Heart failure

Heart failure is a disorder of a multi-system nature, which is caused by disruptions of the SSS, urinary system and skeletal muscles in conjunction with changes in the neurohumoral nature, thus forming a peculiar pathological syndrome. Heart failure occurs as a result of cardiac failure to provide normal blood supply to the body, due to poor blood pumping on the background of euvolemia or normal vascular tone.

Cardiac failure is characterized by two types, such as stable( CHF) and unstable, which includes OCH( cardiogenic shock and pulmonary edema) and decompensated CHF.This pathological syndrome is not a disease of an independent nature. As a rule, it is considered a complication of other pathologies and conditions, and its prevalence is constantly increasing with the age of patients, reaching 10% among people after 70 years. Heart failure is characterized by a fairly frequent hospitalization and death.

Heart failure of cause

The etiological factors affecting its development are divided into causal and contributing factors. The most common causes of heart failure include arterial hypertension, IHD in various forms, valvular heart defects and non-coronary anomalies of the myocardium. Determination of the causes and factors contributing to the development of the disease, as well as their timely correction are of great importance in increasing the effectiveness of therapeutic treatment.

The main causes of heart failure are primary myocardial damage, disturbances in the processes of filling the cardiac ventricles and overloading their hemodynamics. The primary lesions include diffuse lesions of the cardiac muscle( myocarditis, cardiomyopathy), focal( acute form of myocardial infarction, postinfarction cardiosclerosis, atherosclerotic cardiosclerosis) and iatrogenic( medicinal, radiation).Disorders of filling of the ventricles is stenosis of the atrioventricular aperture both to the left and to the right, pericarditis of exudative and constrictive nature, fibroelastosis, cardiac muscle hyperthyre of different etiology, endomyocardial fibrosis. The hemodynamic overloads of the ventricles include the processes of increasing resistance to the expulsion of blood, pulmonary and systemic arterial hypertension, aortic stenosis. In addition, volume overload is also a causative factor of heart failure, which is developing because of the deficiency of valves and congenital malformations. Also this syndrome with a high MOC( minute heart volume) in the form of hypoxic conditions( pulmonary heart in chronic form, anemia);Increased metabolism( thyrotoxicosis), and pregnancy contribute to the formation of heart failure.

Also, the factors that provoke the development of this pathology include the discontinued therapeutic treatment of heart failure or decreased activity;Overvoltages of various genesis;Adverse environment in the form of heat or strong humidity. Also, nutritional factors associated with the abuse of fluid and salt;Heart rhythm and conduction disorders;Infections of an intercurrent nature;TEVLA( thromboembolism of the branches of the pulmonary artery);Arterial hypertension, febrile state;Various drugs that are capable of retaining fluid in the body and many concomitant cardiac pathologies that may be unrecognized contribute to the formation of this multi-systemic condition.

Heart failure symptoms

Symptoms of heart failure may result from minor manifestations that occur only when exercising, as well as severe dyspnoea in a calm state.

Patients who have a reduced pumping function with an ejection fraction of about 40% and who do not present special complaints and characteristic symptoms of heart failure are referred to as asymptomatic LV dysfunction. However, this condition can not be considered a clinical picture, which is characteristic of the first stage of the pathological process, since its symptoms are characterized by worsening hemodynamics, which is provoked by functional tests. As a rule, heart failure is a kind of syndrome of progression of pathology.

The earliest symptom of LUF is shortness of breath, which first appears when running fast, exercising or walking, while climbing up the stairs. And later, labored breathing begins to appear and in an absolutely calm state, which can intensify with a change in the position of the body, even when talking or eating.

Various heart diseases causing shortness of breath, only contribute to its amplification in the horizontal position of the patient. It is this fact that forces the patients to adopt a position of the orthopnea type, under which they experience considerable relief. The semi-sitting position relieves the heart due to a drop in incoming blood to the right side of the heart, which as a result reduces the pressure in the ICC.

