Left ventricular heart failure

Author Ольга Кияница

2018-03-17

Many cardiovascular diseases in the absence of appropriate treatment are complicated by left ventricular heart failure. This disruption of the heart is considered the most dangerous, because in a short time can lead the patient to death. When performing adequate therapy it is possible to improve the condition of a person.

Left ventricular heart failure (LHRC) is not defined as a separate nosological disease, but as a symptom complex that includes signs and symptoms characteristic of pathology. It develops on the background of gradual weakening of the activity of the left ventricle.

Heart failure is considered a common, costly and potentially dangerous disease. In 2015, the pathology affected about 40 million. Man in the world [1 - Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years of disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015"]. In general, about 2% of the adult population suffers from heart failure, whereas after 65 years an increase in the incidence of the disease is observed up to 6-10%.

For the diagnosis of the disease, not only the physical examination of the patient, but also instrumental methods are used. This allows the complex to examine all organs and systems of the body and after appointing effective treatment. Prophylaxis of LVHOS is also important because it increases the duration and quality of a person's life.

Video Heart Failure. From what the heart is weakening

Description

Usually the heart directs oxygen-filled blood from the lungs through the pulmonary veins to the left atrium, and then to the left ventricle. After this, through the aorta and the system of large and smaller arteries, capillaries spread throughout the body. Thus, the left ventricle is performed in the body of a very important role, therefore, when for various reasons its development develops, complicated and dangerous pathological conditions begin to be joined.

A bit of statistics:

  • Within a year after diagnosis of LHRC, the risk of death is about 35%, after which it is reduced to less than 10% per year.
  • The risks of LVHOS development are as high as with certain types of cancer.
  • In the UK, the disease is responsible for 5% of hospital admissions in an emergency.
  • Heart failure has been known since ancient times, in particular, papyrus Ebers described it about 1550 BC.

Reasons

Left ventricular heart failure can develop against the background of the following diseases:

  • Cardiomyopathy
  • Ischemic heart disease
  • Diabetes
  • High Blood Pressure
  • Obesity
  • Sleep apnea
  • Drinking alcohol and drugs
  • Crying

Risk factors

To this group of factors contributing to the development of LSHS, includes:

  • Age: Men aged 50 to 70 often have left-handed heart failure, especially if they have had a heart attack before.
  • Gender: Men are at greater risk of developing left ventricular heart failure.
  • Aortic stenosis: the aortic aperture is narrowed, resulting in a slowing of blood flow and weakening of the heart.
  • Vascular thrombosis: A blood clot in the lungs can cause left ventricular heart failure.
  • Cardiomyopathy: some types of this disease can be hereditary that can disrupt the work of the heart.
  • Congenital heart defects: organic organ defects can prevent proper circulation and disrupt general hemodynamics in the body.
  • Chronic diseases: diabetes, HIV, hyperthyroidism, hypothyroidism, or iron or protein accumulation can lead to left ventricular heart failure.
  • Arrhythmias: Abnormal heart rhythms, especially if they appear very often and suddenly, can weaken the heart muscle.
  • Myocarditis: A similar condition occurs when the virus causes myocardial inflammation.
  • Pericardium: Inflammation of the pericardium (cardiac pouch) or the adhesive process develops, which slows and impairs the functioning of the heart muscle.
  • Myocardial infarction: the heart muscle is damaged, which may affect the body's ability to pump blood effectively.
  • Race: African American men are more likely to develop LCHR than men of other nationalities.
  • Some medicines (chemotherapy and diabetes): some drugs increase the risk of developing left ventricular heart failure.
  • Viral diseases: some viruses can damage the heart muscle, resulting in the development of LSHS.

Clinic

Initially, the symptoms of left ventricular heart failure may remain unnoticed, but with time they get worse. It is important to consult a doctor for early diagnosis and the appointment of appropriate treatment in the presence of characteristic symptoms.

Heavy flow of left ventricular heart failure is a favorable condition for the development of complications, including diseases of the kidneys and / or liver, as well as myocardial infarction and even death of the patient.

