Stagnation in the pulmonary circulation. Description of congestive heart failure

Congestive heart failure is a serious pathology of the heart muscle, manifested by a loss of the ability to pump required amount blood to saturate the entire body with oxygen. Stagnant processes can be left-sided or right-sided.

Because circulatory system has two circles of blood circulation, then pathology can manifest itself in any of them separately or in both at once. Congestive heart failure can occur acutely, but most often the pathology occurs in a chronic form.

Often this disease is diagnosed in people aged 60 years and above and, unfortunately, the prognosis for this age category quite disappointing.

• All information on the site is for informational purposes only and is NOT a guide to action!
• Can give you an ACCURATE DIAGNOSIS only DOCTOR!
• We kindly ask you NOT to self-medicate, but make an appointment with a specialist!
• Health to you and your loved ones!

Causes

The main cause of CHF is considered hereditary factor. If close relatives suffered from heart disease, which necessarily developed into heart failure, then the next generation will most likely have the same problems with this organ.

Acquired heart disease can also lead to CHF. Any disease that impairs the contractility of the heart ends in its severe weakening, manifested by poor blood pumping and stagnation.

Common causes of congestive heart failure:

Often a stagnant process develops in people suffering from diabetes mellitus, hypertension and thyroid disorders. A course of radiation and chemotherapy can provoke CHF. People living with HIV also quite often suffer from this pathology.

In patients with congestive heart failure, an imbalance of water and salt balance is often discovered during diagnosis. This dysfunction leads to increased excretion potassium from the body, as well as to stagnation of water and sodium salts. All this negatively affects work main muscle human - heart.

Lifestyle plays a significant role in the development of CHF. In people who have a sedentary job and do not play sports, congestive processes in the heart are most often diagnosed. The same applies to people suffering from excess weight and those who have a lot of junk food in their diet.

The normal functioning of the heart is disrupted by smoking and alcohol abuse. Adverse habits change the structure of the muscle walls, which leads to poor blood permeability and stagnation.

Symptoms of congestive heart failure

The symptoms of CHF in patients with right- and left-sided heart disease can differ significantly. The intensity and severity of symptoms depends on the degree of damage, which medicine divides into three stages of development.

The following are noted general signs stagnant process:

• weakness and fatigue;
• chronic fatigue;
• the body's susceptibility to stress;
• rapid heartbeat;
• cyanosis of the skin and mucous membranes;
• wheezing and shortness of breath after physical activity;
• (dry or foamy);
• loss of appetite;
• nausea, sometimes vomiting;
• lethargy;
• nocturnal attacks of suffocation;
• unreasonable anxiety or irritability.

Congestion in the lungs in heart failure is also quite common. This symptom is accompanied by a wet cough, which, depending on the severity of the disease, may have bloody discharge. The presence of these symptoms indicates left-sided congestive heart failure.

Also, shortness of breath and wheezing, which are constant, indicate a left-sided stagnation process. Even at rest, the patient cannot breathe normally.

Right-sided CHF has its own characteristics in the manifestation of symptoms. The patient has frequent urination, especially at night, and due to stagnation. There are complaints of abdominal pain and constant feeling heaviness in the stomach.

A patient with right-sided congestive heart failure rapidly gains weight, but this is not due to the deposition of fat, but due to the accumulation excess liquid. Bloated veins in the neck - another one reliable symptom right-sided stagnation process.

In the pulmonary circulation

During a stagnant process in the pulmonary circulation, which occurs due to heart failure, the liquid component of the blood exits into the alveoli - small spherical cavities that are filled with air and are responsible for gas exchange in the body.

Subsequently, the alveoli, due to the large accumulation of fluid, swell and become denser, which adversely affects the performance of their main function.

Chronic congestive heart failure, which adversely affects the pulmonary circulation, leads to irreversible processes in the lungs (changes in tissue structure) and blood vessels. Also, against the background of this pathology, congestive sclerosis and diffuse thickening in the lungs develop.

Signs of stagnation in the pulmonary circulation:

In a large circle of blood movement

The symptoms of a stagnant process in the systemic circulation have its own characteristics. This pathology is manifested by the accumulation of blood in internal organs, which, as the disease progresses, acquire irreversible changes. In addition, the liquid component of blood fills the extracellular spaces, which provokes the appearance of edema.

Signs of stagnation in the systemic circulation:

• obvious and hidden edema;
• pain syndrome in the right hypochondrium;
• cardiopalmus;
• fast fatiguability;
• dyspeptic manifestation;
• kidney dysfunction.

At the beginning of the development of swelling, only the foot area suffers. Then, as the disease progresses, the swelling rises higher, reaching the anterior wall of the peritoneum. Prolonged swelling leads to the formation of ulcers, skin tears and cracks, which often bleed.

Pain in the right hypochondrium indicates that due to stagnation of blood, the liver is filled with blood, and it has increased significantly in size.

Rapid heartbeat is a characteristic sign of CHF in the systemic circulation in women; men present with such a complaint much less frequently. This symptom occurs due to frequent contraction of the heart muscle or high susceptibility nervous system.

Fatigue occurs due to excessive filling of the muscles with blood. Dyspeptic symptoms (pathologies of the gastrointestinal tract) manifest themselves due to a lack of oxygen in the vessels, since it is directly related to the work of peristalsis.

Kidney function is disrupted due to spasms in blood vessels, which reduces urine production and increases its reabsorption in the tubules.

Diagnostics

To establish an accurate diagnosis, the doctor conducts a survey to collect anamnesis, an external examination of the patient and prescribes additional necessary examination methods.

