Chronic heart failure

Description:

The Chronic Heart Failure (CHF) is one of the most frequent complications of diseases of cardiovascular system. Any heart trouble leads to decline in the ability of heart to provide an organism with sufficient inflow of blood. I.e. to reduction of its pumping function /

In many cases heart failure becomes a cause of death and according to the American researchers reduces quality of life of the patient by 81%.

Symptoms of Chronic heart failure:

Chronic heart failure at early stages of development is shown generally by symptoms of reduction of cordial emission: bystry fatigue, muscular weakness, feeling of shortage of air, chill. At an exercise stress an asthma, feeling of serdtsebiyeniye are observed. In process of progressing of heart failure the complaints reflecting development of stagnation in bodies (the II stage of a circulatory unefficiency) begin to prevail. At a left ventricular failure into the forefront the asthma at the lesser exercise stress and then arising and at rest acts, especially at horizontal position of a body because of what patients prefer to sit or stand — an orthopnea. At night there are suffocation attacks — cardiac asthma; the exercise stress can lead to edematization of lungs. When progressing right ventricular insufficiency patients complain of decrease in a day diuresis, emergence of hypostases on feet and shins by the end of day. Then hypostases become constant, widespread, but more expressed on low-sited body parts — hypostatic hypostases. The stomach at the expense of a meteorism, congestive increase in a liver, later — ascites increases. Nausea and a loss of appetite (congestive gastritis) are possible. At a mitral stenosis cough, a pneumorrhagia quite often develop.

Reasons of Chronic heart failure:

The accruing heart failure exceeds that disease which caused it heart failure on danger to the patient's life eventually. More often chronic heart failure coronary heart disease, a myocardial infarction, arterial hypertension, a cardiomyopathy cause, defects of valves of heart.

Treatment of Chronic heart failure:

Treatment of chronic heart failure is generally carried out on an outpatient basis, includes, in addition to therapy of a basic disease (for example, coronary heart disease), restriction of physical activity and psychoemotional tension, occupation with physiotherapy exercises, use rich with protein and vitamins of a diet with restriction of table salt up to 3 — 4 g a day (sometimes to 1 — 2 g a day) and liquids (to 800 — 1200 ml a day), medicinal impact on pathogenetic links of heart failure. The main pathogenetic remedy for the chronic heart failure which developed against the background of a ciliary tachyarrhythmia are cardiac glycosides. Parenterally enter строфантан, Korglykonum, digoxin. For intake appoint digoxin, Celanidum  , etc. The dose of cardiac glycosides is selected by the doctor. The average health worker helps to control efficiency of the picked-up dose (on dynamics of an asthma, hypostases, portability the patient of loading, etc.) and its safety.

In the presence of peripheral hypostases, a hydrothorax, ascites use diuretics — lasixum (furosemide), Uregitum, hypothiazid, etc. sometimes in combination with antagonists of Aldosteronum (верошпирон at a hyper aldosteronism) and potassium drugs (potassium chloride, etc. at a hypopotassemia). For prolonged use use kaliysberegayushchy diuretics (Triamterenum, Triampur compositum). These means are appointed by the doctor; the average medic helps to control their action, measuring a diuresis and body weight of the patient in dynamics. In the course of treatment by diuretics it is periodically necessary to investigate the content in blood of potassium, sodium, uric acid and indicators of acid-base balance.

Purpose of the drugs improving a hemodynamics as a result of peripheral vasodilating action (vazodilatator) is in most cases reasonable. First of all apply the angiotensin-converting enzyme inhibitors (капотен, enalapril, kyyulaprit, etc.) operating both on arterial and on venous vessels. Use nitrates less often — nitroglycerine, Nitrosorbidum (generally reduce a tone of veins), apressine, phentolamine (expand arterioles), Sodium nitroprussidum, Prazozinum (affect a tone of arterioles and venules). At their use decrease in the ABP, emergence or strengthening of tachycardia, development of the hypostases steady against effect of diuretics are possible. Appoints vazodilatator and controls effect of their action only the doctor.