First aid for acute heart failure

The question of how PMP turns out in acute heart failure should be asked long before the onset of pathology.

Each person must know how to help the patient during an attack.

Cardiovascular diseases most often end in death from the occurrence of heart failure. This is due to the fact that the heart loses its pumping function, as a result, the body ceases to receive the proper portion of oxygen. The cause of the loss of synchronous contraction of the heart may be ischemia, high blood pressure, or dysfunction of the valvular ducts. Heart failure can eventually lead to disability or death.

Dependence of first aid on the type of acute heart failure

Acute heart failure (AHF) occurs when there is a violation of the contractility of the muscle layer of the heart. The ventricular muscles do not relax enough, resulting in limited filling of the heart with blood. As a result, the amount of blood ejected into the aorta is not enough for the normal functioning of the entire body system.

In medicine, there are 3 types of AHF:

• HF of the left ventricle;
• HF of the right ventricle;
• low ejection syndrome.

AHF can develop as a result of cardiac and non-cardiac factors.

In the first case, heart failure can be provoked by:

• myocardial infarction;
• complications of chronic heart failure;
• hypertension, the target organ of which is the heart;
• inflammation of the inner lining of the heart;
• unstable heart rate;
• decompensated aortic stenosis;
• severe inflammation of the myocardium;
• accumulation of fluid between the sheets of the pericardium;
• blockage of a lung artery.

Non-cardiac reasons include:

• stroke;
• kidney dysfunction;
• severe anemia;
• thyrotoxic crisis;
• hormonally active tumor of the adrenal glands;
• bad habits;
• bronchial asthma;
• high cardiac output syndrome.

If a patient has any of the pathologies described above, the risk of developing AHF is significantly increased. In order to protect a person from serious consequences, his family and friends should know how to provide emergency care during the onset of CH. First of all, you should familiarize yourself with how acute heart failure manifests itself and what characterizes its onset.

Treatment of left ventricular heart failure

People who suffer from chronic hypertension, have cholesterol plaques in the arteries, have heart defects and myocardial dysfunction are at risk of developing left ventricular heart failure. It is possible to develop left ventricular heart failure after brain injury or in the presence of a tumor in it.

Due to the fact that left ventricular acute heart failure manifests itself when stagnation occurs in the pulmonary circulation, there is a dysfunction of gas exchange in the lungs.

As a result, symptoms appear that correspond to cardiac asthma:

• suddenly there is shortness of breath;
• feeling of suffocation;
• increased heart rate;
• "heart" cough;
• loss of vitality;
• skin color acquires a pale bluish tint;
• a sharp drop in blood pressure.

As a result of the development of symptoms, pulmonary edema occurs. It is manifested by a characteristic cough, when a bloody foam is released from the patient's mouth, breathing acquires a bubbling sound. The person is covered with cold and sticky perspiration. The heartbeat loses its rhythm, and the pulse is practically not palpable.

Left ventricular heart failure with subsequent pulmonary edema involves the provision of emergency care to the patient.

You need to do the following:

1. The patient should be seated and ensure that his legs are in a lowered state.
2. With an interval of five minutes, give the patient 2 tablets of nitroglycerin.
3. Provide the best possible circulation of fresh air in the room where the patient is.

After the arrival of the paramedics, the patient is hospitalized and the following actions are carried out already in the department:

1. With the help of analgesics, which belong to the group of narcotic substances, they reduce the excitability of the respiratory center.
2. Reduce congestion, thereby improving contractile left ventricular function.
3. When high blood pressure is observed, the patient is given injections with vasodilator drugs. Along with this, diuretics are used.
4. At reduced pressure, medications are given, the action of which is aimed at increasing it.
5. If at the time of hospitalization the patient has a stable pressure within the normal range, then diuretics and nitrates are prescribed.