If congestive heart failure is suspected, the patient should undergo the following diagnostic methods:

• echocardiogram;
• coronary angiography;
• chest x-ray;
• electrocardiogram;
• tests for laboratory research;
• angiography of blood vessels and heart.

The patient may also be prescribed to undergo a procedure for physical endurance. The method consists of measuring blood pressure, pulse, heart rate, taking a cardiogram and recording the amount of oxygen consumed while the patient is walking on a treadmill.

Such a diagnosis is not always carried out if heart failure is obvious, severe clinical picture, then such a procedure is not resorted to.

When diagnosing, one should not exclude the genetic factor of heart disease. It is also important during the interview to tell as accurately as possible about the existing symptoms, when they appeared and what could have caused the illness.

Treatment

Treatment is prescribed only after a complete diagnosis has been carried out and a diagnosis has been established. It is carried out strictly in a hospital under the supervision of specialists. Therapy is necessarily comprehensive, consisting of medications and a special diet.

First of all, the patient is prescribed medications that relieve the acute symptoms of CHF. After a slight improvement in the condition, the patient is given drugs that suppress the main cause of the disease.

Treatment for CHF includes:

• cardiac glycosides;
• diuretics (diuretics);
• beta blockers;
• ACE inhibitors;
• potassium preparations.

They are the main drugs in the fight against congestive heart failure. In parallel with them, diuretics are prescribed to remove accumulated fluid from the body and thereby remove excess stress from the heart.

Treatment is also acceptable folk remedies, but only with the permission of a doctor. Many herbal tinctures and decoctions perfectly remove fluid from the body and eliminate some symptoms. Traditional recipes against CHF can greatly improve the quality of drug therapy and speed up recovery.

When the disease is advanced, the patient is prescribed oxygen masks to improve his condition, especially during sleep, to avoid an attack of suffocation.

In addition to drug treatment, the patient is recommended to change, and after discharge from the hospital, return the lungs to normal. physical exercise. A patient with CHF should reduce salt intake, eat frequently but in small quantities, and completely eliminate caffeine from the diet.

Circulatory failure is pathological condition, expressed in the inability to deliver the amount of blood necessary for the normal functioning of the body to organs and tissues. Circulatory failure develops when the function of the heart or blood vessels or the whole function is impaired. Most often, circulatory failure is associated with weakness of the heart muscle arising from the following reasons: 1) prolonged myocardial overstrain (with,); 2) disturbances in the blood supply to the heart muscle (with coronary atherosclerosis, myocardial infarction, anemia); 3) inflammatory, toxic and other myocardial lesions (with myocarditis, myocardial dystrophy);
4) disturbances in blood oxygen saturation (for lung diseases);
5) insufficient or excessive intake of metabolic products, hormones, etc. into the blood. The weakening of myocardial contractility leads to the fact that during systole from the ventricles of the heart into arterial system less than normal amount of blood is released; a large amount of blood accumulates in the venous system, venous stagnation is created, blood flow slows down, and metabolism is disrupted.

If the contractility of the left ventricle or left atrium weakens predominantly, venous stagnation occurs in the pulmonary circulation; when the right ventricle is weakened, stagnation develops in the systemic circulation. Often all parts of the heart weaken at the same time, then venous congestion appears in both the large and small circles. Less commonly, circulatory failure is caused by vascular insufficiency. The latter occurs when there is a violation of the relationship between blood volume and the capacity of the vascular bed. This is observed either due to a decrease in blood mass (with blood loss, dehydration), or with a decrease in blood vessels - due to infection, intoxication, injuries (see Collapse,). Circulatory failure can be acute or chronic. Acute heart failure can be caused by acute weakness of the left side of the heart (myocardial infarction, hypertension, mitral stenosis, etc.). It is accompanied by rapid blood overflow of the pulmonary circulation and disruption respiratory function lungs (see). IN severe cases Pulmonary edema may develop. Acute right ventricular failure of the Heart is characterized by sharp, cyanosis, swelling of the neck veins, and rapid enlargement of the liver. If both ventricles are affected, acute heart failure can be mixed. Acute vascular insufficiency is clinically manifested by fainting, darkening of the eyes, weakness, pallor of the skin, a drop in arterial and venous pressure, and a frequent, small, soft pulse. Chronic failure blood circulation is more often associated with weakening of all parts of the heart and simultaneous vascular insufficiency. Initial symptoms circulatory failure occurs only during physical activity, during which patients develop weakness, weakness. At rest, these symptoms disappear, and upon examination it is not possible to identify objective signs of circulatory failure. As circulatory failure progresses, shortness of breath becomes more constant. The skin becomes bluish in color; the neck veins swell and begin to pulsate; increases; swelling appears on the legs, at first, only in the evening, they disappear overnight; later, the swelling becomes permanent, and dropsy of the cavities occurs (see, Hydrothorax). When examining the heart, they find an expansion of its borders, a weakening of tones, and sometimes a gallop rhythm is heard (see). The pulse becomes frequent, small, and often arrhythmic. The liver increases in size, becomes dense and painful. Rise venous stagnation in the pulmonary circulation is accompanied by increased shortness of breath, due to which patients take a forced sitting position (). They may develop a cough and hemoptysis. When auscultating the lungs, especially in the lower parts, moist, congestive sounds are heard. The accumulation of fluid in tissues due to circulatory failure leads to a decrease in urine output. The urine becomes concentrated and protein often appears in it. With prolonged circulatory failure, metabolism is disrupted, sclerotic changes develop in organs (liver fibrosis, etc.), their function is impaired; cardiac cachexia appears. Depending on the clinical picture, three stages of circulatory failure are distinguished: Stage I - latent failure, when its symptoms appear only during exercise; Stage II - severe deficiency; Stage III - dystrophic, final, characterized deep violation metabolism. Long-term circulatory failure can lead to various complications. Prolonged congestion in the lungs predisposes to the development of bronchitis, pneumonia, and pulmonary infarctions. Prolonged congestion in the liver causes congestion. Swelling skin of the legs easily becomes infected and ulcerated, and can develop.

