Symptoms and treatment of heart failure

Heart failure symptoms are varied depending on the etiology and pathogenesis. These are manifestations of the heart, lungs and the whole body.

HF among patients is detected frequently, as many diseases of this muscular organ remain untreated.

This pathology determines the insufficient pumping function of the heart, which causes every cell in the human body to suffer. Adequate blood supply provides oxygen and nutrients to the entire organ and tissues, so their lack worsens the general condition.

Inadequate heart function is characterized by many symptoms that cannot be combined into a single complex characteristic of each patient.

Definition of pathology

Signs of heart failure are formed due to changes in general hemodynamics. Any overvoltage of cardiomyocytes or a general overload of the myocardium due to defects, high blood pressure, and other things is determined by the abnormally low work of this muscular organ.

This heart disease mainly occurs in the elderly.

It is worth taking into account the main pathological conditions that reduce the functionality of the pumping organ:

1. Ischemic starvation or acute myocardial infarction.
2. Inflammatory lesions of the heart - myocarditis.
3. Congenital and acquired cardiomyopathy.
4. Hormonal disorders, in particular thyrotoxicosis.

If the heart is not efficient enough to expel the proper volumes of blood, fluid begins to stagnate in nearby veins.

The classification of heart failure is as follows:

1. Left ventricular.
2. Right ventricular.

This largely determines certain symptoms of the disease. So, with damage to the left parts of the heart, the blood stagnates in the pulmonary circulation, which is manifested by pulmonary symptoms, the pulse and pressure increase. Right ventricular heart failure is accompanied by accumulation of fluid and the development of extensive edema. Initially, the lower limbs suffer, edema from which gradually rises higher. The presence of fluid in the abdominal cavity is called ascites, in the transition to the whole body - anasarca. Nausea, dyspepsia can occur at any degree of the disease.

In medical practice, it is convenient to subdivide heart failure into acute and chronic. An acute condition is formed almost immediately and often appears after a heart attack.

Chronic pathology develops more slowly:

• as a result of atherosclerotic changes;
• with the progression of insufficiency with heart defects;
• upon infection.

Diagnostic methods for heart failure are also extensive. A blood test, an EKG, and other basic activities follow a detailed patient history, where it is important to recognize all symptoms of heart failure.

Symptoms in the lungs

Medical practice shows that in patients with a probable diagnosis of cardiac dysfunction, it is worth clarifying its following manifestations:

Shortness of breath most often appears first, regardless of the stage of heart failure. Patients define it as a sensation of interruptions in breathing with an increase in its frequency. There are also:

• chest pain;
• nausea;
• fear of suffocation;
• sweating.

Heart failure is usually accompanied by inspiratory dyspnea, which is not fully understood pathogenesis. It should be taken into account that shortness of breath occurs due to the accumulation of sweated plasma in the pleural cavity, which makes it difficult to carry out a full breath. The oxygen saturation of the blood decreases, which quickly recognizes the respiratory center in the brain. It increases the number of respiratory movements, pulse, pressure, which is why the patient's condition is aggravated. The nervous system and hemostatic parameters also have an impact on the functionality of the lungs.

For adults and the elderly, unlike children and adolescents, this manifestation of cardiac dysfunction has a low specificity for any degree of the disease. Initially, patients do not suffer from shortness of breath, being in familiar conditions.

As a compensated state, shortness of breath occurs:

• with forced intense load;
• when climbing a mountain or stairs;
• after walking a long distance.

The increase in cardiac dysfunction complicates the usual actions for a person. It becomes difficult to talk, eat, and perform hygiene procedures. This symptom can be brought to a chronic state if it is not treated in a timely manner.

Heart failure in newborns, children and adolescents should accept dyspnea as a full syndrome. Congestive dysfunction usually develops immediately and is accompanied by other severe symptoms. In adolescents, this may be due to intensive growth, when the rate of increase in heart mass is reduced.

The consequences of heart failure and its symptom of dyspnea force patients to take a position that alleviates the painful manifestations of the disease. This means that shortness of breath reaches a severe degree, and the work of the auxiliary respiratory muscles is necessary to achieve effective breathing. This semi-sitting position of the patient is called orthopnea.

