Etiology and pathogenesis of the disease
The main pathological factor that contributes to the occurrence of an attack is an increase in hydrostatic pressure in the pulmonary capillaries and the subsequent addition of the following complications:
- Long-term emotional and mental stress.
- Inadequate physical abilities.
- Excessive consumption of water (more than 2 liters per day).
- Fluid retention (hypervolemia, hyperhydration).
- Abundant meals.
- Violation of blood circulation during sleep.
- A sharp influx of blood into the blood circulation system of the small circle when the position of the body changes.
- Viral infection.
Acute left ventricular failure is notable to pump all the blood from the lungs into the aorta, and the normal contractile function of the right atrium continues to fill the pulmonary circulation with it, causing it to overflow. Further pathogenesis in the lungs disrupts gas exchange, and thus carbon dioxide accumulates, which leads to disruption of the blood supply to the central nervous system, irritates the respiratory center and leads to shortness of breath.
Symptoms and course of the disease
Most often, cardiac asthma makes itself knownat night, which is explained by the increased tone of the vagus nerve. Thus, the patient may feel fine during the day and even perform simple work, and at night wake up from a sharp lack of air. He begins to have excruciating suffocation, accompanied by fear of death. Immediately before the attack, the patient may complain of chest pain radiating to the left arm, attacks of palpitations or interruptions, headache and a feeling of heaviness in the back of the head. A characteristic symptom of the disease is the inability to take a horizontal position. The patient can only stand, leaning on a windowsill or chair, and if there is no way to get up, then sit with support on his hands, hanging his legs down. The head is tilted forward, the shoulder girdle is overstrained, the chest is expanded, swollen veins are clearly visible on the neck. This body position helps to reduce shortness of breath. An attack of cardiac asthma has another typical symptom - This is rapid breathing with difficulty inhaling and exhaling, as well as a dry or phlegmy cough. When listening to the lungs, you can hear moist wheezing in the lower sections and wheezing on an extended exhalation (bronchial spasm). Pulmonary edema occurs suddenly. Symptoms of its growth are characterized by small and medium bubbling wheezing, which are clearly audible in the area of the anterior-upper section of the lungs. In this case, foamy, pink-tinted sputum (release of red blood cells) may appear, which is another confirmation of edema. A symptom that should be paid attention to at the beginning of an attack is a rapid pulse and increased blood pressure. But then the blood pressure gradually drops, which is a signal of the onset of collapse. Listening to the heart is impossible, since noisy breathing and an abundance of wheezing do not allow this. The duration of an attack can range from several minutes to many hours.
Diagnosis of the disease
Cardiac asthma has similar symptoms tobronchial, so its diagnosis is somewhat difficult. However, the correct diagnosis will be very important, since these two diseases have different treatment. During the examination, special attention is paid to the signs of the underlying pathology, which will help to clarify the etiology of shortness of breath. Diagnosis of this disease is also carried out taking into account the suspicion of bronchial asthma, which usually occurs against the background of an allergy. By external signs: when listening to breathing and, if possible, the heartbeat - the doctor makes a primary diagnosis. To confirm it, an ECG will be required. If cardiac asthma has typical signs, then it will not be difficult to distinguish it. In this case, exhalation will not be difficult, distant wheezing will be heard and characteristic features of pulmonary distension will be present. However, the doctor may have questions if cardiac asthma is accompanied by bronchospasm with dry wheezing. It is very important to find out about the presence of an allergic anamnesis or other lung pathology, which will help to exclude cardiac asthma. The last confirming factor that cardiac asthma took place will be the positive effect of stopping the suffocation with cardiac glycosides.
First aid and further treatment
As soon as the first signs appearedthe onset of suffocation, the patient should be given first aid before the ambulance arrives. To do this, sit him comfortably in a bed or chair with his legs down. If possible, you can lower the upper and lower limbs into hot water. Also, to reduce the return of venous blood to the heart, tourniquets should be applied to the legs. Free from tight clothing, unbutton collars and cuffs, belts, provide access to fresh air, if necessary, carry out oxygen therapy and give nitroglycerin under the tongue. This drug will help lower systemic blood pressure, which significantly facilitates the work of the heart. Other appointments are carried out strictly as prescribed by the doctor. The treatment with nitroglycerin started as part of first aid is continued after the doctor's arrival. Most often, a satisfactory condition is established after 7 ... 10 minutes. If nitroglycerin is not effective enough or if the attack is caused by a neuroreflex effect, 1% morphine administered subcutaneously or intravenously will have a calming effect and prevent further constriction of arterioles and veins. Extreme caution should be exercised if there is a symptom indicating a cerebrovascular accident: the use of such a drug can have an extremely negative effect on the excitability of the respiratory center. If there are signs of low diuresis, a 1% furosemide solution is administered intravenously to stimulate it. In case of symptoms of alveolar membrane damage, onset of hypotension, mixed asthma, prednisolone or hydrocortisone are administered intravenously. If foam appears, an electric suction device is used or inhalations with defoamers (10% antifoamsilane solution) are performed. If it is not possible to perform internal bloodletting to redistribute blood filling, it is replaced by alternate application of a tourniquet for 15 minutes on the limbs or venous bloodletting up to 200-300 ml. The decision on hospitalization is made either at the first signs of incipient cardiac asthma or after recovery from the state of suffocation. The patient is transported with great caution and according to the same rules as for a stroke. Further treatment is carried out taking into account the underlying disease.
Treatment with folk remedies
Treatment with folk remedies first of allis aimed at eliminating the causes of cardiac asthma, that is, curing the underlying disease. For these purposes, various decoctions of medicinal herbs, mumiyo and goat's milk with iodine are widely used. But I would like to note that it is impossible to relieve an attack with folk remedies, since it requires urgent medical care, which these methods cannot provide. And delay in this case, even if the first single symptom appears, can lead to disastrous consequences. Taking an infusion of dried rose hips has a good effect. Regular intake helps to reduce the number and severity of attacks. To do this, 2 tbsp. well-dried, washed and crushed berries should be placed in a thermos and poured with boiling water. Keep for 10-12 hours, then take 100 ml twice a day immediately before meals. Teas from medicinal herbs are considered good folk remedies. To prepare such tea from coltsfoot leaves, you will need 1 tsp. herbs pour boiling water, keep in a water bath for 10 ... 12 minutes. Drink it several times a day with honey. The same principle applies to the leaves of quinoa, nettle, and reeds. A decoction of yarrow herb, an infusion of walnut partitions, and hawthorn fruits have a good effect. It will be very useful to take mumiyo dissolved in a decoction of licorice root. For this, a decoction is prepared from 1 tbsp. root and 0.5 liters of water. In the resulting mixture, mumiyo is dissolved in an amount of 0.5 g and taken in the morning on an empty stomach, one glass at a time. All of the above tips have not only a therapeutic effect, but also have an excellent preventive effect.