The diagnosis of circulatory failure is made based on the patient’s complaints (shortness of breath, weakness, palpitations, etc.) and objective data (with the appearance of venous stagnation in the pulmonary and systemic circulation), edema, enlarged liver, congestive changes in the lungs, changes in the heart, increasing venous pressure, slowing down the speed of blood flow, etc. (see). helps in identifying pulmonary congestion and hydrothorax.

In case of circulatory failure, it depends on the cause that caused it. In case of circulatory failure associated with severe heart damage, the prognosis is always serious. in stage II, circulatory failure is sharply limited, in Stage III patients are unable to work.

This condition, with its progressive course, leads to the development of acute heart failure. Depending on the factors that provoked the disease, treatment can be conservative or surgical.

Mechanism, causes and signs of development of stagnation

Pathological processes are caused by the low ability of the left half of the heart to pump blood from the right half and the vessels of the lungs. Right-sided cardiac strength is preserved.

The condition can develop due to a number of factors:

• decreased tone and pumping force of the left atrium and ventricle in various diseases;
• anatomical changes in the myocardium due to hereditary predisposition or during dystrophic, cicatricial, adhesive processes;
• atherosclerosis or thrombosis coronary vessels, pulmonary veins.

Various diseases can cause stagnation:

• angina pectoris, ischemia, heart attack;
• cardiomyopathy, cardiosclerosis;

• hypertension;
• valve stenosis of the left half of the heart;
• myocarditis, rheumatism.

At first, the clinical picture of the disease is blurred. This happens because vascular system The lungs have many spare capillaries that can compensate for congestion in the heart for a long time. But the weakening of the muscle tone of the left ventricle over time leads to an increase in the volume of blood in the vessels of the pulmonary circulation, the lungs are “flooded” with blood, that is, it partially enters the alveoli, causing them to swell and stick together. The rate of blood circulation in the venous bed of the lungs slows down, and gas exchange function is impaired.

Depending on the compensatory capabilities of the capillaries in the pulmonary circulation, the disease can be acute, subacute and chronic.

At acute process There is a rapid development of pulmonary edema and cardiac asthma.

Vivid clinical signs of pulmonary edema

Shortness of breath is a feeling of lack of air, inability to take a deep breath and increased breathing movements. Shortness of breath is an early sign of the disease, observed before symptoms of heart failure appear. On early stages development of the disease, it is possible to detect respiratory dysfunction only after physical activity, and late stages the disease is observed even in complete rest. The main sign of pulmonary pathology is the appearance of shortness of breath when lying down and at night.

But there are other signs:

• Cough. Explained by swelling of the pulmonary tissues (vessels of the bronchi and alveoli) and irritation of the recurrent nerve, the cough is often dry, sometimes with scanty sputum.

• Lung wheezing and crepitus. The first sign is heard as small and medium bubbles, the second - as a series of characteristic clicks.
• Expansion of the chest. It is visually wider than that of healthy people.
• Dullness of percussion sound. On the losing side he is deaf and stupid.
• Deterioration general condition. Patients experience dizziness, weakness, and fainting.

The clinical picture of cardiac asthma is characterized by the following symptoms:

1. suffocation, which manifests itself in paroxysms, inhalation becomes very difficult until breathing stops;
2. cyanosis of the face and limbs develops rapidly, the patient turns blue before our eyes;
3. general weakness, confusion.

Cardiac symptoms may be observed: tachycardia and bradycardia, arrhythmic contractions, increased or critical decrease in blood pressure.

Possible complications, treatment tactics

The consequences of blood stagnation in the pulmonary circulation include:

• sclerosis, compaction, necrotization of lung tissue, as a result - disruption of normal respiratory functions;
• development of dystrophic changes in the right ventricle, which experiences high blood pressure and over time it overstretches, its tissues become thinner;

• changes in the vessels of the heart due to increased pressure in the pulmonary circulation.

The standard examination method is x-ray. The pictures show expansion of the borders of the heart and blood vessels. With ultrasound (ultrasound examination), increased volumes of blood in the left ventricle are clearly visible. In the lungs, the roots of the bronchi are dilated, and multiple focal opacities are observed.

Treatment of the disease is based on reducing physical activity, using cardiac glycosides, drugs that improve tissue metabolism, drugs that lower blood pressure and reduce swelling. To improve respiratory function, Eufillin and adrenergic agonists (stimulants) are used.

Surgical interventions are indicated for progressive narrowing of the atrioventricular opening in the left ventricle and valve stenosis.

How fortunate that I came across this article, a lot became clear. Not long ago, my grandmother was literally returned from the other world. At the clinic they treated her for bronchitis (she had been coughing for a month), nothing helped, she had a cough that led to attacks of suffocation, and the shortness of breath was such that she could not walk around the apartment. Until we called an ambulance ourselves and she was immediately admitted to intensive care, she lay there for a week. The doctors said that it was her heart that was sick and not her lungs. Now, thanks to the information in this article, I will keep an eye on my granny so as not to repeat such horror.

Signs of heart failure in children and adults

Circulatory failure is the most common complication of the pathology of cardio-vascular system. Since there are two circles of blood circulation in the human body, blood stagnation can occur in each of them separately, or in both at once. In addition, this process can occur chronically, over a long period of time, or be a consequence emergency. Depending on this, the symptoms of heart failure will vary.