Dyspnea, as a rule, is characterized by a lack of air and is subjectively manifested by inflation and tension of the wings of the nose with the participation of additional muscles in the process of breathing. At the same time the patient feels tired, begins to sweat profusely, constantly feels the beating of his heart and his motor activity decreases. In addition, sleep is disturbed as a result of increasing choking at night. This symptomatology, as well as a poor appetite, does not refer to specific manifestations of heart failure, and if patients do not actively present their complaints, the early symptoms of cardiac left ventricular pathology may go unnoticed.

In addition, a characteristic symptom of heart failure, such as tachycardia, manifests itself as a result of increased pressure in the left atrium and the processes of irritation in it of the baroreceptors.

Pathognomonic symptoms of the cardiac pathology of the left ventricle is a different kind of cough that can be dry or wet when separating the mucous sputum. In general, it develops under various forms of exercise and during sleep. But with the rupture of dilated veins in the bronchi, pulmonary hemorrhage and hemoptysis may occur, although very rarely.

In some cases, when the recurrent nerve is squeezed when the LL increases or the LA enlargement is on the left, the patient has hoarseness in his voice or aphonia. In addition, with characteristic symptoms of blood stagnation in the ICC, the number of respiratory movements does not increase, and dyspnea develops, that is, breathing is difficult and the exhalation is prolonged as a result of the rigidity of the lungs. At the same time, damp, various calibres, rattles are heard, at the very beginning below and at the sides of the lungs, and then everywhere, i.e. Diffusely. As a result of insufficient work of the respiratory center, cyanosis of the mucous membranes and skin appears. The main cause of cyanosis is an increased amount of hemoglobin in the blood of a restored character. This is manifested by the crimson-red color of the lips and fingertips.

Patients diagnosed with heart failure have characteristic cyanosis both central and peripheral. In the first case, it develops as a consequence of impaired oxygenation of blood in the lungs, as well as as a result of the mixing of blood. As a rule, this cyanosis is characterized by diffuse localization and is often not a consequence of severe circulatory disturbances. Acrotsianosis or peripheral cyanosis has no connection with increased oxygen consumption, therefore it is characterized by cyanoticity in the remote parts of the body and its severity depends on the severity of the disturbed blood circulation. As a rule, a mixed type of cyanosis is observed in patients with heart failure of the left ventricle.

The symptomatology of the disturbance of the right ventricle, characteristic of heart failure, consists of the rapid fatigability of the patient, disturbed sleep, and his weakness. Symptoms such as difficulty breathing, cyanosis and cough have a different degree of severity and quite often act as a burden of stagnant processes in the CCB.This mainly depends on the underlying pathology, which is based on insufficient work of the right side of the heart. As a result of a weak contraction of the heart, large veins are badly emptied and all cardiac units are not able to produce a normal cardiac output. Thus, all venous blood is collected in the BPC of the venous system, and this becomes the cause of venous congestion of certain organs and blood stagnation. Outwardly this is manifested by swelling of the veins, which are very close to the heart, in particular, the jugular ones. And the veins on the periphery are mostly dilated, and those that are visible are enlarged.

The increasing increase in pressure in the veins is also due to the increase in the volume of blood that participates in the circulation. Stagnation of blood in the CCB leads to hepatomegaly. First, the left lobe of the liver increases, and then the right lobe. With palpation, it is soft, with a flat surface and a rounded tip, sometimes painful, especially if the PZHN is rapidly developing. When pressure is applied to the liver, there is swelling of the cervical veins and their increased pulsation. With a significant increase in the liver, it is possible to feel its pulsation. Against the backdrop of chronic venous congestion, the liver is painless, dense, reduced in size. Thus, hepatic cirrhosis of the heart type is formed.

Clinical liver disorders are detected in the second( B) and third stage of heart failure. Laboratory parameters also change: bilirubin, transaminase is increased, dysproteinuria is observed.

Occasionally, gastrointestinal disturbances are detected as a result of stagnation of blood in mesenteric vessels, which is manifested by pain, impaired intestinal function in the form of constipation and diarrhea, and frequent vomiting.