Left ventricular heart failure symptoms that can be caused by major health problems vary in severity from mild to severe, and may include:

  • Sudden awakening at night with a sense of shortness of breath
  • During the workout or in the lying position, shortness of breath also occurs
  • Delay of fluid passing into swelling in the region of the ankles, thighs, abdomen
  • Lack of appetite and the appearance of nausea
  • Rapid or irregular heartbeat
  • Violation of concentration
  • Unexpected weight gain
  • Chronic cough
  • Vomiting in the voices
  • Fatigue

As these symptoms appear, they cause the heart to contract more often and more, which leads to the development of additional disorders:

  1. Fast pulse
  2. Heart increase
  3. High blood pressure
  4. Slow down blood circulation, especially in the arms and legs.

Species

There are several left ventricular heart failure, the development of which is different in different time intervals:

  1. Acute LDLC is a life- threatening condition, and therefore requires the immediate intervention of medical personnel. It develops due to serious disorders in the body, when the left ventricle suddenly stops working normally. At the same time, the blood stays in the small circle of blood circulation, the alveoli (cells of the lungs) swell because they begin to accumulate fluid. As a result, the volume of air in the lungs dramatically decreases, which threatens suffering suffocation.
  2. Chronic LVHD - a similar condition often develops in patients for decades. Symptoms in this form of LDLC are not so pronounced, the patient's condition worsens gradually. Pathology has no reversible development, so it is very important to begin treatment on time. Otherwise, the same pulmonary edema may occur, but not as fast as in the case of an acute form of the disease.

Diagnostics

For the determination of left ventricular heart failure in a person, advanced technologies are used. With their help, an effective diagnosis is carried out, information is obtained for further effective treatment and careful monitoring of the patient's condition.

Diagnostic procedures and methods under LVCHN:

  • Cardiac catheterization: an invasive study in which a long, thin flexible tube moves through the blood vessel in the arm or groin toward the heart. The contrast agent is fed through the tube, and then an X-ray video is shown which shows how the heart functions and there are any violations.
  • X-ray of the chest: a picture of OGK is made, after which a general figurative analysis of the state of the lungs, heart and aorta is performed.
  • Echocardiography: an ultrasound study, in which, using sound waves, images of moving images, namely, chambers and heart valves, are taken.
  • Electrocardiogram (ECG): The method allows you to measure the electrical activity of the heart and can help determine whether the individual parts of the heart have increased, whether there is overload or damage.
  • Electrophysiological study: With this type of diagnosis, electrical effects of the heart are recorded. This can help find what causes heart rhythm abnormalities and determine the best treatment.
  • Radionuclide Imaging: A non-invasive procedure that can detect serious heart damage. The radioactive isotope is injected into the vein, after which a special camera or scanner is recorded as it passes through the heart.
  • Treadmill test: Determines the patient's ability to exercise and the amount of oxygen that the heart muscle consumes during exercise. The results show the severity of left ventricular heart failure and help determine the possible course of the disease.

After the diagnosis, the doctor uses the results obtained to determine the severity of heart failure in the patient. According to the classification, the severity of CH is divided into four classes, based on the ability to perform normal physical actions and symptoms that arise when performing these actions.

Treatment

Left ventricular heart failure therapy is associated with a concentration of attention on the management of symptoms and treatment of the underlying causes of the disease. Each patient is given an individual treatment plan, which may include medications, lifestyle changes, as well as operations for device implantation, reconstruction, or transplantation of the heart.

Medicinal treatment

Drugs can help improve cardiac function and cure symptoms such as impaired heart rhythm, high blood pressure and increased fluid retention. In particular, drugs are prescribed for the following tasks:

  • Reduce fluid retention in the body and loss of potassium
  • Open narrowed blood vessels to improve blood flow
  • Reduce arterial pressure
  • Slow down the fast heart rate
  • Increase blood flow throughout your body
  • Promote urination
  • Prevent the formation of blood clots
  • Decrease Cholesterol

Changing lifestyle

Some lifestyle adjustments can improve the symptoms and quality of life of the patient. To do this, you should follow a series of recommendations:

  • Follow diet low in sodium, fat and cholesterol
  • Exercise permissible physical exercises.

Surgical treatment

If the drugs are not effective at left ventricular heart failure or if the clinic is very serious, surgical intervention may be required. Depending on the state of the heart and the underlying cause of the LCHC, the options for surgery may include implantation of devices, heart restoration or transplantation.