Manifestations of blood stagnation in the pulmonary circulation

When the functioning of the heart is disrupted and a large amount of blood accumulates in the pulmonary circulation, the liquid part of it escapes into the alveoli. In addition, due to congestion, the wall of the alveoli itself can swell and thicken, which adversely affects the process of gas exchange.

At acute development Symptoms of pulmonary edema and cardiac asthma come first. With a long-term process, irreversible changes in the structure may occur lung tissue and its vessels, congestive sclerosis and brown compaction develop.

Dyspnea

Shortness of breath is the most common symptom cardiovascular failure in the pulmonary circulation.

In this case, there is a feeling of lack of air, a change in the frequency and depth of breathing. Patients complain that they cannot breathe deeply, that is, there is an inspiratory obstacle.

This sign may appear on the most early stages development of the pathological process, but only with intense physical activity. As the condition worsens, shortness of breath appears at rest and becomes the most painful symptom of chronic heart failure (CHF). At the same time, it is characteristic that it appears in horizontal position, including at night. This is one of the distinguishing signs from pulmonary pathology.

Orthopnea

Orthopnea is a forced sitting position when a person suffering from heart disease even sleeps with the head end elevated. This symptom is objective a sign of CHF, which can be detected during a routine examination of the patient, since he tends to sit down in any situation. If you ask him to lie down, then after a few minutes he will begin to choke.

This phenomenon can be explained by the fact that in an upright position, most of the blood accumulates in the veins lower limbs under the influence of gravity. And since the total volume of circulating fluid remains unchanged, the amount of blood in the pulmonary circulation is significantly reduced. In a horizontal position, the fluid returns to the lungs, due to which plethora occurs and the manifestations intensify.

Cough

Congestive heart failure is often accompanied by a patient coughing. It is usually dry or with a small amount of mucous sputum. There are two reasons for the development of this symptom:

• swelling of the bronchial mucosa due to plethora;
• irritation of the recurrent nerve by the dilated cavities of the left chambers of the heart.

Due to the fact that through damaged vessels Blood cells can enter the cavity of the alveoli, and sometimes the sputum becomes rusty in color. In this case, it is necessary to exclude other diseases that could lead to similar changes (tuberculosis, pulmonary embolism, disintegrating cavity).

Cardiac asthma

An attack of cardiac asthma manifests itself in the form of quickly occurring suffocation up to complete cessation of breathing. This symptom should be distinguished from bronchial asthma, since the approaches to treatment in this case will be diametrically opposed. Appearance patients may be similar: they often breathe shallowly. But in the first case, inhalation is difficult, while in the second, exhalation is difficult. Only a doctor can distinguish between these two conditions, so a person with such symptoms is advised to undergo emergency hospitalization in a hospital.

In response to an increase in the concentration of carbon dioxide in the blood and a decrease in the amount of oxygen, it activates respiratory center, which is located in the medulla oblongata. This leads to more frequent and shallow breathing, and the fear of death often appears, which only aggravates the situation. In the absence of timely intervention, the pressure in the pulmonary circle will continue to increase, which will lead to the development of pulmonary edema.

Pulmonary edema

This pathology is the final stage of increasing hypertension in the pulmonary circulation. Pulmonary edema often appears in acute heart failure or in decompensation of a chronic process. The previously listed symptoms are accompanied by coughing up pink, frothy sputum.

In severe cases, due to increasing oxygen deficiency, the patient loses consciousness, his breathing becomes shallow and ineffective. In this case, it is necessary to immediately intubate the trachea and begin artificial ventilation lungs with a mixture enriched with oxygen.

Manifestations of blood stagnation in the systemic circulation

Symptoms associated with stagnation of blood in the systemic circulation appear with primary or secondary right ventricular failure. In this case, plethora of internal organs occurs, which ultimately undergo irreversible changes. In addition, the liquid part of the blood accumulates in the interstitial spaces, leading to the appearance of hidden and obvious edema.

Edema

This symptom is one of the most common in chronic heart failure. They usually begin to appear in the area of ​​the feet, and then, as the disease progresses, they move upward, up to the anterior abdominal wall. There are several distinctive signs of edema in heart failure:

1. Symmetrical, in contrast to unilateral lesions with thrombophlebitis or lymphostasis.
2. Dependence on the position of the body in space, that is, after a night's sleep, fluid accumulates in the back and buttocks, while during walking it moves to the lower limbs.
3. The face, neck and shoulders are usually not affected, unlike renal edema.
4. To identify hidden edema, the patient's weight is monitored daily.

Complications of long-term edema are trophic changes in the skin associated with impaired nutrition, the formation of ulcers, cracks and tears from which fluid leaks. With secondary infection, gangrene may develop.

Pain in the right hypochondrium

This symptom is associated with the filling of the liver with blood and an increase in its volume. Since the capsule around it is not stretchable, pressure occurs on it from the inside, which leads to discomfort or pain. In chronic heart failure, transformation of liver cells occurs with the development of cirrhosis and dysfunction.

At the final stage, the pressure in the portal vein increases, which leads to the accumulation of fluid in the abdominal cavity (ascites). On the front abdominal wall The saphenous veins around the navel may enlarge to form a “jellyfish head.”

Heartbeat

Most often, this symptom appears with rapid contraction of the heart muscle, but it can also be caused by increased susceptibility of the nervous system. Therefore, this symptom is more typical for women and very rarely occurs in men.

Tachycardia is a compensatory mechanism aimed at normalizing hemodynamics. It is associated with activation of the sympatho-adrenal system and reflex reactions. Increased work of the heart quite quickly leads to depletion of the myocardium and an increase in stagnation. That is why in the treatment of CHF in last years began to use small doses of beta blockers, which slow down the frequency of contractions.

