Chronic heart failure in the stage of decompensation

A pathology in which the heart, even at rest, is not able to perform its functions - this is what decompensated heart failure is.

DHF is the last degree of development of heart failure. At this stage, the heart does not cope with its functions and cannot provide the body with normal blood circulation, not only during physical and emotional stress, but also in a calm state. Clinical picture of DHF

The following symptoms are characteristic of the disease:

• shortness of breath with minimal physical exertion. It occurs as a result of stagnation of blood in the lungs. Without treatment, shortness of breath bothers patients at rest;
• asthmatic attacks occur in patients at night;
• clouding of consciousness, slowing down of thought processes, problems with memory;
• pain in the right hypochondrium;
• swelling in the limbs.

Forms of pathology

There are two forms of the disease:

• acute;
• chronic.

Symptoms of acute pathology develop rapidly: from several hours to 2-5 minutes. It occurs as a result of myocardial infarction, hypertensive crisis, mitral valve stenosis.

Acute decompensated insufficiency manifests itself through the following symptoms, which occur in turn:

1. The patient has problems with breathing, it becomes difficult, sudden shortness of breath appears.
2. There is a dry cough, veins swell in the neck as a result of increased intrathoracic pressure.
3. Clouding of consciousness, fainting, acute pain in the region of the heart.
4. Foamy fluid may come out of the mouth and nose and form in the lungs.

The acute form of the disease can occur against the background of heart rhythm disturbances, blood movement inside the organ, as a result of aortic dissection.

The chronic form progresses slowly and over several years. Symptoms appear gradually. There are right ventricular and left ventricular types of chronic decompensation.

Chronic insufficiency requires symptomatic treatment and constant medical supervision.

Causes of the disease

Among the main reasons that provoke the development of DHF, there are:

• ischemic heart disease;
• arterial hypertension;
• Congenital heart defect;
• aortic stenosis;
• myocarditis;
• tachyarrhythmia;
• hypertrophic cardiomyopathy.

There are also non-cardiac causes that provoke DHF, among them:

• alcohol abuse;
• bronchial asthma in the advanced stage;
• bacterial toxic poisoning;
• excess weight;
• incorrectly selected treatment regimen that is not suitable in a particular case.

In the presence of these factors, the symptoms of the disease are more pronounced, the pathology develops faster.

The risk group includes people with diabetes, obesity and bad habits. These factors stimulate the development of heart failure, exacerbate the state of the cardiovascular system and lead to the formation of fluid decompensation in the heart.

Treatment of the disease

Before prescribing therapy, each patient undergoes a medical examination, which includes the following mandatory diagnostic measures:

• collection of a complete history. Since decompensated heart failure is a complicated form of general heart failure, at the time of diagnosis, the patient is already registered with a cardiologist. Before choosing a treatment regimen, a thorough analysis of his medical history, its symptomatic severity at each stage is carried out;
• general blood analysis;
• using a radiograph, determine the size of the heart and the presence of pathological processes in the lungs, as well as their stages;
• studies the structure of the heart, the thickness of the heart muscle using an echocardiogram.

Such a comprehensive examination guarantees an accurate determination of the cause of the disease, its specificity and stage, which is necessary to prescribe the most effective treatment regimen.

After receiving the results of the studies, the doctor determines the treatment regimen, which includes taking the following drugs:

• ACE inhibitors;
• beta-inhibitors to reduce the energy needs of the heart muscle;
• Morphine;
• vasopressor agents are prescribed to prepare for surgical treatment and to maintain perfusion if there is a risk of arterial hypotension that threatens life;
• to increase cardiac output, cardiac glycosides are prescribed;
• aldosterone antagonists to increase blood pressure and remove excess fluid from the body;
• Digoxin normalizes the heart rhythm.

This combination of drugs allows you to slow down the development of pathology and provide the most effective treatment for symptoms.

Some drugs are taken in combination with hepatoprotectors and immunomodulators, which provide additional support to the body during the main therapy.

It is recommended to avoid physical stress, stress, exclude red meat, fatty and fried foods from the diet. Salt, alcohol and spicy foods should be completely abandoned.

At a severe stage of the disease, when there is a risk of sudden cardiac arrest, surgical treatment may be indicated for patients:

• coronary angioplasty;
• shunting;
• implantation of a piece defibrillator or stimulator.

It is imperative to conduct a complete examination of the body in order to exclude the presence of contraindications.

Prognosis of treatment and prevention

About 20% of all hospitalized patients over the age of 65 are diagnosed with decompensated heart failure. Studies confirm that about 75% of men and 62% of women die from this disease within 5 years after diagnosis, with each year the death rate from DHF increases. This is due to the fact that patients untimely seek help from specialists, do not follow the doctor's prescriptions.

If medical treatment and surgical operations are carried out in accordance with the recommendations, then many preventive and therapeutic tips are ignored. It is difficult for people in old age to change their diet and sleep and rest patterns, to abandon established food and bad habits. Often, the treatment of heart failure requires large financial costs.

Prevention of the disease consists in observing the following rules:

• all patients with heart failure at any stage should be under the supervision of a cardiologist and diagnose the condition of the heart several times a year;
• hypodynamia should be avoided. It is necessary to enter into the mode of minor physical activity;
• monitor nutrition: limit the use of salt, alcohol, salty and smoked foods, spices. Increase the amount of vegetables, berries and fruits in the diet;
• control the water balance;
• timely treatment of infectious diseases;
• strengthen immunity.

This form of the disease, in fact, is the pathology of heart failure of the last stage.

This is a serious disease, the treatment and diagnosis of which must be timely. The first therapeutic measures should be implemented immediately after diagnosis. It is also important to determine the cause of the pathology in order to choose the most effective treatment regimen.