The syndrome allows you to identify HF at the first glance at a person - which means it is specific:

• the patient usually sits with his legs dangling from a chair or bed, can lean on a nearby table;
• it happens that patients lie with their heads high on several pillows.

The pathogenesis of this symptom increases shortness of breath when trying to lie down due to the fact that the blood passes into the depot of the upper half of the body. The functionality of the heart increases in the upright position, and the patient feels relieved, why patients even sleep half-sitting if drowsiness overcomes.

Congestive insufficiency from the side of the heart is dangerous with the onset of a sharp suffocation, called "cardiac asthma." This condition helps to diagnose left ventricular failure almost immediately and urgently treat the patient with pulmonary edema.

Asthmatic status occurs with any degree of CHF. The attack occurs more often at night, when the latent interstitial fluid passes into the bloodstream, the depth of breathing and the pulse weaken, and bronchoconstriction occurs. Drowsiness is not typical for such patients, they are often frightened by a nightmare, seized by the fear of death, tend to take the position of "orthopnea".

The condition may be accompanied by:

• chest pain;
• cough with copious sputum;
• nausea;
• high pressure;
• rapid pulse.

A comfortable posture somewhat relieves a sudden onset, but mild shortness of breath usually persists. If heart failure is left untreated, the frequency of attacks tends to increase.

Causes of heart failure usually cause a cough that gets worse at night.

The intensity of the cough, the presence of chest pain and sputum helps to determine the localization of the pathological process:

• right ventricular dysfunction is manifested by an unproductive cough, sputum is practically not excreted;
• with damage to the right halves of the heart, pathogenesis determines a paroxysmal cough with copious sputum, which has the character of a dilute foamy liquid.

The etiology of blood overflow of small capillaries with their rupture gives blood impurities in the sputum, which means hemoptysis.

These are the most common and characteristic symptoms of the lungs, which form heart failure. On the part of other organs, there are also violations and their complications.

Symptom complex from the side of the heart

Diagnosis of heart failure takes into account each syndrome, which also manifests itself from the affected organ.

Functional disorders in the heart are reflected through such manifestations:

Palpitations - a feeling when the patient feels contractions in the chest. A rapid pulse or tachycardia is usually accompanied by such a sensation during intense exercise. The syndrome is typical for people with an excitable nervous system, who perceive pain and other stimuli more intensely and more emotionally colored.

In the absence of heart problems, a person does not feel the manifestations of his activity. Pathological processes disrupt the closure of reflex circuits, as a result of which impulses reach the cerebral cortex. So, a person involuntarily “hears” how the heart beats, feels the pulse.

Early types of heart failure do not affect the pulse and force of contractions of the heart. With physical exertion, a feeling of palpitation is allowed, but it quickly passes. Congestive insufficiency of any degree determines a recovery time of more than 10 minutes.

If the underlying disease is not eliminated in a timely manner, then they are felt at rest:

• frequent pulse;
• increased heartbeat;
• nausea;
• chest pain.

Tachycardia occurs as a compensatory reaction due to oxygen starvation. However, it overworks the myocardium even more, as a result of which heart failure increases. The treatment regimen for such patients completely abolishes the use of tea and coffee, smoking. These are the main provocateurs of increased heart rate, which provoke abnormal pulse and pressure. Lifestyle largely determines the intensity of symptoms, so the prevention of heart failure begins with its rationalization.

Edema as a complication of cardiac dysfunction is formed when the volume of excess fluid in the body exceeds five liters. This means that this syndrome can be noticed on the lower extremities, while edema in bedridden patients is the first to form on the lower back. An increase in edema is observed in the evening, as a result of which patients note that shoes become cramped after a working day. If you do nothing and just watch the swelling, it will rise higher over time, reaching the ankles, knees and even the hips. Sometimes you can see patients whose congestive heart failure has led to swelling of the abdominal cavity and even the whole body - to ascites and anasarca. It is almost impossible to remove such a volume of fluid from the body and cure the pathology in this case.