Fast fatiguability

Fatigue is rarely considered as specific symptom CHF. It is associated with increased blood flow skeletal muscles and can also be observed in other diseases.

Dyspeptic phenomena

This term combines all the signs of malfunction gastrointestinal tract(nausea, vomiting, increased gas formation and constipation). The function of the gastrointestinal tract is impaired both due to a decrease in oxygen delivery through the vessels and due to reflex mechanisms affecting peristalsis.

Impaired renal excretory function

Due to spasm renal vessels the amount of primary urine decreases, and at the same time its reabsorption in the tubules increases. As a result, fluid retention occurs and signs of heart failure increase. This pathological process leads to decompensation of CHF.

Heart failure is a serious manifestation of diseases of the cardiovascular system. This pathology is more common in adults than in children, and the manifestations depend on the circulation in which blood stagnation occurs. If fluid accumulates in the lungs, respiratory failure develops; when the internal organs become congested, their function is disrupted and their structure changes.

Description of congestive heart failure

Congestive heart failure is a serious pathology of the heart muscle, manifested by a loss of the ability to pump the required amount of blood to saturate the entire body with oxygen. Stagnant processes can be left-sided or right-sided.

Since the circulatory system has two circles of blood circulation, pathology can manifest itself in any of them separately or in both at once. Congestive heart failure can occur acutely, but most often the pathology occurs in a chronic form.

Often this disease is diagnosed in people aged 60 years and above and, unfortunately, the prognosis for this age category is completely disappointing.

• All information on the site is for informational purposes only and is NOT a guide to action!
• Only a DOCTOR can give you an ACCURATE DIAGNOSIS!
• We kindly ask you NOT to self-medicate, but to make an appointment with a specialist!
• Health to you and your loved ones!

Causes

The main cause of CHF is considered to be a hereditary factor. If close relatives suffered from heart disease, which necessarily developed into heart failure, then the next generation will most likely have the same problems with this organ.

Acquired heart disease can also lead to CHF. Any disease that impairs the contractility of the heart ends in its severe weakening, manifested by poor blood pumping and stagnation.

Common causes of congestive heart failure:

• Prolonged lack of treatment allows harmful microorganisms to spread beyond the main focus and penetrate the heart muscle.
• The result is heart damage, which often ends in blood stagnation.

Often, a stagnant process develops in people suffering from diabetes, hypertension and disorders of the thyroid gland. A course of radiation and chemotherapy can provoke CHF. People living with HIV also quite often suffer from this pathology.

In patients with congestive heart failure, an imbalance of water and salt balance is often discovered during diagnosis. This dysfunction leads to increased excretion of potassium from the body, as well as stagnation of water and sodium salts. All this negatively affects the functioning of the main human muscle - the heart.

Lifestyle plays a significant role in the development of CHF. In people who have a sedentary job and do not play sports, congestive processes in the heart are most often diagnosed. The same applies to people who are overweight and those who have a lot of junk food in their diet.

The normal functioning of the heart is disrupted by smoking and alcohol abuse. Adverse habits change the structure of the muscle walls, which leads to poor blood permeability and stagnation.

Symptoms of congestive heart failure

The symptoms of CHF in patients with right- and left-sided heart disease can differ significantly. The intensity and severity of symptoms depends on the degree of damage, which medicine divides into three stages of development.

The following general signs of a stagnant process are noted:

• weakness and fatigue;
• chronic fatigue;
• the body's susceptibility to stress;
• rapid heartbeat;
• cyanosis of the skin and mucous membranes;
• wheezing and shortness of breath after physical activity;
• cough (dry or foamy);
• loss of appetite;
• nausea, sometimes vomiting;
• lethargy;
• nocturnal attacks of suffocation;
• unreasonable anxiety or irritability.

Congestion in the lungs in heart failure is also quite common. This symptom is accompanied by a wet cough, which, depending on the severity of the disease, may have bloody discharge. The presence of these symptoms indicates left-sided congestive heart failure.

Also, shortness of breath and wheezing, which are constant, indicate a left-sided stagnation process. Even at rest, the patient cannot breathe normally.

Right-sided CHF has its own characteristics in the manifestation of symptoms. The patient experiences frequent urination, especially at night, and due to stagnation, the lower back, legs and ankles swell. There are complaints of abdominal pain and a constant feeling of heaviness in the stomach.

A patient with right-sided congestive heart failure rapidly gains weight, but this is not due to the deposition of fat, but due to the accumulation of excess fluid. Swollen veins in the neck are another reliable symptom of right-sided congestion.

Read here how heart failure manifests itself in older people.

In the pulmonary circulation

During a stagnant process in the pulmonary circulation, which occurs due to heart failure, the liquid component of the blood exits into the alveoli - small spherical cavities that are filled with air and are responsible for gas exchange in the body.

Subsequently, the alveoli, due to the large accumulation of fluid, swell and become denser, which adversely affects the performance of their main function.

Chronic congestive heart failure, which adversely affects the pulmonary circulation, leads to irreversible processes in the lungs (changes in tissue structure) and blood vessels. Also, against the background of this pathology, congestive sclerosis and diffuse thickening in the lungs develop.

Signs of stagnation in the pulmonary circulation:

In a large circle of blood movement

The symptoms of a stagnant process in the systemic circulation have its own characteristics. This pathology is manifested by the accumulation of blood in the internal organs, which, as the disease progresses, acquire irreversible changes. In addition, the liquid component of blood fills the extracellular spaces, which provokes the appearance of edema.

