Pulmonary heart disease - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Chest

pulmonary heart disease - wall thickening and enlargement of the right atrium and right ventricle of the heart, developing as a result of increasing pressure in the pulmonary circulation as a result of bronchopulmonary diseases, lung disease, or vascular changes in the chest.

Causes of pulmonary heart

customary to distinguish between acute, subacute, chronic pulmonary heart disease.When acute pulmonary heart disease symptoms increases for a number of hours, days, and it is based on more often:

1. vessels Defeat:
- pulmonary embolism (PE) or its branches,
- pneumomediastinum.
2. bronchopulmonary disease:
- heavy episodic bronchial asthma with the development of asthma status,
- extensive pneumonia.

for development subacute pulmonary heart takes several weeks or months.The reason for its occurrence can be:

1. vascular lesions:
- recurring microemboli medium-sized branches of the pulmonary artery,
- pulmonary vasculitis,
- primary pulmonary hypertension,

2. bronchopulmonary disease:
- diffuse fibrosing alveolitis,
- oncological processesin the mediastinum, the so-called lymphogenous kantsiromatoz light (distant metastases of malignant tumors of the stomach, prostate, urinary system, etc..),
- severe course of bronchial asthma,

3. Torakodiafragmalnaya pathology:
- alveolar hyperventilation with botulism, poliomyelitis, myasthenia gravis.

Chronic pulmonary heart disease developing for several years.Causes -

1. vascular lesions:
- primary pulmonary hypertension,
- arteritis,
- recurrent emboli,
- removal of part or the entire lung,

2. bronchopulmonary disease:
- obstructive bronchitis disease (emphysema, asthma, chronic bronchitis, pulmonary fibrosis),
- restrictive processes,
- fibrosis and granulёmatozy,
- multiple cysts in the lungs,

3. Torakodiafragmalnaya pathology:
- the defeat of the chest and spine deformation,
- pleural adhesions,
- obesity, caused by various diseases.

Symptoms

pulmonary heart When acute pulmonary heart disease complaints of patients are reduced to the appearance of a sharp pain in the chest, shortness of breath rapidly evolving severe, widespread cyanosis, swelling of the neck veins, a sharp decrease in blood pressure, increased heart rate over 100 beats per minute.Possible pain in the right upper quadrant of the sharp liver capsule tension, nausea, vomiting.

In subacute pulmonary heart disease the same symptoms of the disease do not occur with lightning speed, and more stretched in time.

Symptoms of chronic pulmonary heart before the onset of decompensation may be caused by a long period of time, the main bronchopulmonary disease.Most patients notice early heart palpitations, fatigue under normal loads.Gradually increasing shortness of breath.If I degree dyspnea disease appears only when a significant physical exertion, then to the III degree she worried patients, even at rest.Patients report heart palpitations often.Pain in the heart may be intensive and take place after the oxygen inhalation.There is a clear relationship between the occurrence of pain and physical activity, receiving nitroglycerin does not relieve pain attack.It is attached to popular cyanosis purple-bluish color of the skin of nasolabial triangle, lips, ears.Perhaps the jugular vein, the appearance of swelling in the lower extremities, and in severe cases develop ascites (fluid in the abdominal cavity).

survey

Along with the complaints of the patient are important objective survey data (increase the size of the heart of the cross, the expansion of the boundaries of the heart to the right of the sternum, the appearance of specific noise when listening to the heart, pain in the right hypochondrium on pressure, enlargement of the liver, etc.), as well as the presence of bronchopulmonary diseases in the past.To confirm the diagnosis carried out a number of diagnostic procedures listed below.

Laboratory and instrumental examination.

1. Complete blood count (KLA) - possible polycythemia (an increase in the number of red blood cells), increase in hemoglobin, ESR retardation, increased clotting ability in chronic pulmonary heart.

2. Urinalysis (OAM) is carried out in the framework of general clinical examination.3. Biochemical analysis of blood (BAC): pay attention to the content of total protein, protein fractions, sialic acid, fibrinogen, seromucoid.

4. ELISA - the high content of D-dimer in the blood plasma in pulmonary thromboembolism.

5. ECG - revealed signs perenruzki and increasing the mass of the right atrium and the right ventricle, the heart's electrical change in the position axis;

6. echocardiography (echocardiography, or ultrasound of the heart) allows to visually identify extended the right atrium and right ventricle of the heart, reveals signs of increased pressure in the pulmonary artery and quantifies the degree of pulmonary hypertension, assesses the state of central hemodynamics.

7. X-rays of the heart and lungs - the increase in the right atrium and ventricle, increasing the distance between the branches of the pulmonary artery enlargement of the pulmonary artery descending branch.

8. Spirography - diagnosed manifestations of the underlying disease causing pulmonary heart disease.

9. Selective angiography (opacification of the pulmonary arteries using endovascular techniques) - one of the most informative methods in the diagnosis of acute pulmonary heart disease, which developed as a result of pulmonary embolism.

10. radiopaque study of the lower extremities - the method reveals thrombosis in the veins of the lower extremities.

Treatment of pulmonary heart

self-medication and the use of traditional medicine for symptoms of pulmonary heart at best be ineffective and at worst - the patient to lose precious time.

In acute pulmonary heart disease treatment is reduced to the resuscitation, restore patency of the pulmonary vessels and combat pain.Thrombolytic therapy should be carried out in the first 4-6 hours of onset with massive pulmonary embolism, the use of it in the later stages of the disease may be unfounded.Thrombolytic therapy is carried out in a hospital only when the possibility of laboratory control over the treatment and absence of contraindications of the patient (recent injury, peptic ulcer in the acute stage, recent stroke, etc.).

With all the advances of modern medicine, treatment of pulmonary heart remains challenging and is aimed at slowing disease progression, increased life expectancy, improved quality of life.An integrated approach in the treatment of pulmonary heart disease include: the treatment of the underlying disease or relapse, treatment of respiratory insufficiency and disorders of gas exchange, the elimination or reduction of symptoms of heart failure decompensation.

Given the underlying pathology that led to the development of pulmonary heart disease, prescribe appropriate treatment: at various bronchopulmonary infections prescribe antibiotics for bronchial obstruction - drugs that enhance the bronchi, thrombosis or thromboembolism, pulmonary vessels - anticoagulant and fibrinolytic.In the treatment of pulmonary heart necessarily prescriptions expanding peripheral vessels, diuretics, drugs reduce the clotting ability of cardiac glycosides, the ineffectiveness of these drugs prescribed small doses of glucocorticosteroids.

Almost all patients need oxygen inhalation.Of great importance is avoiding harmful habits (smoking), removal of industrial hazards, identifying and removing allergens from the body, the cessation of further additions to the body, and others. Some importance in the complex treatment of patients with pulmonary heart disease is breathing exercises and chest compressions.If the patient suffers from chronic inflammatory diseases of the respiratory system, it is necessary to teach him the position of the bronchi drainage methods.

How dangerous symptom of pulmonary heart

Chronic pulmonary heart disease is the natural result of a long and difficult occurring diseases bronchopulmonary system, which reduces the ability to work, reduce their quality of life, disability of patients, and ultimately death.

To what doctor to treat the symptoms of pulmonary heart

therapist, pulmonologist, cardiologist.

therapists Kletkina Y.