The scheme for the occurrence of edema is quite complex and includes factors:

• hormonal,
• metabolic,
• hemodynamic.

The edematous syndrome of cardiac origin always has cyanotic manifestations, dense to the touch, with thinned skin above the surface, pain is not typical. Recommendations on how to determine heart failure often come down to the characteristics of edema. When the ECG still does not show significant abnormalities in the work of the heart, edema recognition methods work best in making a diagnosis. A differentiated analysis of heart failure with edema can be performed with kidney and liver diseases, lymphostasis.

Other clinical manifestations

But the reaction to such complications can be traced throughout the body, which forms a slightly different syndrome:

Pain in the right hypochondrium is observed at any localization of the pathological focus. Congestive dysfunction of the heart affects the liver, which also tends to enlarge and swell. Hepatomegaly occurs earlier than edema and pulmonary symptoms, which can be detected by ultrasonography.

The pain syndrome is associated with overstretching of the organ capsule, which has antinociceptive receptors. Increased pressure in the veins of the liver due to their overflow causes the detoxification function of the organ to suffer, which gives symptoms of obstructive jaundice. Laboratory research methods, namely a biochemical blood test, can reveal an elevated level of bilirubin.

With the onset of ascites, portal hypertension develops - high pressure in the portal vein, which is characterized by:

• nausea;
• vomit;
• diarrhea and other dyspeptic disorders.

For quality of life, heart failure carries the second most common fatigue syndrome. CHF, even of an initial degree, reduces a person's working capacity, so that the inability to perform the usual amount of work is noted first. Not always increased fatigue, as well as episodic headache, attracts attention. The syndrome has low specificity, because such is the reaction of the human body in each pathology. The constancy of the internal environment in any disease requires an excess of energy, which must be saved on external work.

This results in:

• drowsiness;
• unwillingness to do something;
• inattention;
• irritability.

Lifestyle largely determines the intensity of this manifestation of heart dysfunction. For adolescents, increased fatigue and headache are the most significant and serve as a reason for a general examination, which includes a blood test, ECG, and instrumental diagnostic methods. Prevention of heart failure should begin as early as the age of adolescents, as there is a trend towards rejuvenation of many diseases.

Dyspeptic disorders (nausea, vomiting, loose stools or constipation) accompany cardiac pathology almost always. Scientists find two reasons for this. Heart failure forms a hypoxic state of many organs, and the gastrointestinal tract is no exception. Nausea and vomiting are reflex reactions to a decrease in the concentration of oxygen in the blood. Stool disorders are complications that the liver gives due to its oxygen starvation. The syndrome of dyspeptic disorders can occur with any degree of CHF, so it can be regarded as a side effect of drug therapy. Treatment of heart failure is carried out with rather aggressive drugs if the disease has reached an extreme degree of its development, so nausea, vomiting, and diarrhea are quite expected.

Reduce these complications and form a favorable outcome of the disease:

• compliance with the requirements of the doctor;
• timely blood test;
• ekg study;
• rational lifestyle.

Diagnosis of heart failure may be based on a decrease in diuresis. It leads not only to edematous syndrome, but also to high pressure in the renal spasmodic veins. Nocturnal diuresis usually does not change, which means that the blood supply in the horizontal position remains adequate. Urinalysis shows the release of a large amount of protein in dissolved form, the ecg-cardiogram may remain normal.

Change in body weight in the direction of its increase in the first degree, severe weight loss at the stages of decompensation. Unreasonable weight gain is due to latent edema, when the patient, having learned about his disease, leads an irrational lifestyle. In this case, signs of ventricular hypertrophy increase on the ECG, the pulse and pressure increase, anemia increases in the blood test, drowsiness and headache are characteristic of patients. These symptoms may be mistaken for hormonal imbalances.

Even minor symptoms should be taken into account, especially in children and adolescents. With any severity of heart failure, headache, high blood pressure, fatigue require a minimum examination: blood test, ECG study. If the results deviate from the norm, this means that the patient requires clarification of the diagnosis and hospitalization.