Heart (cardiac) asthma - a heavy clinical syndrome, which is a sudden appearance of asthma attacks.The main reason for the attack of cardiac asthma is in violation of the functioning of the left heart (acute left ventricular failure ), occurs most often in the background of the disease of the circulatory system.
Cardiac asthma is characterized by decreased myocardial performance and, as a result stagnation in the pulmonary circulation.Recently become a cause of acute disorders in the respiratory and circulatory systems.At risk are people over 60, but it is possible occurrence of attacks at a young age, as the recent trend to an increase in diseases of the cardiovascular system among the youth.
Cardiac asthma causes
determines the cause of a given syndrome - acute left ventricular failure, mitral stenosis (narrowing of the mitral valve), aortic regurgitation.Deterioration of the left ventricle leads to interstitial pulmonary edema, which causes disturbances in the process o
These pathological processes usually occur at any circulatory disease: myocarditis, acute coronary syndrome, aortic valvular heart disease, postpartum cardiomyopathy, hypertension, arrhythmia, cardiosclerosis, heart aneurysm, and others. Dangerous paroxysmal ups of blood pressure (BP) with a significantload on the myocardium of the left ventricle (hence its voltage, for example, in the case of a pheochromocytoma).
identify risk of heart attack of asthma when there is an increase in the volume of circulation (fever, physical activity), the volume of circulating blood (human intake of large amounts of fluid during pregnancy), and finding the patient in the supine position, a strong emotional disorder.In all cases, it increases blood flow to the lungs.Before an attack, patients often feel discomfort in the chest in the form of embarrassment, felt the heartbeat, can cough.
in the development of cardiac asthma are guilty and some extracardiac causes: infectious diseases (pneumonia, septitsiemii), acute circulatory disorder in the brain, acute glomerulonephritis (kidney disease), severe substance dependence, asthma and others. The attack can occur as a postoperative complication.
Cardiac asthma symptoms
main signs of cardiac asthma during wakefulness are shortness of breath, coughing, feeling of tightness in the chest during minor physical work under mental stress or overeating, making the horizontal position.
However, in most cases, cardiac asthma attack catches off guard man at night, because in the process of sleep weakens adrenergic regulation and increases blood flow to the lungs.The patient wakes up from lack of air, increases shortness of breath, which goes into suffocation.Noted dry cough with phlegm or later transparent pinkish sputum streaked with blood.Increased respiratory rate - the number of 40-60 breaths / min.at a rate of about 20 / min.
cardiac asthma attack When a person is forced to take a vertical position, sitting on the bed, as a result of this action is decreased shortness of breath (orthopnea), which brings some relief to the person.The patient breathes through the mouth, it is difficult.The lungs are heard whistling dry rales (in the case of bronchospasm), finely crackles (while listening to the chuck area, wheezing both sides or just on the right side).
Auscultation of the heart becomes a time consuming process, as when listening to the noises and wheezing observed.However, when listening can be detected in deafness cardiac tones, single or wheezing rales scattered form.Can not reveal signs leading disease (failure of the heart valves, aortic valves, heart rhythm disturbance).Chest radiography will reveal signs of stagnation of blood in the veins and an excess of blood in the pulmonary circulation.Transparent lung field, the roots of the lungs can be expanded and blurred on the radiograph.
sudden awakening of attack causes a patient excited state, anxiety, panic, developing into the fear of death.Therefore, patients with cardiac asthma often differ inappropriate behavior, which complicates the process of providing them with first aid.Examination of the patient can detect cyanosis in the area of the nasolabial triangle cyanosis of the finger phalanges, increased diastolic blood pressure, tachycardia.
cardiac asthma attack usually lasts a few minutes or it may take up to 2-3 hours.The frequency of attacks and their features are dependent on the course of the underlying disease:
- in the case of mitral stenosis attacks are rare because of the presence of reflex Kitaeva (reflex narrowing of the pulmonary alveoli, which hampers the occurrence of stagnation in the capillaries, venous)
- attacks in acuteright ventricular failure may all pass.
Long bouts of cardiac asthma causes the emergence of "gray" cyanosis, serves cold sweat, swollen neck veins.There thready pulse and fall in blood pressure, the patient feels fatigue.
Cardiac asthma treatment
in cardiac asthma due to increased capillary permeability is extensive flow of plasma in the lung tissue, especially in the perivascular, peribronchial space.In this regard, it is developing interstitial pulmonary edema.The result of this process, it becomes a violation of lung ventilation and the normal exchange of gases between the alveoli of the lungs and blood.
separate role in the event of an attack from neuroreflex regulation links the process of respiration, blood circulation in the brain.Stimulation of the respiratory center due to irregularities in its blood supply or rejection reflex character (a response to the pulses of the centers of irritation) entails development of the autonomic symptoms during cardiac asthma.