  • Operation on implantation of the device

The left ventricular auxiliary device can be implanted to help the weak heart work more efficiently. Depending on the circumstances, it is considered as the main method of treatment or a temporary measure in anticipation of a heart transplant.

Cardiac pacemaker is a device used in the implantation process. It can be implanted during a minor operation, after which the right and left ventricles can work more efficiently.

  • Heart reconstruction or transplantation operations:

With congenital heart defects is used:

  1. Recovery of a defect , which helps to improve blood flow.
  2. Coronary bypass surgery - this operation creates a bypass path around the narrowed coronary arteries by implanting arteries or veins taken from other parts of the patient's body. As a result, blood circulation improves, chest pain is eliminated, and the development of myocardial infarction is prevented.
  3. Heart restoration surgery. It is based on conducting electrical signals through the heart of an irregular shape, causing it to be compressed. Reconstruction of the shape of the heart can improve its electrical conductivity and work. The main types of reconstruction are: the installation of an artificial cardiac valve, dynamic cardiomyoplasty, the procedure Dor (articulation of the enlarged artery or aneurysm), the Acorn procedure (preventing the expansion of the heart).
  4. Heart transplant operation. It is conducted in those cases where all other surgical methods of treatment of LSH were unsuccessful. The damaged heart is surgically removed and replaced by a healthy donor.

Complications

In left ventricular heart failure, the following complications may develop:

  • Angina: Occurs on the background of a decrease in the amount of blood flowing to the heart.
  • Atrial fibrillation: Irregular heart rhythm, which can increase the risk of stroke and thrombophlebitis.
  • Cardiac cachexia (cardia cachexia): Inadvertent weight loss of at least 7.5% of normal weight for six months, which is often life-threatening in the absence of supplementary nutrition.
  • Problems with the heart valve: An increased load on the heart leads to a malfunction of the valves, most often mitral and aortic.
  • Myocardial infarction: heart muscle is damaged due to lack of normal nutrition for a long period of time.
  • Kidney impairment: The decline in their function is fairly common in patients with LCHC. If your kidneys get less blood, you may have kidney failure requiring dialysis treatment.
  • Damage to the liver: the fluid accumulated in the body under LHRC, exerts pressure on the liver, which can cause scarring of its cells with further difficulty in the functioning of the organ.
  • Right ventricular heart failure: on the background of LHRC blood stays in a small circle of blood circulation that moves through the lungs, thereby weakening the right side of the heart.

Forecast

The prognostic conclusion for left ventricular heart failure largely depends on the cause and severity of the symptoms. Some of them are improved in the treatment and change of lifestyle. The development of others leads to the fact that left-sided heart failure can threaten life.

In severe cases, implantation of the device, repair of heart valves or its transplantation may be required. This helps to prevent further damage to the structures of the heart and the development of severe complications, including renal and / or hepatic failure, myocardial infarction.

Prevention

Preventing the effects of all risk factors associated with left ventricular heart failure is quite difficult. Yet, sometimes, steps can be taken to help reduce or, in some cases, even reverse the risks of morbidity. To do this, follow these guidelines:

  1. Blood sugar should be in balance. If there is diabetes, then you should be attentive to food, the level of glucose in the blood. It is important to talk to your doctor about medicines that control the amount of sugar in the blood.
  2. Activity needed. Moderate exercises help normalize blood circulation and reduce stress on the heart muscle.
  3. The nutrition should be dietary and healthy. It is worth limiting salt, sugar, saturated fat and cholesterol. It is useful to eat lots of fruits, vegetables, whole grains and skim milk products.
  4. If necessary, it is necessary to be examined by the doctor. If new or changing symptoms are detected, there are side effects from medications, you need to contact a doctor.
  5. The weight should be within the normal range. Losing weight and keeping it within normal limits reduces the load on the heart.
  6. Decrease in the number of stressful situations. Stress can contribute to rapid or irregular heartbeat.
  7. The consumption of alcohol should be reduced. In some cases, it may be necessary to stop drinking completely.
  8. You need to quit smoking. Tuberculosis damages the blood vessels, increases blood pressure, reduces the amount of oxygen in the blood and makes the heart beat faster.
  9. It is important to control the amount of fluid in the body, so it is necessary to weigh regularly.
  10. Drugs should be taken in accordance with prescriptions.

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