Signs of stagnation in the systemic circulation:

• obvious and hidden edema;
• pain in the right hypochondrium;
• cardiopalmus;
• fast fatiguability;
• dyspeptic manifestation;
• kidney dysfunction.

At the beginning of the development of swelling, only the foot area suffers. Then, as the disease progresses, the swelling rises higher, reaching the anterior wall of the peritoneum. Prolonged swelling leads to the formation of ulcers, skin tears and cracks, which often bleed.

Pain in the right hypochondrium indicates that due to stagnation of blood, the liver is filled with blood, and it has increased significantly in size.

Rapid heartbeat is a characteristic sign of CHF in the systemic circulation in women; men present with such a complaint much less frequently. This symptom occurs due to frequent contractions of the heart muscle or high susceptibility of the nervous system.

Fatigue occurs due to excessive filling of the muscles with blood. Dyspeptic symptoms (pathologies of the gastrointestinal tract) manifest themselves due to a lack of oxygen in the vessels, since it is directly related to the work of peristalsis.

Kidney function is disrupted due to spasms in blood vessels, which reduces urine production and increases its reabsorption in the tubules.

Diagnostics

To establish an accurate diagnosis, the doctor conducts a survey to collect anamnesis, an external examination of the patient and prescribes additional necessary examination methods.

If congestive heart failure is suspected, the patient should undergo the following diagnostic methods:

• echocardiogram;
• coronary angiography;
• chest x-ray;
• electrocardiogram;
• tests for laboratory research;
• angiography of blood vessels and heart.

The patient may also be prescribed to undergo a procedure for physical endurance. The method consists of measuring blood pressure, pulse, heart rate, taking a cardiogram and recording the amount of oxygen consumed while the patient is walking on a treadmill.

Such a diagnosis is not always carried out; if heart failure has an obvious, severe clinical picture, then such a procedure is not resorted to.

When diagnosing, one should not exclude the genetic factor of heart disease. It is also important during the interview to tell as accurately as possible about the existing symptoms, when they appeared and what could have caused the illness.

Treatment

Treatment is prescribed only after a complete diagnosis has been carried out and a diagnosis has been established. It is carried out strictly in a hospital under the supervision of specialists. Therapy is necessarily comprehensive, consisting of medications and a special diet.

First of all, the patient is prescribed medications that relieve the acute symptoms of CHF. After a slight improvement in the condition, the patient is given drugs that suppress the main cause of the disease.

• cardiac glycosides;
• diuretics (diuretics);
• beta blockers;
• ACE inhibitors;
• potassium preparations.

Cardiac glycosides are the main drugs in the fight against congestive heart failure. In parallel with them, diuretics are prescribed to remove accumulated fluid from the body and thereby remove excess stress from the heart.

Treatment with folk remedies is also acceptable, but only with the permission of a doctor. Many herbal tinctures and decoctions are excellent at removing fluid from the body and eliminating some symptoms. Traditional recipes against CHF can greatly improve the quality of drug therapy and speed up recovery.

When the disease is advanced, the patient is prescribed oxygen masks to improve his condition, especially during sleep, to avoid an attack of suffocation.

In addition to drug treatment, the patient is recommended to change his diet, and after discharge from the hospital, introduce light physical activity to the norm. A patient with CHF should reduce salt intake, eat frequently but in small quantities, and completely eliminate caffeine from the diet.

Symptoms of cardiopulmonary failure are listed here.

From here you can learn about the causes of heart failure in children.

In severe cases of the disease, when medications do not help and the patient’s condition only worsens, the patient needs a heart transplant.

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Symptoms and treatment of venous blood stasis

Physical inactivity is the scourge of our civilization. We move little, stuck in our comfort zone, and reap the corresponding benefits - digestive and respiratory disorders, cardiovascular problems, obesity. Low physical activity is the main cause of venous stagnation, which will be discussed in this article.

Venous stagnation - what is it?

Venous stagnation is a pathological process manifested in obstructed outflow of venous blood with normal arterial inflow. Stagnation is provoked by low elasticity of the vascular walls and increased blood viscosity. At first, tone is lost, after which blood flow becomes difficult. Extensive accumulation venous vessels determines the localization of pathology.

Known to medicine following areas lesions:

Causes

Operation arterial vessels depends on heart contractions - they give the blood an impulse. Stimulation and normal pressure provide contractions of the gastrocnemius and abdominal muscles, effects on the arch of the foot and sole.

There is a second important factor - breathing. Venous vessels are designed in such a way that the valves of the inner walls push blood exclusively in the direction of the heart.

If the skeletal muscles are not fully involved, the “muscle pump” works poorly, unable to cope with the task assigned to it.

Where is pathology observed most often?

Pathology is observed primarily in places of the highest concentration of venous vessels. Let us consider, as an example, stagnation affecting the pulmonary circulatory system.

There may be several reasons for its appearance:

• left ventricular failure (this occurs after arterial coronary sclerosis, bullet wound, heart attack);
• aortic disease (sclerosation of the semilunar valves);
• mitral disease (occurs with sclerosis, rheumatism of the heart).

When the systemic circulation is affected, the lungs may be affected by diffuse sclerotic changes. The disease can also manifest itself in the form of abdominal and pleural cavity, liver, pericardium and hyperpericardium.

Brain

Venous congestion in the head is secondary; it is a consequence of extracranial or intracranial pathology.

Methods for diagnosing the disease are as follows:

• radiography of the skull;
• phlebography;
• pressure measurement (performed in the area of ​​the ulnar vein).

If hyperemia has entered the chronic stage, catastrophic changes may occur in the metabolism - it will begin oxygen starvation brain, then swelling. After this, intracranial pressure rapidly increases.