In addition, a characteristic symptom of heart failure is the latent form of edema. Edema on the periphery, as a rule, appear at the end of the day. Initially, they are noted in the area of ​​the lower limbs, and then spread to other places due to hydrostatic pressure, that is, if the patient constantly lies, edema appears on the sacrum, and in the case of forced sitting and while walking - on the legs. Later they pass to internal organs. At the same time, the patient begins to excrete less urine, nicturia increases, turning into oliguria. In extreme cases, a kidney block with a possible anuria develops, which requires emergency treatment.

Symptoms of heart failure

They depend on the stagnation of blood in the ICC and CCB, or simultaneously in two. This process can be characterized by a chronic course or an emergency condition. At the same time, various signs of heart failure are distinguished.

In acute formation of stagnation in the MCC, cardiac asthma and pulmonary edema are formed. With long-term processes, sclerosis and compaction in the vessels develop.

The main sign of heart failure is shortness of breath, which is characterized by a lack of inhaled air, changes in depth, as well as respiratory rate, that is, inspiratory breathing is observed. At the very beginning of the pathological process, difficulty breathing occurs when performing intensive physical work, and later, with progressive heart failure processes that appear even in a lying position, especially at night.

The second important sign of heart failure is orthopnea( semi-sitting position), when the patient is forced to even sleep in this state. This symptom refers to the objective indicators of CHF, which can be identified when examining a patient seeking to sit. It is in the horizontal position that the patient feels a shortage of air due to the accumulation of blood in the lungs.

A characteristic feature of the disease is the appearance of dry cough, and sometimes even with the separation of sputum. Cough occurs as a result of edema of the bronchi as a consequence of hyperemia and irritation of the nerve with enlarged dimensions of the left side of the heart. In some cases, due to damaged blood vessels, blood enters the alveoli, so sputum is also released from the sputum.

The onset of cardiac asthma manifests itself rapidly onset asphyxiation followed by a possible respiratory arrest. For cardiac asthma, unlike bronchial asthma, it is difficult to breathe in and out. In the blood, the concentration of carbon dioxide increases and the amount of oxygen decreases, so the respiratory center begins to activate. This leads to frequent and shallow breathing with the appearance of a feeling of fear for one's life, and as a result is manifested by aggravation of the pathological process.

Lung edema refers to the last stage of hypertension in LCC.As a rule, this sign develops against the background of OSN, as well as in decompensated CHF.In this case, the patient coughs up foamy phlegm with a pink tint. In the severe course of the pathology, the patient loses consciousness, breathes superficially and ineffectively.

In heart failure, signs of stagnation of blood in the CCB include edema, pain in the liver, palpitations, rapid fatigue, dyspepsia, and impaired renal function.

Swelling refers to the most common symptom of chronic heart failure. As a rule, their primary appearance falls on the foot area, and further, with the progression of the disease, they spread to the upper parts of the body, penetrating even the front wall of the peritoneum. With heart failure edema has characteristic distinctive features: symmetrical;After a night appear on the back and buttocks, and when walking - on the lower limbs;They are not localized in the face, neck and shoulders, which distinguishes them from edema in kidney disease. Swelling, which for a long time is present in the patient, leads to various complications in the form of trophic skin changes, ulcer formations, ruptures and cracks with fluid leaking out of them.

As a result of the fact that the liver is filled with blood and develops hepatomegaly, there is pain in the right part, under the ribs. With CHF, there is a change in the liver cells with the transition to cirrhosis and a violation of its work. In the last stage of heart failure, there is an increase in pressure in the vein, and this is the result of ascites. A characteristic feature of ascites is an increase in the subcutaneous veins around the navel in the form of a jellyfish head.
For such a sign of heart failure as a strong heartbeat, a rapid contraction of the myocardium is characteristic as a result of increased susceptibility of the nervous system. Tachycardia is considered a replacement mechanism, which is directed to the processes of normalization of hemodynamics. Such an intensified contraction of the heart rapidly depletes the myocardium and causes stagnation.

Rapid fatigue of patients with CHF is considered as a specific sign of the disease, which is associated with increased blood filling of the muscles, which is typical for other pathologies.