In the treatment of cardiac asthma is necessary to the differential diagnosis of this disease with bronchial asthma (as well as with acute laryngeal stenosis, mediastinal syndrome, dyspnea in uremia, hysterical attacks).It is compared with cardiac asthma occurs with other manifestations of allergy.
cardiac asthma attacks occur with small changes in respiration rate, which is much more difficult, and lengthening the time of exhalation.The sputum by coughing consistency resembles a viscous mucus.When you exhale marked swelling of the neck veins, which falls during inspiration.There have been signs of emphysema (percussion), dry wheezing (during auscultation).
effectively conduct in the differential diagnosis of ECG at the time of the attack, the study of cardiac asthma clinic, medical history of the patient, an objective examination and chest X-ray.
If you are unable to provide urgent medical care at an attack, emergency treatment of cardiac asthma has been a paramedic, a nurse.Advance preparation of the patient is reduced to its convenient location (half-sitting) and the release of the neck, abdomen to facilitate breathing.
Then may use the following means:
- Furosemide intravenous administration;
- the use of narcotic analgesics (pantopon, Morphine).Analgesics administered in combination with atropine, in the case of a tachycardia - with pipolfenom, Suprastinum instead of atropine;
- if developed bronchospasm, swelling of the brain, and others. Complications used neyroleptanalgetik (droperidol);
- if necessary, reduce the load on the pulmonary circulation may be bled to 0.5 liters of blood;
- tourniquet (unless contraindicated);
- inhalation of oxygen for a long time, which should be repeated (carrying out the procedure by ethanol using a mask, nasal cannula);
- adjustment of blood pressure (the use of antihypertensive drugs, the use of diuretics;
- use cardiac glycosides (digoxin, Strophanthin).
result of an attack of cardiac asthma is mainly determined, the flow of the underlying pathology, which leads to seizures.
Mosttotal predictions of cardiac asthma is unfavorable. However, preventing the recurrence of attacks possible during the combined treatment and strict observance of the patient medical prescriptions. In this case is supported by the normal condition of the patient, efficiency is maintained for several years.
of the treatment of chronic ischemic heart disease, hypertension, nedopuskanie developmentinfectious diseases, as well as following the water-salt regime are the basis for the prevention of cardiac asthma and her attacks.
Cardiac asthma first aid
At the first sign of cardiac asthma should call an ambulance, and in anticipation of her arrival - provide the patient first aid.
To reduce the load on the heart, facilitate breathing, give the patient Half-upright position, you also need to release the throat and the whole body of compressive garments (open collar, loosen the belt on the abdomen, if there is one, and so forth.).The patient is best positioned at the open window for fresh air.It is recommended to do a foot bath, which will have a calming effect on the patient.
Before the arrival of emergency should be at all times to monitor your blood pressure (if the person prior to the event with an attack of cardiac asthma have had problems with the cardiovascular system, in his house is likely to be present tonometer).It is recommended to give the patient nitroglycerin.Sublingual tablet is held (ie under the tongue), until it is completely dissolved.After 5 minutes, the manipulation may be repeated no more than 2 times.If you have a spray nitroglycerin should give it preference.If preparations containing nitroglycerin, no nearby, give the patient a pill Validol.
efficacy in primary care has the imposition of venous harnesses, after 5-10 minutes as the patient brought into a state of half-sitting.If there is no special wiring harness, it can perform the role of an elastic bandage, nylon stockings.The strands are superimposed simultaneously in an amount of 3 pieces: on both legs and hands.When overlaying tourniquet on his leg is 15 cm from the inguinal fold, the arm harness - 10 cm from the shoulder joint.After 15 minutes, change the location of one of his harness laying on the free limb.Tourniquet is used to create a stagnation of blood in the extremities, thus becoming less strain on the heart and decreases the likelihood of developing pulmonary edema.Correctness tourniquet test is controlled pulsation of the arteries in which the pulse must be perceptible at a palpation below the location of the harness.Certainly after compression harness after a few minutes it becomes purple-bluish color.
patient with an attack of cardiac asthma had to be hospitalized in the hospital, despite the fact whether it was possible to stop an attack before the arrival of medical ambulance workers.The main cause of heart attack, asthma is found in the hospital, after which the doctor will prescribe the appropriate treatment.
self-medication at home and appeal to traditional medicine is strictly prohibited.This can lead to complications of the disease or cause at all to death.