Symptoms of cerebral venous stagnation look like this:

• dilated fundus veins;
• increased migraines when turning and bending;
• sudden attacks of dizziness;
• noise in the head;
• morning headaches;
• swelling of the lower eyelids;
• cyanosis of the face;
• fainting;
• increased pain with alcohol consumption and emotional experiences;
• mental disorders;
• decreased sensitivity of the limbs.

Treatment of venous stagnation of the brain involves a whole range of measures.

We list the types of therapeutic effects:

• reduction of venous pressure through aminophylline (in tablets or intravenously);
• reducing the severity of edema (diacarb, mannitol, furosemide);
• neutralization of stagnant processes (escusan, glivenol, detralex, troxevasin);
• self-massage of the collar area;
• electrical stimulation;
• laser-LED therapy;
• phytotherapy;
• types of reflexology.

Small pelvis

Stagnation of blood in the pelvis refers to passive hyperemia and is considered very common. For women, this disease poses a particular danger during pregnancy, as it can lead to miscarriage, infertility, and the birth of premature babies.

Early diagnosis and timely treatment allow for a good prognosis.

The provoking factors of the disease are usually:

With venous stagnation of the lower extremities, vascular deformation may appear - this indicates acute form diseases. A decrease in blood flow speed leads to the diagnosis of “venous insufficiency”.

The symptoms of the pathology are:

• heaviness and tension calf muscles(worsens in the evening);
• cyanosis of the skin;
• swelling of the legs;
• low body temperature;
• plasmorrhagia (impregnation of surrounding tissues with plasma);
• pinpoint hemorrhages (observed in the area of ​​concentration of small vessels).

Treatment of venous stagnation involves normalizing blood circulation and eliminating excess vascular tone. Folk and medications, surgical intervention is practiced only in the most advanced cases.

• therapeutic walking;
• contrast shower for feet;
• elevated position of the lower extremities;
• gels and ointments containing heparin (Heparoid, Hepatrombin, Heparin-Sodium Brown, Lechiva);
• diuretics (good for swelling);
• mountain chestnut tincture (rubbed into the affected area);
• compression jersey (can be replaced with elastic bandages);
• medications - angioprotectors and venotonics (Venoruton, Venitan, Detralex).

A feeling of heaviness can manifest itself not only with venous congestion of the legs - this symptom is inherent in patients suffering from obesity and ordinary people who spend a lot of time on their feet. Therefore, do not try to diagnose the pathology yourself - consult a doctor.

Lungs

Obstructed blood flow in the vessels supplying the lungs can lead to swelling of the latter. Compacts lung tissue, gradually acquiring a brown tint. this color is due to the accumulation of hemosiderin, and the whole process is called “brown compaction of the lungs.”

The consequences are stagnation in the pulmonary circulation and the occurrence of sclerosis.

Symptoms of pulmonary pathology are:

• low mobility of the diaphragm;
• hard breathing;
• systematic shortness of breath;
• difficult to separate viscous sputum with blood streaks;
• wheezing (observed in the posterior lower region of the lungs);
• mitral/aortic heart defects;
• pastiness of the legs;
• roundness of the liver, increase in its size, pain on palpation;

How to cure pulmonary venous congestion?

The following methods are practiced:

1. Surgical intervention (valve replacement, valvotomy).
2. Therapy aimed at normalizing heart failure.
3. Assignment of a disability group - in case of persistent pulmonary congestion.

Kidneys

Chronic venous congestion in the kidneys leads to an increase in the size of this organ, its cyanosis and compaction. Blood circulation is disrupted (changes affect a large circle), spasm of the renal arterioles occurs, glomerular filtration becomes limited. The kidneys excrete water with sodium worse, and in the adjacent tissue fluid The plasma content increases, which worsens tissue metabolism and blood circulation in general.

Dilatation of the renal veins and congestive anemia lead to edema of the stroma and the development of lymphostasis. The glomeruli are full-blooded and slightly enlarged, intercellular spaces expanded.

Pathology can lead to a number of complications:

• stone formation;
• pyelonephritis;
• general inflammation;
• increase in blood pressure.

Infectious complications must be prevented and pain must be reduced. That's why doctors prescribe painkillers and antibacterial agents. Surgery will be required to restore normal blood flow.

The methods are as follows:

• percutaneous nephrostomy;
• bladder catheterization;
• open surgery;
• endoscopy.

Cervical osteochondrosis and venous stagnation

Venous congestion can develop against the background of cervical osteochondrosis.

In general, the causes of pathology are as follows:

• bone fracture;
• traumatic brain injuries;
• previous strokes;
• internal hematomas;
• formation of tumors (cervical spine);
• vein blockage;
• chest and abdominal injuries;
• strangulation lesions.
• prolapse of vertebral discs;
• cervical osteochondrosis.

Problems with the spine always cause large-scale systemic disorders - the functioning of many organs is called into question. Protrusion invariably leads to disruption of blood flow, and then to venous stagnation.

Cervical osteochondrosis provokes compression of nerve formations and blood vessels - most often this affects the vertebral artery, which runs in the spinal canal. A hernia of the cervical segment leads to damage to the membrane and subsequent swelling. After this, venous stagnation begins, the apotheosis of everything - inflammation of the spine.

Compression vertebral artery has extremely unpleasant consequence- slowing blood flow to the brain stem and cerebellum. If you don't do it timely treatment osteochondrosis, the matter can end in chronic ischemia and spinal stroke.

Final recommendation: for any form of venous stagnation, you should immediately consult a doctor and begin treatment depending on the location of the pathology. It is also worth thinking about your diet and getting rid of bad habits.