As a result of the fact that oxygen delivery to the organs decreases, dyspeptic disorders are noted. And since there is a spasm of the kidney vessels, then the secretion of urine decreases, so the fluid is retained in the body. This process causes the development of decompensation of chronic heart failure.

Heart failure in children

This disease in children is caused by the inability of the heart to function fully, that is, it is normal to inject blood in accordance with metabolic needs of tissues, which is manifested by changes in circulation processes and neuroendocrinal disorders.

In children, cardiac insufficiency of the acute form is very rare in the period of neonatal development. This is expressed, as a rule, in signs of asphyxia, congenital cardiomyopathy, tachyarrhythmia, bradycardia, congenital heart defects, severe sepsis.

The cause of the onset of this disease on the first day of a child's life can be intrauterine myocarditis, congenital heart disease with insufficient work of atrioventricular valves, left ventricular hypoplasia and aortic atresia.

Later, closer to the third day after birth, heart failure may occur as a consequence of posthypoxic cardiac ischemia, diabetic cardiomyopathy, severe anemia, metabolic disorders and arrhythmia.

The middle and end of the early neonatal period are characterized by the development of heart failure as a result of various circulatory disorders and movements of large vessels.

The late neonatal period of heart failure is due to congenital heart defects such as stenosis and coarctation of the aorta, large defects of the ventricles.

In newborns, heart failure is mainly caused by insufficient LV work, as the MCC is overloaded. In children, this pathology is characterized by development in several stages. Hypoxemia, hypocapnia and tachypnea of ​​a reflex character cause an increase in the volume of blood in the lungs and edema of the lungs of the interstitial property. Hypoxemia promotes the appearance of hypercatecholemia, which supports heart failure due to palpitation and centralization of blood circulation.

To date, in medical pediatric practice, heart failure of the right ventricle, left ventricle and mixed form are considered, as well as three stages of its development.

Pediatric heart failure is characterized by rapid progression with unclear symptoms. Sometimes they even hide behind the difficult state of the child.

Heart failure, in the initial stage, is the appearance of shortness of breath at the time of eating or during crying. The frequency of respiratory movements may exceed eighty per minute. When listening to the heart, there is a tachycardia with cardiac contractions of 180-190 ud.in a minute. The skin is pale with peripheral cyanosis as a result of increased pressure in the ICC and stagnant processes in the CCB.

In newborns, heart failure in later stages is characterized by difficulty in sucking, significant weight gain, and sweating on the head. Tachypnea is always accompanied by a shortness of breath of an expiratory nature, and rales are audible over the lungs. In addition, the cyanoticity of the central parts of the body is noted, the heart beat is diminished and a heart rhythm of the gallop type appears. A characteristic feature of this period is hepatomegaly and oliguria.

Also in newborns appears the pastosity of the lower lumbar region, in the perineum and in the lower abdomen. Ascites and edemas of a peripheral nature are typical of older children diagnosed with heart failure. Dyspeptic disorders refer to the characteristic symptoms of this pathology.

The first stage of pediatric heart failure is characterized by the appearance of shortness of breath, rapid heartbeat, fatigue after minor exertion. In this case, everything is noted without hemodynamic disorders.

The second( A) stage of the pathological process is characterized by mild dyspnoea at rest, then the heart rate increases and breathing becomes more difficult, signs of acrocyanosis appear, the wheezing of wetness in the lower part of the lungs is heard, the liver is slightly enlarged, and edema on the legs is noted.

For the second, irreversible( B) stage, shortness of breath is typical for small loads, involuntary semi-sitting position, wet rales are persistent in the lungs, rales, hepatomegaly, edema rises and does not pass after rest.

The third stage of heart failure is presented by shortness of breath in absolute rest, cardiac asthma, orthopnea, jugular veins, pulmonary edema, hepatomegaly, hydrothorax, ascites and oliguria.

