Cardiopulmonary insufficiency: symptoms and treatment

Often we hear the expression "cardiopulmonary insufficiency," but few can definitely say what this pathology is. What is this disease, what are its signs and causes, we will understand.

Cardiopulmonary insufficiency - what is it?

In modern medicine, cardiopulmonary insufficiency is understood as a condition in which heart failure, that is, the inability of the heart to provide a normal blood supply in the body, is combined with a pulmonary disease that occurs as a result of excessive blood pressure in the lung vessels where gas exchange takes place. All this leads to a decrease in the level of oxygen in the blood.

In practice, pulmonary insufficiency usually first develops, the symptoms of the heart are attached to it after a while. Strictly speaking, this symptom complex can be observed with many diseases of the cardiovascular system, as well as with lung diseases. In its course, the pathology can be manifested in an acute form, when the symptoms increase in a short time period, and can have a chronic variety, when the deterioration occurs for several years or even decades.

Causes of acute cardiopulmonary failure

Acute pulmonary insufficiency is a complication arising under certain conditions that threaten the patient's life. This requires urgent medical intervention. As a rule, it can develop under the following conditions:

• As a consequence of thrombosis or pulmonary artery spasm;
• With thromboembolism;
• With pneumatic or hydro-rotor;
• With exacerbation of bronchial asthma, asthmatic status.

However, the cause of increased pressure in the pulmonary artery can be and pathology of the heart. Most often, this happens when there is a sudden deficiency of the mitral valve. Also, the cause of the development of pulmonary insufficiency can be a failure of the pulmonary valve, acute myocardial infarction, myocarditis, heart defects in the stage of decompensation, cardiomyopathy. In this case, the cavity of the left ventricle expands, and the contraction of its wall is no longer capable of pushing the entire volume of blood into the lumen of the vessel. Some part of it stagnates and increases the pressure in the pulmonary veins. Since the right ventricle continues to pump blood in full, the pressure continues to increase, which can lead to pulmonary edema or cardiac asthma.

Causes of chronic cardiopulmonary failure

Chronic pulmonary insufficiency, in contrast to the acute form, grows slowly. The process of increasing pathological changes has been going on for several years. In this case, the development of hypertension in the pulmonary vessels occurs in connection with the following pathologies:

• Hereditary idiopathic hypertension;
• atherosclerosis;
• Failure of the pulmonary artery, which can be caused by endarteritis or repeated embolism of small branches;
• Chronic lung diseases - emphysema, pleurisy, pneumosclerosis, obstructive bronchitis;
• Slowly progressing congenital heart defects ;
• Acquired valve disorders.

Pulmonary insufficiency: severity

Due to the fact that the chronic form of this disease is characterized by a slow and often almost imperceptible increase in pathological symptoms, four degrees of severity of the disease are determined:

• I degree - signs of the disease are absent, with the usual physical activity of the manifestations of the disease is not observed, with the increase in the load there is a slight shortness of breath.
• II degree - at rest the symptoms do not appear, but with habitual physical exertion, dyspnea and frequent heart beat appear.
• III degree - symptoms of insufficiency appear with minimal physical exertion, but at rest are absent.
• IV degree - a person can not exercise minimal physical exertion, signs of the disease manifest at rest.

An acute attack of pulmonary insufficiency can develop according to one of two options - right and left ventricular failure. Left ventricular failure may be manifested by pulmonary edema or cardiac asthma.

Cardiac asthma

This is pulmonary insufficiency, the symptoms of which are gradually increasing. In the early stages, it manifests itself as shortness of breath, which appears first after physical exertion, with time it intensifies, appearing even at rest. At shortness of breath, an act of inspiration (an inspirational nature) is difficult. In the future, it is replaced by attacks of suffocation, most often occurring during sleep. For this stage, the compulsory posture is a high head, during the attacks the patient is forced to sit down, lowering his legs from the bed and leaning on his hands, except for shortness of breath, there are palpitations, sweating, and the fear of death. Cough with cardiac asthma is dry, with sparingly separated phlegm. Skin covers are pale, pronounced cyanosis of the nasolabial triangle, fingers. The pulse is irregular, weak, the pressure is reduced.

Consider what cardiac and bronchial asthma features:

Swelling of the lung

Acute pulmonary insufficiency can be complicated by the development of pulmonary edema. This is the release of a significant amount of blood into the lung tissue. The attack develops suddenly, regardless of the time of day. The beginning is characterized by a sharp suffocation, while there is a rapid deterioration of the patient:

• Dyspnea is worse, the patient does not have enough air, cyanosis of the skin of the face and limbs, cold sweat;
• Consciousness is broken - it can be both motor excitement and stupor up to complete loss of consciousness;
• Breathing noisy, bubbling, rose pink foam;
• If the attack occurred against a background of myocardial infarction or myocarditis, cardiogenic shock may develop.

Right ventricular failure

It can also arise as a complication of myocardial infarction or myocarditis. Its manifestations, except for shortness of breath and growing suffocation, are:

• Cyanosis of face and fingers;
• Well visible, especially on inhalation, swollen cervical veins;
• Swelling of the shins, face, abdominal wall right up to ascites;
• Enlargement of the liver, pulsation is observed in the epigastrium.

Chronic cardiopulmonary insufficiency

Due to the fact that the chronic form of this pathology develops over many years, its clinical manifestations are less pronounced. Since the pathology of the respiratory system is at the heart of the disease, it is manifested first of all by shortness of breath. The following symptoms can be attached to it:

• Pain in the chest;
• arrhythmia;
• tachycardia;
• cyanosis;
• Swelling on the legs;
• Swelling of the veins of the neck;
• Encephalopathy.

As the disease progresses, the symptoms begin to increase, and if at first they appear after certain loads, then in the final stages (in the stage of decompensation) this occurs in complete rest.

Cardiopulmonary insufficiency: treatment

The development of acute insufficiency usually requires rapid and professional intervention. As a rule, treatment is carried out in a hospital, and more often in the intensive care unit. In case the attack develops at home, it is necessary to deliver a person as soon as possible to a medical institution. Therapy of the chronic form of the disease consists in an integrated approach to the treatment of the disease. This is not only a medical correction, but also an optimization of the level of physical activity, nutrition. Drug therapy with this pathology consists in the appointment of the following groups of medications:

• Beta-blockers;
• Diuretics;
• Cardiac glycosides.

The scheme of therapy and dosage in each case is determined by the doctor. To engage in self-medication in such cases is unacceptable. In the case of ineffectiveness of conservative treatment, the problem is solved surgically.