat often, but in small portions.
- Food should be high in calories, but well absorbed.
- Pastries and sweets, coffee, spicy and fatty foods, smoked meats and semi-finished products should be excluded from the diet.
- Cooking is best in a double boiler or oven. Preference should be given to light food: lean meats and fish, cereals. Be sure to include fresh vegetables and fruits in your diet. Black tea should be noticed on green or herbal infusions, fruit drinks.
- It is important to pay attention to the drinking regimen. It is recommended to consume up to two liters of non-carbonated pure water per day. But it is better to refuse a large amount of s alt and spices.
Diet and drug treatment of cardiac asthma is selected by a doctor, taking into account the general conditionthe patient's he alth, the presence of concomitant ailments.
Some patients prefer treatment with folk remedies. The most popular are decoctions based on coltsfoot, wild rose root, and strawberry leaves. All of them are prepared according to the same principle. A tablespoon of dry grass requires a glass of boiling water. The resulting infusion must be left for 30 minutes, strain. Take it in small sips throughout the day. It is worth noting that treatment with non-traditional means is permissible only during the inactive period of the disease and after consulting a doctor.
Possible consequences
The development of heart failure, asthma against its background is accompanied by unpleasant symptoms. In most cases, they indicate serious damage to the heart muscle. Therefore, without appropriate treatment can not do. Patients with such a diagnosis are shown therapy in a hospital setting. After discharge, they need to be constantly monitored by a cardiologist.
If you follow all the recommendations from the attending physician after recovery, you can maintain a satisfactory condition. However, in this case, the patient will have to radically change their usual way of life. As a rule, it is necessary to give up addictions and intense sports, follow a diet, and regularly undergo preventive examinations.
Prevention Methods
To prevent the occurrence of cardiac asthma with subsequent pulmonary edema, it is necessary to engage in prevention. It implies timely treatment of allcardiac diseases. In addition, it is necessary to completely reconsider the pace of life, try to relax more.
It is important to completely eradicate addictions, normalize nutrition, sharply limit excessive consumption of s alt and products with animal fats. Do not overeat or exceed the allowable amount of fluid consumed, especially in the evening. The last meal, according to doctors, should take place about 4-5 hours before bedtime.
On the one hand, intense physical activity is not recommended, and on the other hand, a sedentary lifestyle. They worsen hemodynamic parameters approximately equally. After therapeutic measures in a hospital, breathing exercises, exercise therapy and walking are necessarily used with a gradual increase in duration and pace.
