Author Ольга Кияница
Cardiac asthma (CA) develops in the form of breathlessness attacks, which are often manifested at night. Their occurrence is primarily due to left ventricular failure, so CA, as well as the failure of the left ventricle, is a formidable complication of many severe cardiovascular diseases.
Cardiac asthma is in most cases combined with pulmonary edema, which can lead to a patient's death very quickly if ill-health occurs.
Cardiac asthma manifests itself as a characteristic feature. Other diagnostic methods are used, if necessary, but in most cases, ambulances are being taken to prevent the patient from losing.
What Is Cardiac Asthma?
Cardiac asthma is a complication of other severe cardiovascular diseases. All of them are mainly related to the growing insufficiency of the left ventricle. Most often, CA develops at the stage of decompensation of the following diseases:
- Myocardial infarction.
- Stenting the mitral valve.
- Chronic aneurysm of the heart.
- Aortic defect.
- Arterial hypertension.
Some kidney diseases in the form of acute nephritis and diffuse glomerulonephritis are also able to lead first to cardiac asthma, and then to pulmonary edema.
In a number of severe cardiological diseases, the left ventricular failure is formed, which prevents the weakened muscle from pushing the blood coming from pulmonary veins into a large circle of blood circulation. As a result, stagnation of blood occurs in a small circle of blood circulation, sputuming blood plasma into the alveoli of the lungs. In particularly severe cases, the fluid accumulates in the bronchi. All this causes the symptoms characteristic of cardiac asthma in the form of shortness of breath, coughing, and so forth.
An increase in blood pressure in a small circle of blood circulation provokes a reflex reaction, in which the vessels in the alveoli are reduced. This organism tries to prevent further transduction of the plasma into the lung tissue. Such a compensatory reaction is known as the reflex of Kitaev.
In fact, a vicious circle is formed, since the higher the pressure in the pulmonary veins, the stronger the protective response of the body acts in the form of a reflex of Kitaev. The more narrow the arterial vessels, the higher the pressure in the veins of the lungs, through which the blood flow to the left ventricle, becomes. Due to the weakness of his myocardium, full reductions can not be made and this further aggravate the situation with high pressure in the small circle of blood circulation.
The following factors may affect the patient's condition:
- Increased fluid content in the body (hyperhydration, complicated process of fluid withdrawal from the body).
- Increased blood circulation of a small circle of blood circulation when occupying a horizontal position.
- Disturbance of central regulation, which occurs more often during sleep.
- Physical or emotional load.
Cardiac asthma is accompanied by a rapid heartbeat and respiration, hypertension, and increased activity of respiratory muscles. In addition, at the time of breathing, the suction power of the forced breath operates, which in turn increases the blood flow to the blood vessels of the small circle of blood circulation. On this background, the central neuro-regulation, which gradually weakens the activity of the heart, breaks down. As a result, the cardiac activity becomes less effective, and the patient's condition worsens even worse.
Patients with cardiac asthma often spend their work and perform a different physical activity until the moment of the appearance of extremely frightening symptoms comes. This, in the first place, indicates that the disease previously present (heart failure, hypertension, or kidney disease) went into a stage of decompensation, when irreversible changes in the body began to occur, often threatening the patient with death.
Sudden onset of breathlessness is a hallmark of cardiac asthma. It can last for a few minutes or longer. Often develops in the first half of the night's sleep.
During an attack, the patient is further concerned:
- feeling of lack of air;
- a cough that can be damp due to the secretion of the sputum mucosa;
- noisy breathing, often accompanied by clamorous wheezing in the chest;
- increased heart rate;
- cold sweat
Due to lack of oxygen in the body, pale skin and cyanosis appear in the nasolabial triangle. Violation of vegetative regulation is expressed in dizziness, weakness, and feeling of nausea. In severe cases, vomiting (central genesis) occurs, seizures appear and the person loses consciousness. Sometimes the patient gets a foam from the mouth.
The sudden appearance of severe shortness of breath, accompanied by other symptoms of cardiac asthma, is the cause of panic attacks and fear of death in the patient.
Video Pulmonary Edema - causes, symptoms, diagnosis, treatment, pathology
Cardiac asthma with its clinical course may be similar to a number of other diseases. For example, a feeling of air shortage and other signs of suffocation are also characteristic of bronchial asthma. Noisy breathing and panic attacks are often encountered in a hysterical seizure. Other similar signs can be taken instead of CA for laryngeal stenosis or mediasthenic syndrome.
In the correct formulation of the diagnosis, the anamnesis of the illness of the patient helps first of all. If it is known that he had an early history of hypertension or heart failure, then the development of cardiac asthma can be assumed with high probability.
It is rather difficult to carry out a diagnosis during a CA attack, since the first thing to do is to stop the onset of shortness of breath. Nevertheless, doctors carry out a quick, objective examination in the form of probing the pulse, evaluating mucous membranes and skin, listening to breathing and heart tones.