Treatment of right ventricular heart failure

Unlike left ventricular HF, the right ventricle is characterized by stagnation of blood in the systemic circulation. It manifests itself by increased pressure in the heart and pulmonary artery, a decrease in the contraction function of the right heart, and a decrease in the amount of oxygen entering the organs.

With the onset of right ventricular heart failure, a number of symptoms appear that help to identify an attack:

• spasms in the lungs and subsequent pain in the chest;
• dyspnea;
• cold perspiration;
• cyanotic skin color;
• a sharp drop in pressure;
• volumetric accumulation of free fluid in the abdominal cavity;
• puffiness;
• the pulse is very weak or not felt at all, while the frequency of strokes is very high;
• swelling of the veins in the neck;
• pain and enlargement of the liver.

As first aid, the patient must be provided with:

1. Ensure a comfortable lying position so that the upper body is elevated.
2. As with left ventricular heart failure, the patient should be given sublingual nitroglycerin tablets twice, 5 minutes apart.
3. Provide fresh air circulation.

An ambulance should take the patient to a medical facility, where the patient is shown the following emergency measures:

1. Artificial saturation of the body with oxygen.
2. Pain relief by injection with a narcotic analgesic.
3. Maintaining the necessary medications to relieve pulmonary edema, relieve symptoms and normalize the patient's condition.
4. The appointment of therapy with nitrates, which reduce cardiac workload and increase right ventricular functionality.

Providing care for low cardiac output syndrome

The syndrome can occur as a result of a heart attack, as a result of a change in the structure and functionality of the myocardium, inflammation of the serous membrane of the heart, intense accumulation of air or gases in the pleural cavity of the lungs, or a decrease in the amount of circulating blood.

Small ejection syndrome is expressed in the following symptoms:

• pain in the chest;
• lowering blood pressure to a minimum, in some cases to 0;
• the pulse is extremely difficult to feel, and the rhythm of the heartbeat rises significantly;
• stopping the flow of urine into the bladder;
• pallor of the skin;
• collapsed peripheral vessels.

The development of symptoms leads to pulmonary edema and impaired renal function.

To alleviate the condition, a person needs to take a horizontal position in a well-ventilated area. After the arrival of paramedics, hospitalization takes place in the intensive care unit.

In the hospital, first aid for acute heart failure, which is manifested by low ejection syndrome, is carried out in several stages:

1. The patient is provided with access to oxygen with the help of oxygen therapy.
2. Inject painkillers analgesics containing narcotic substances.
3. They give injections with psychotropic medications.
4. Monitor the state of blood pressure during infusion therapy.
5. Cardiotonic medications are used to increase cardiac output.
6. Apply anticoagulants that normalize microcirculation.

Which doctor will help

The first step after the onset of AHF is to urgently call the cardiology team. This is necessary for patients who have previously undergone a heart attack or stroke. In other cases, the line crew can also provide PMP.

After hospitalization, the patient is treated by a cardiologist.

At the same time, the doctor prescribes therapy both to eliminate AHF and to treat the disease that provoked it. It is extremely rare to need the help of a cardiac surgeon, who, if necessary, can install a pacemaker.

In order to prevent acute heart failure, everyone should lead a healthy lifestyle, and especially people who are at risk of AHF.

For prevention, doctors recommend following certain rules that will reduce the risk of heart failure:

1. Maintain a "healthy" body weight. Large weight and obesity contribute to the oppression of the cardiovascular system.
2. Moderate salt intake.
3. People with hypertension should avoid caffeinated drinks (strong tea and coffee). Those who do not have pressure problems should also observe moderate consumption of these drinks.
4. Give up bad habits, especially alcohol in large quantities, which has a negative effect on the cardiovascular system.
5. Include exercise and moderate exercise in your daily routine.
6. Try to avoid stressful conditions and psycho-emotional changes.

Another important rule that most people neglect is regular visits to a cardiologist. Then the occurrence of acute heart failure can be avoided, since visits to the doctor help to identify abnormalities even before the onset of an attack.