Edema in heart failure

With this pathological process, swelling is a serious symptom that requires a thorough comprehensive examination of the patient and the appointment of appropriate therapeutic treatment. As a rule, this symptom is a symptom of not only heart failure, but also many other diseases: allergies, liver and kidney diseases. Therefore, in order to diagnose the edema of cardiac pathology, it is necessary to determine the cause that contributes to their occurrence, and be able to differentiate with the edema of another pathology.

As a rule, with DOS as a result of violations in the MCC, there may appear abundant, liquid, foamy sputum with blood or it can be evenly colored in pink. This is a characteristic sign of the development of pulmonary edema, which is a common cause of death of patients with prolonged heart failure. The cause of the development of pulmonary edema can be cardiac overload of a temporary nature, emotional overstrain and even hypothermia. In this case, the pulmonary edema serves as a vicious circle.

But heart failure of a chronic form is characterized by the appearance of swelling of the feet and shins( first in the evening, and then in the daytime).This is due to the inability of the heart to cope with the load, which causes a slowing of blood flow in the channel and the accumulation of a sufficient amount of fluid in the tissues of the lower limbs. A simple test is used to confirm cardiac swelling. In this case, you can press your finger on the shin area above the bone and hold for about two seconds. In the event that, as a result of pressure, the emerging fossa disappears slowly, then one can assert the presence of edema. Another sign of the underlying concealed edema is the increase in body weight, as a result of accumulation and retention in the body of the fluid.

Swelling characteristic of heart failure at the very beginning of the disease appear on the legs and in the lower abdomen, and in patients who are forced to lie on the sacrum and lower back. Cardiac edema is characterized by symmetry. In addition, they appear gradually with a slow build-up over several months. When pressed, they are dense and leave a deepening after themselves. Also, they are characterized by simultaneous hepatomegaly.

In cases of severe congestive heart failure, the development of edema is accompanied by ascites. In addition, they note their combination with the characteristic signs of heart failure, which include shortness of breath;tachycardia;Pallor, turning into cyanotic lips;Poor tolerance of physical activity. Cardiac swelling may disappear after the treatment with the treatment of the compensation of the pathological process.

Edema of the legs with heart failure

Since heart failure does not belong to an independent disease, therefore, it is considered a violation of the work of the heart and various consequences of pathological processes. For heart failure characterized by quite distinct symptoms, among which there are foot swelling, which are the cause of stagnant processes of blood in the vessels and fluid in the tissues.

Almost always this pathology of the heart is characterized by edema, the localization of which depends on disorders in the circulatory system and the specificity of heart failure. When violations of the left heart, namely the ventricle as a result of hypertension or ischemic heart disease, develops pulmonary edema, which is accompanied by shortness of breath and tachycardia. And with insufficient functioning of the prostate in the body, a significant amount of fluid is retained, causing swelling of the legs. Also for heart failure is characterized almost always bilateral puffiness of the legs. The main cause of swelling of the lower limbs is the stagnation of blood in the veins of the BPC.

Cardiac failure in progression causes a worsening of the symptoms of the disease. If in the early stages of the pathological process the legs swell slightly( only edema of the feet and legs) and this swelling quickly passes, then in the future it grows into a chronic form. Therefore, as a rule, at the beginning of the disease, swelling on the legs does not cause any special complaints in patients and is considered a natural manifestation after a prolonged stay on the feet or uncomfortable position.

Since the swelling of the legs is noted mostly closer to the evening time, and after an overnight rest it passes, the patient first does not attach special importance to this symptom. However, in the future, puffiness continues to intensify and no longer disappears as before, but, on the contrary, spreads to the upper part of the limbs, grabbing the hips already. In this case, there are other signs that characterize heart failure: shortness of breath, hepatomegaly, liver soreness, cyanosis and rapidly arising fatigue.

To eliminate edema on the legs, it is necessary to find out the cause of its onset, and then proceed with the appointment of the appropriate treatment. At the very beginning of the disease sometimes helps rest, massage, compresses for legs or baths. But heart failure at later stages requires specialized medical examination and treatment. Diuretics( Furosemide, Torasemide, Piretanide, Bumetanide) are prescribed to cause fluid outflow from the body, which have a pronounced diuretic effect. Simultaneously, cardiac glycosides are used for the therapy of heart failure, which in complex influence on SS.These drugs normalize circulatory processes, prevent stagnation and increase the effect of diuretics. Thus, there is a withdrawal of excess fluid from the body, which leads to the removal of edema on the legs.