An important diagnostic criterion for cardiac asthma is the occurrence of first attacks in adulthood. Also, in such patients almost always there is another cardial pathology.
In CA, the following changes may be noted:
- Pulse thread-like or slightly probable.
- The tones of the heart are muffled, you can listen to the rhythm of the gallop.
- Blood pressure is first defined as elevated, and then decreases.
- Individual moist rattles or scattered dry can be heard in the lungs.
In order to clarify the diagnosis necessarily conducted instrumental research methods. First of all, electrocardiography, which shows the characteristic signs of left ventricular failure, arrhythmias, or ischemia of the myocardium.
If possible, chest radiography is done. The picture will show signs of a stagnation of blood in a small circle of blood circulation: enlarged roots of the lungs, strengthened pulmonary pattern, the contours of the heart may be changed.
Medical care is provided in accordance with the condition of the patient and his place of residence. If an attack occurred at home or at work, then the first aid type should be performed. The purchase of CA with the use of special preparations can be carried out only by qualified specialists, therefore without their presence the introduction of drugs is not acceptable.
From the quality of emergency care for cardiac asthma, the patient's life often depends. Therefore, at the first signs of suffocation, it is necessary to call a medical brigade and perform certain actions:
- The patient should be seated or put up with his raised head.
- The shirt should be unbuttoned, and the tight clothing should be removed.
- Under appropriate weather conditions, you can open the window for fresh air access.
- The patient can be given nitroglycerin, the best option is aerosol.
- Nitroglycerin can be replaced with corinphorus or validol.
Legs above the knees and one arm above the elbow is desirable to rebench or put on the wiring, which will help ease the work of the heart. Instead of harnesses you can use a capron stocking or elastic bandage.
When applying harnesses it is important to adhere to certain rules:
- From the inguinal fold on the legs you need to retreat down 15 cm.
- From the shoulder joint, the hands retreat down 10 cm.
- Every quarter of an hour, one harness is transferred to the free limb and so in order.
With the correct pulse of the burn, the pulse on the artery can be tested below the placement.In addition, after a few minutes after the transfer, the color of the limb becomes purplish-bluish.
In the extreme case, the legs can be put in a bowl with hot water, which will allow a slight easing of the load on the heart due to the expansion of the vessels of the lower extremities.
Hospitalization of a patient for cardiac asthma is obligatory, since the appearance of signs of suffocation indicates serious disturbance of the work of the heart. The hospital conducts a special examination of the patient, which helps to identify the cause of the pathology and to conduct etiologic and symptomatic treatment.
The incoming emergency team will try to stop the attack of cardiac asthma as quickly as possible. For this, as a rule, morphine or pantopon is used. Their introduction is especially indicated in severe heart pain, which may be associated with shortness of breath.
Do not be afraid if a patient starts bleeding. This method is used quite often and precisely in cardiac asthma complicated by pulmonary edema. With its help, a small circle of blood circulation is rapidly discharged. For its carrying out at the patient take 200 ml of blood, but not more than 500 ml.
Health workers, as a rule, have the opportunity to hold the patient oxygen inhalation. For this, oxygen is passed through ethyl alcohol, which helps to quickly normalize the patient's condition as quickly as possible.
Symptomatic therapy for cardiac asthma:
- Acquired heartbeat is removed by suprastin or pepofen.
- When hypertension is used, lasix, furosemide or other diuretics.
- Cardiac glycosides in the form of strophanthin and digoxin are used in almost all attacks of cardiac asthma.
- When combination of an attack of CA with a mitral stenosis, eufillin is used.
- Severe rhythm disturbances can be terminated by defibrillation.
Cardiac asthma is a serious illness, and if it occurs once, then today there is no such treatment that would allow it to be fully recovered from it. But the implementation of medical recommendations helps to reduce the frequency of attacks and their severity, which makes it possible to delay for so long a so-called cardiac arrest.
Forecast and prevention
In the statement of the prognostic conclusion important role is played by the severity of the underlying disease, which led to cardiac asthma. In the case of a fast and effective reduction of pulmonary edema, one can speak of a relatively favorable prognosis. In this case, it is important that the disease positively perceives the treatment prescribed by the doctor. In most cases, the prediction for cardiac asthma is not favorable.
Prevention of cardiac asthma is to treat the underlying disease and prevent the development or aggravation of left ventricular failure.
Medical treatment can be supplemented by non-traditional methods of exposure, which include the following recipe for phytotherapy:
- Half a tablespoon of fresh young nettles mixed with a tablespoon of swans and reeds. (Only the leaves are used from the proposed plants). The vegetable components should be crushed, poured a glass of boiling water and insisted on a couple of hours. But the medicine is not ready yet. In the resulting infusion you need to add half a teaspoon of soda, after which it is placed in a warm place in the light, where it can last for 10 days. Take one teaspoon three times a day for half an hour before eating. The course of treatment - 3-4 weeks.
It is important to remember that any recipes from phytotherapy need to be agreed with the treating doctor. Self-medication with questionable drugs can lead to disastrous consequences.