The prerequisite for stagnation in the pulmonary circulation is that left half the heart was not able to transport the amount of blood that the right half of the heart pumps into the vessels of the lungs. In practice, this can have two reasons: depletion of the left side of the heart or narrowing of the left atrioventricular orifice. Congestion in the pulmonary circulation develops only if the strength of the right half of the heart is relatively preserved. In carditis, when usually the whole heart is affected equally, the degree of congestion in the lungs practically depends on the ratio of the decrease in the strength of the two halves of the heart.

Consisting of short and expandable capillaries, the vascular network of the lungs, which has many reserve capillaries, can, by increasing its diameter over a long time, well balance fluctuations in the pulmonary circulation. However, if the left ventricle is unable to maintain the same minute volume as the right ventricle for a long time, then sooner or later the amount of circulating blood in the lungs increases, and the vessels of the pulmonary circulation “flood”. There are no valves between the pulmonary veins and the left atrium, and thus they are hemodynamically a single system. The blood accumulating here is partly due to a passive increase in pressure, partly due to high pressure, which occurs as a result of active spasm of the veins, has a stimulating effect on the activity of the left half of the heart. However, if the narrowing of the opening is so significant that the increased pressure in the pulmonary circulation is not able to drive blood through it, or if the strength of the left ventricle is already so reduced that it is not capable of further compensation, then the increased pressure in the venous system also passes to the pulmonary arteries. The right ventricle thus has to overcome the increased pressure. The speed of blood flow in the lungs decreases, and a combined study (from the shoulder to the lungs and from the shoulder to the tongue) can also be stated that the speed of blood flow has slowed down primarily in the veins.

IN certain cases the consequence of increased pressure in the pulmonary arteries is hypertension in the pulmonary circulation. In this case, the pulmonary vessels respond functionally and anatomically to the increased load, like the vessels of the systemic circulation in hypertension. Spasm of the arterioles increases the resistance in the pulmonary circulation and thereby, often due to the right half of the heart, reduces the load of the pulmonary circulation and the left half of the heart (for example, with stenosis of the left atrioventricular orifice).

Upon opening congestive lungs do not fall off, but retain their shape. The cut surface with fresh stagnation is red, with older stagnation it is reddish-brown; more or less foamy liquid can be squeezed out of it. There is clear or purulent mucus in the bronchi. Microscopically, this condition is characterized by an expanded capillary system that compresses the alveoli. Red blood cells, white blood cells and alveolar epithelium are visible in the alveoli. In the alveoli themselves, in the interalveolar connective tissue, in wide capillaries and in lymphatic vessels, “cells of heart defects” are found. “Cells of heart defects” are large mononuclear cells, in the cytoplasm of which there are pigment grains. Their origin has not been reliably determined; it is suggested that they may come from different places. Pigment grains are formed from the iron of red blood cells that extend beyond the vascular walls. With prolonged congestion, the supporting tissue of the lungs grows. If heart failure is accompanied by a weakening of respiratory movements, then in low-lying parts, in bedridden patients near the spine, in walking patients, hypostasis occurs above the diaphragm.

Most characteristic symptom with stagnation in the pulmonary circulation, shortness of breath occurs, which intensifies in severe cases to shortness of breath with a forced sitting position. If the reduction in respiratory surface is too large and blood flow through the lungs slows down significantly, the patient becomes cyanotic. Stagnation also occurs in the own vessels of the bronchial wall, bronchitis and cough occur. Shortness of breath and cough are worse when doing work, and in walking patients they are worse at night due to an increase in the amount of blood flowing back to the lungs. When decompensation begins, the child hardly complains of shortness of breath, but upon detailed questioning of the parents, it turns out that the child quickly begins to cough when walking up stairs or running, “gets a cold easily,” and often has “bronchitis.” The sputum is mucous, bloody, and with long-standing stagnation, it may have “cells heart defect» brown color resembling rust. Fresh blood, mixed with sputum, occurs from a pulmonary infarction or from minor bleeding from the pulmonary vessels. In rheumatic carditis, the admixture of blood in the sputum is not necessarily a consequence of stagnation, but can also occur from vascular disease of the lungs.

The chest of a patient with shortness of breath as a result of stagnation in the pulmonary circulation is usually wide; due to a decrease in the excursion of the lungs, it is closer to the state of inspiration. If dullness can be tapped over the chest, then congestion in the lungs has been accompanied by an accumulation of free fluid in chest cavity. When listening, scattered fine-bubble wheezing is heard, and crepitus is heard above the base of the lungs or near the spine.

On X-ray examination, the hilus pattern is rich, the pulmonary vessels are wide. In the enhanced hilus pattern, pulsating vessels are visible. The tracheobronchial glands are swollen, their edges are washed away. The volume of blood stuck in the lungs is large, the pulmonary pattern is very pronounced. In the formation of a pronounced pulmonary pattern, congestion in the lymphatic vessels certainly plays a role. The pulmonary pattern is uneven, cloudy, with focal shadows observed in places. In newborns and infants, pulmonary congestion is often mixed with focal bronchopneumonia.

The total and vital capacity of the lungs is significantly reduced. Residual air makes up a larger portion of the total capacity than usual. Despite the decrease in vital capacity, due to the increase in respiratory rate, the minute volume of breathing increases. The vital capacity of healthy children is approximately 15 ml per cm of body height. In the sitting and standing positions, the vital capacity, according to the amount of blood flowing back and the change in the position of the diaphragm, is greater than in the supine position. Standing tall diaphragm during flatulence may decrease vital capacity also regardless of stagnation. In severe or long-term illness, weakening muscle strength certainly also plays a role in the deterioration of breathing.

Shortness of breath is very closely related to stagnation in the pulmonary circulation; since its significance is great, we will consider it separately.

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