Cardiology

Chronic heart failure


Chronic heart failure

Most heart disease in the absence of treatment is chronic heart failure (CHF). This is a condition in which the heart cannot pump blood in sufficient quantity, resulting in organs and tissues lack of oxygen and nutrients.

The most obvious signs of heart failure are shortness of breath and swelling. Shortness of breath occurs due to stagnation of blood in the pulmonary vessels and increased the body’s need for oxygen. Swelling appear due to stagnation of blood in the venous line.

Heart failure develops gradually, so there are several stages of this disease. There are different principles of division of heart failure at the stage, one of the most convenient and clear classifications developed by the new York heart Association. It is divided into four functional class in patients with chronic heart failure:

Causes and symptoms of heart failureType I heart failure – the patient is not experiencing limitations in physical activity. Typical load not provoke the appearance of weakness (lightheadedness), palpitation, dyspnea or anginal pain.

Type II heart failure – moderate limitation of physical activity. The patient feels comfortable at rest, but ordinary physical activity causes weakness (faint), palpitation, dyspnea or anginal pain.

Type III heart failure – marked limitation of physical activity. The patient feels comfortable only at rest, but less than usual, exercise lead to weakness (lightheadedness), palpitation, dyspnea or anginal pain.

Type IV heart failure – the inability to perform any load without discomfort. Symptoms of heart failure and syndrome of angina may occur at rest. When the minimum load is growing discomfort.

What is chronic heart failure?

The state of chronic heart failure occurs when the heart is no longer sufficient to supply the tissues and organs with blood, and therefore oxygen and nutrients.

Causes of heart failure?

Chronic insufficiency of the cardiac muscle (myocardium) is unable to develop due efforts to expel blood from the left ventricle. The causes of this disorder can be associated with damage to the myocardium, aorta (the main artery that runs directly from the heart) and heart valves.

The myocardium is affected with ischemic heart disease, myocarditis (inflammation of heart muscle), cardiomyopathies, systemic diseases of connective tissue. There is also toxic myocardial damage in case of poisoning poisons, toxins and drugs.

The aorta and arteries occurs in atherosclerosis, hypertension, diabetes and some other diseases.

Not the operated heart diseases (congenital and acquired) also lead to heart failure.

What is heart failure?

Slow circulation causes chronic oxygen starvation of tissues and organs, causing a characteristic manifestation of heart failure – shortness of breath during physical activity or (in advanced cases) alone. He complains of fatigue, poor sleep, palpitations (tachycardia).

The lack of oxygen in the more remote from the heart to the body parts (fingers, toes, lips) leads to the fact that the skin becomes gray-bluish (cyanosis). Inadequate cardiac output leads not only to reduce the volume of blood flowing in the arterial tree, but to stagnation of blood in the venous line. This leads to swelling (first – leg), and pain in the right hypochondrium, associated with the overflow of the veins of the liver.

In the most severe stages of heart failure all of the above symptoms persist.

Cyanosis and shortness of breath disturb a person even in a state of complete rest. He is forced to spend in a seated position all day, as in lying down shortness of breath increases, and even sleep can only sit. The swelling spread to the whole of the lower part of the body, the fluid accumulates in body cavities (peritoneal, pleural).

Symptoms of heart failure

The diagnosis is based on examination by a cardiologist and additional methods of examination, such as electrocardiogram in different variations: monitoring of ECG and treadmill test. Airway and dimensions of the parts of the heart, rating them in the aorta blood can be found by using echocardiogram. Possible cardiac catheterization (thin tube is introduced through a vein or artery directly into the heart, this procedure allows to measure the pressure in the chambers of the heart and identify the location of the blockage of blood vessels).

Treatment of heart failure

Heart failure is much easier to prevent than to cure.

Its prevention includes treatment of hypertension, atherosclerosis prevention, healthy lifestyle, exercise, Smoking cessation and diet.

If heart failure is still developed, cardiologist prescribes treatment. Typically, it includes diuretics (to reduce the amount of pumped blood), ultraselective beta-blockers (to reduce the need of the heart for oxygen), metabolic therapy, and, of course, treatment of the underlying disease.