First aid for heart failure

There are many reasons that can contribute to the inability of the heart to decrease sufficiently. As a result, stagnant processes occur in the vessels, causing the development of heart failure. And it, in turn, can cause the death of the patient.

Very often, acute heart failure is characterized by the development of cardiac asthma and pulmonary edema. Therefore, it is necessary in these situations to be able to properly carry out first aid before the arrival of a doctor.

To understand that a patient has an attack of cardiac asthma, one must know that this is a characteristic suffocation related to stagnation of blood in the lungs. Cardiac asthma does not belong to an independent disease, but is a symptomatic complex of acute left ventricular failure.

Causes of cardiac asthma can be acute or prolonged overstrain of the heart muscle.

Symptomatic of an attack can occur at any time of the day, but most often at night with a characteristic suddenness. Suffocation is manifested by difficult processes of inspiration and exhalation combined with a sense of fear of death. The patient at the same time takes a forced position for him - he sits with his legs down or orthopnea. During an attack, the patient's skin becomes covered with a cold sweat, and acquires a cyanotic shade.

Initially, cardiac asthma manifests itself by the appearance of a dry cough or cough with a sparse separation of mucous sputum. Breathing begins to accelerate sharply, and with a protracted character it is characterized by bubbling, which can be heard from a distance. The frequency of breathing is noted up to thirty to fifty per minute, the pressure can be increased, and the pulse rate is greatly increased. Cardiac asthma is complicated in 1/4 of cases by pulmonary edema and is characterized by the appearance of liquid, foamy, pink sputum and loud bubbling breath.

First aid in case of an attack of cardiac asthma, as a symptom of heart failure, is, first of all, in calling a doctor and measuring blood pressure. Then the patient assumes a sitting position, at which it is necessary to lower the legs. It is also necessary to put a tablet of Nitroglycerin under the tongue, and if the systolic pressure does not fall below a hundred, then repeat the drug in ten minutes. Then you can apply the tourniquets to the veins of the three limbs, and after fifteen minutes, you can remove one of the tourniquets and then put them round for no more than an hour. A good effect is achieved when staging cans, mustard plasters or warm foot baths. And the last step in helping is oxygen therapy with defoamers through the nose with the help of a catheter.

Under the supervision of a doctor, intravenously administered are Strophantine, Fentalin, Euphyllinum, and with the growth of wet wheezing, intravenously, Lasix. Occasionally, bloodletting is carried out to 300-500 ml. After arresting the attack, the patient is hospitalized in the cardiology department.

The second sign of the pathological process is pulmonary edema, which is a threatening condition for the patient. The causes of its occurrence are various infections, intoxications, CNS lesions, anaphylactic shock, heart defects, hypertension, repeated myocardial infarction.

Symptomatic of interstitial pulmonary edema is a feeling of suffocation;The patient sits in bed, leaning on the edge;The respiration rate is thirty per minute;The face is pale, gray-cyanotic and covered with sweat;It is frightened, tense, focused;Cyanosis on the lips and nails;It is difficult to speak;Tachycardia, rhythm of "gallop";The blood pressure is increased;The expansion of the boundaries of the heart, systolic murmur, there may not be wheezing, but with alveolar edema - small-medium-large-bubble rales;Sound boxed.

In alveolar edema, liquid penetrates into the alveoli and a persistent protein foam appears - pink or white to 3-5 liters. A tickling breath over the entire surface. Wet wheezing with strong foaming can provoke a lethal outcome in a few minutes.

First aid is to call a doctor and make a mandatory BP measurement. Then the patient is seated, limbs are attached to the limbs, as in the case of an attack of cardiac asthma. Give a pill under the tongue Nitroglycerin. If possible, put jars, mustard plasters, and the legs are lowered into hot water. And in the end, oxygen therapy is carried out or fresh air can be inhaled.

