Cardiac asthma

Short characteristic of a disease

Cardiac asthma is a complication of a hypertension, an atherosclerotic cardiosclerosis, a heart attack, cordial defects.

Cardiac asthma as the attack of short wind and suffocation provoked by stagnation of blood in pulmonary vessels, difficulties of its outflow in the left cordial ventricle looks.

Emergence reasons

Cardiac asthma develops because of narrowing of the left atrioventikulyarny opening or left ventricular heart failure at myocarditis, an acute heart attack, an extensive cardiosclerosis, aortal cordial defects, insufficiency of the mitral valve, aneurism of a left ventricle, paroxysmal big rises in pressure which are followed by the excessive tension of a myocardium of a left ventricle.

As the attack reason serves usually emotional or exercise stress, increase in pressure, a stenokardichesky attack in the afternoon. In rare instances asthma arises after plentiful drink or food, but more often the attack develops at night, during sleep.

Symptoms of cardiac asthma

The main symptom of cardiac asthma – a pristupoobrazny asthma at which the extended noisy breath prevails.

Symptoms of the cardiac asthma arising in the afternoon: heartbeat, constraint in a breast just before an attack.

If asthma develops at night, the patient wakes up from shortage of air, the complicated breath, constraint in a breast, dry cough. On a face there is a sweat, the patient feels concern and fear. During an attack usually breathe through the mouth, it is difficult to talk, there is notable oxygen requirement.

Diagnosis of a disease

Diagnosis during an attack is carried out by means of assessment of symptoms of cardiac asthma. Differential diagnosis with bronchial asthma is of great importance (especially at elderly persons).

It is very important to establish asthma origin since when rendering acute management at cardiac asthma for stopping of an attack other medicines which are not applied at asthma bronchial are used absolutely.

The doctor has to listen to the patient's heart. The cantering rhythm is characteristic of this type of asthma, over a pulmonary trunk the accent two tones is listened. Pulse can be with weak filling, tachycardia can develop, the exhalation does not cause difficulties and remote rattles are listened. Deviations can be seen also on an ECG: coronary insufficiency, disturbance of a rhythm is noticeable.

At typical symptoms it is possible to diagnose cardiac asthma, but if there are bronchospasms, the patient or his acquaintances are interviewed regarding predisposition of the patient to an allergy, existence of chronic bronchitis or other pulmonary diseases.

Treatment of cardiac asthma

Treatment begins with rendering acute management at cardiac asthma which is directed first of all to reduction of excitability of a respiratory center, loads of a small circle of a blood-groove. For this purpose subcutaneously enter solution of morphine of 1% (or solution of pantopon of 2%) with solution of atropine of 1%. If tachycardia is expressed (more 100ud/minute), instead of atropine enter Pipolphenum, Suprastinum or Dimedrol – 1 ml into a muscle. If pressure at the patient low, morphine (pantopon) is replaced with solution of Promedolum of 2% which is entered subcutaneously. Supplement it with caffeine, camphor. It is impossible to enter morphine and at disturbance of a respiratory rhythm, discontinuous breath at which the frequency and when the origin of an attack remains not clear decreases (at bronchial asthma it is impossible to enter morphine).

As reception of acute management at cardiac asthma apply bloodletting: produce 200-300ml blood. It is impossible to carry out bloodletting with the lowered pressure. In this case, and also, if veins are expressed badly, or it is necessary to carry out bloodletting repeatedly, on legs impose the plaits squeezing veins (not arteries – pulse has to be probed). Plaits hold no more than 30 min., remove them gradually, weakening bucketed several minutes. Imposing of plaits is excluded if at the patient hypostasis of extremities, hemorrhagic diathesis, thrombophlebitis, a heart attack, a stenokardichesky attack is observed.

Also, stopping an attack, at pulse not less 60ud/minute (and if the patient did not accept the drug containing a foxglove) enter solution of strophanthin of 0,05% - 0,5ml. Administer the drug usually at once after bloodletting (if it was carried out), in the same needle. Often drug is supplemented with an Euphyllinum – means is effective at the mixed asthma with symptoms of a cordial and bronchial origin, at a mitral stenosis. It is impossible to enter an Euphyllinum with a low pressure.

Treatment of cardiac asthma is continued by carrying out measures for reduction of stagnation in lungs. For this purpose intravenously enter 40 mg of lasixum (furosemide) or 50gr Uregitum (Acidum etacrynicum). Sometimes at patients with a hypertension, an atherosclerotic cardiosclerosis the good effect is observed after nitroglycerine reception.

All stages of treatment of cardiac asthma carry out against the background of continuous oxygen therapy. At oppression of a respiratory center enter camphor, lobeline, Cordiaminum. To the patient during an attack the maximum rest is put. It is impossible to transport it, all necessary procedures for treatment of cardiac asthma are carried out on site. Hospitalization is necessary, only if it was not succeeded to stop an attack.

Prevention of a disease

The effective prevention of an attack requires urgent and correct treatment of a basic disease that can include restriction of liquid, salt, reception diuretic, cardiacs.