Decompensated heart failure - what is it? Symptoms and Treatment

There is compensated and decompensated heart failure. Compensated is considered insufficiency in mild form (1st stage).

Decompensated heart failure is the terminal stage of the disease, which is the result of the fact that the damaged cardiac muscle is unable to deliver blood to various functional systems of the human body. A characteristic feature is manifestation not only during periods of physical activity, but also at rest. Often with decompensated heart failure, there are significant cardiac pathological and functional changes. These changes, as a rule, are irreversible and can end lethal. This type of pathology refers to a severe form (stage 3).

This article will discuss in detail decompensated heart failure: what is it, what are the types, symptoms of the disease and possible ways of treatment.

Causes of occurrence of NOS

Unfortunately, the origin of this disease by scientists is not fully understood. However, studies in this area indicate that decompensated heart failure may occur in the event that there are provoking factors. It is these factors that can become the root cause of the onset of the disease. Among them:

• Hypertrophy of the myocardium.
• A change in the structural integrity of the myocardium caused by myocardial infarction, trauma, ischemia or myocarditis.
• Hypertensive crisis.
• Arrhythmic phenomena.
• Cases of sudden increase of pressure in a small circle of blood circulation.

This is how decompensated heart failure manifests itself. What it is, interests many.

Along with the above, also the root causes of the disease may be various kinds of stagnant processes of the respiratory system. In all these cases, there is a general rule: LTO, like other types of heart failure, occurs as a result of critical overloads, as well as excessive fatigue of the heart muscle.

The clinical picture and varieties of decompensated heart failure are described below.

Before starting the study of symptoms of NOS, it should be noted that the clinical picture of the disease entirely depends on the type of heart failure. Specialists distinguish two forms - chronic and acute. Let us dwell in more detail on each of them.

Acute Decompensated Heart Failure

It arises and develops after a rapid decompensation, the appearance of compensation at which it is impossible. Mechanisms for heart failure, such as an increase in the tone of the veins, increased tonic function or an increase in the volume of diastolic filling of the blood of the ventricles, can not appear due to the physiological features of the acute form of SDS. These features include:

1. Left ventricular artery in acute form. Develops as a result of a heart attack or stenosis of the mitral valve. Characteristic symptoms are excessive puffiness of the lungs and blood vessel over-filling of the respiratory system. What else is decompensated heart failure? Symptoms will be discussed later.
2. Right ventricular balloon in acute form. It arises from a patient's heart attack or thromboembolism, as a result of which the functionality and integrity of the interventricular septum is impaired. Characteristic symptoms for acute left ventricular SDS are the following: a sharp increase in the liver occurs, blood stasis is fixed on a large circle of blood circulation, the lungs can be filled with blood.

What is dangerous is the acute form?

Unfortunately, the acute form is characterized by a high level of deaths due to the fact that the heart muscle is unable to drive the right amount of blood and there is no compensation function (or is insufficient), and also due to pulmonary edema or myocardial infarction. In the case of manifestations of acute form of SDS, urgent intervention of specialists is necessary, which will place the patient in the hospital and will carry out a number of necessary resuscitation activities.

There is also chronic decompensated heart failure. What it is? About this further.

Chronic form of SDS

CHF may manifest in a decompensated form. In this case, the manifestation of various symptoms, a full specification of which is carried out by diagnostic studies. For CHF characteristic is such a clinical picture:

• Signs of severe swelling of the legs, lower abdomen, scrotum, as well as in the pericardium.
• Arrhythmia and hypoxia.
• Syndrome of cold extremities.
• A sharp increase in body weight.
• Manifestations of mitral and tricuspid insufficiency.
• The appearance of dyspnea, including in the absence of physical exertion.

Decompensated chronic heart failure is a pathology in which the respiratory system is often disturbed. When examined by a specialist, pulmonary rales (when the patient is lying down) can be detected. The cause of such manifestations is the excessive flow of blood to the respiratory organs. Another symptom may be hypoxia and, as a result, blurred consciousness. Hypoxia occurs as a result of insufficient blood supply to the brain of the head and oxygen deficiency.

It is important in time to identify such a disease as chronic decompensated heart failure (what is it, it is now clear).

Diagnostics

The complex of diagnostic measures includes the study of the level of changes in uretic peptide beta-type, H-neutral peptide, as well as echocardiography and X-ray of internal organs, transrononal echocardiography.

More accurate information on the power of blood pressure in the heart chambers can be obtained by a special procedure in which a catheter is inserted into the central vein or pulmonary artery and the necessary measurements are made.

Also, the diagnosis of any form of HF involves a number of laboratory tests, including blood tests for creatinine and urea levels, electrolytes, transaminases and glucose, and other blood and urine tests; A study of the presence and correlation of gases in the blood of arteries.

Decompensated heart failure: treatment

According to statistics for 2010, about 1 million people die each year from heart failure in Russia. It is the emergence of decompensation and heart rhythm disturbances called specialists the main cause of the high mortality rate. Often decompensation requires immediate medical intervention. In this regard, in addition to rare exceptions, drug treatment is carried out by injecting drugs intravenously (to obtain a controlled and timely result).

More on decompensation therapy

The main goal of therapy is to maintain a normal level of oxygen saturation of hemoglobin, which allows to ensure normal supply of tissues and organs with oxygen and avoid multi-organ failure.

One of the methods used is oxygen inhalation (usually non-invasive ventilation (NPVD) is used at positive pressure), which allows to refuse the use of endotracheal intubation. The latter is used to carry out mechanical ventilation if it is not possible to eliminate pulmonary insufficiency by the NSAID.

Treatment with medication

In the treatment of decompensation, medicinal therapy is also used. The drugs used and their groups:

• Morphine and its analogues. It is used to reduce the heart rate and reduce the pain syndrome.
• Diuretics. Applied with symptoms of fluid retention in the body;
• Inotropic agents eliminate peripheral hypoperfusion.
• Vasopressor agents for the development of normal organ perfusion.
• "Dobutamine" increases cardiac output.
• Norepinephrine improves vascular resistance.
• Cardiac glycosides reduce blood pressure, reduce the risk of acute decompensation.

However, only the attending physician can determine and formulate the exact list of necessary medicines for the relief and treatment of NAD.

We examined what decompensated heart failure means.