After medical appointments, intravenous administration of Droperidol or Haloperidol with atyhistamine preparations is made;Conduct an intravenous drip of nitroprusside sodium or Arfonada;Lasix and cardiac drugs are also administered intravenously;Intramuscularly - Prednisolone, Hydrocortisone( at low pressure and intravenously).At increased pressure - Pentamine, and at high - bleeding to 200-300 ml. It is also possible to administer Promedol.

Heart failure treatment

Acute form of heart failure requires urgent hospitalization. Then, general measures are taken to limit physical activity and diet, in which the restriction of table salt is mandatory, and with significant edema, food without salt. In addition, appoint cardiac glycosides, diuretics, potassium preparations, calcium antagonists, vasodilators.

Thus, the main method of treatment of heart failure is drug therapy, and if it is ineffective, surgical treatment is used. However, it is important in the treatment of heart failure is the elimination of possible factors that provoke its occurrence. These include: anemia, alcohol abuse, stressful and febrile conditions, improper nutrition and the intake of medications that delay fluid in the body.

The basis of treatment is the elimination of the cause of heart failure and correction of its manifestations.

First of all, it is important to create a patient's rest with acceptable standards of physical activity, so that they do not cause the patient fatigue and discomfort. In the case of significant restriction of loads, the patient should be more in a sitting position, and not lie. In the absence of attacks and severe shortness of breath, as well as edema, it is recommended to walk outdoors.

Patients diagnosed with heart failure even sleep in a semi-sitting position to avoid seizures.

For the treatment of the disease used drugs that increase the contractility of the myocardium, reduce the tone of blood vessels, reduce fluid retention, eliminate sinus tachycardia and participate in the prevention of blood clots in the heart.

For drugs that increase the contractility of the heart muscle, include cardiac glycosides( Digoxin, Korglikon, Strofantin).They primarily increase the function of the pump in the heart, promote urination, and also help to withstand physical exertion. However, with an overdose of cardiac glycosides, there is nausea, arrhythmia, and color perception is impaired. As a rule, this group of drugs is prescribed for patients with a diagnosis of heart failure in the presence of atrial fibrillation.

Vasodilators are used to reduce vascular tone, which increase coronary blood flow, and with prolonged use reduce the expressed hypertrophy of the myocardium. These drugs dilate the vessels, causing a decrease in blood pressure and, thus, help the heart in pumping blood. These drugs include: Enalapril, Lizinopril, Monopril, Captopril, Benazepril. In the event that ACE inhibitors do not work, patients with heart failure are prescribed BRA antagonists: Diovan, Lozartan, Candesartan and Irbesartan. To date, these drugs are among the main drugs that are used to treat CHF.They contribute to increased exercise tolerance, improve the filling of the heart with blood and CB, enhance urination. But Nitroglycerin is prescribed for heart failure in the presence of IHD, which mainly affects the veins with simultaneous expansion of the arteries.

To reduce the process of retention of excess fluid in the body use diuretics( Furosemide, Etacryn acid), which have a quick effect after taking. However, their frequent administration may lead to disruption of electrolyte metabolism, so they are combined with Triamteren, which is a diuretic, but it retains potassium in the body. In addition, Triampur is suitable in this case, especially for patients with stage II CHF.

The use of beta-blockers helps to reduce the heart rate. As a result of their influence, the filling processes are improved, and ultimately the CB increases. To do this, use Carvedilol, which is initially prescribed in small doses, but further improves myocardial contraction. However, some beta-blockers may constrict bronchial vessels and promote blood glucose, so they are cautiously prescribed to patients with existing bronchial asthma and diabetes mellitus.

And here to prevent the formation of blood clots in the heart chambers and the appearance of thromboembolism, prescribe anticoagulants( Warfamin, Heparin), which prevent clotting of blood with mandatory blood control.

In case of ineffective drug treatment, surgical intervention is recommended in the form of cardiomyoplasty, implantation of an artificial LV or pacemaker.

After the necessary treatment, patients with heart failure are under the supervision of a cardiologist throughout their life.