Etiology and pathogenesis of the disease
The main pathological factor that contributes to the onset of an attack is the increase in hydrostatic pressure in the pulmonary capillaries and the further attachment 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 not incondition to pump all the blood from the lungs into the aorta, and the normal contractile function of the right atrium continues to fill it with a small circle of blood circulation, as a result of which its overflow occurs. Further pathogenesis in the lungs disrupts gas exchange, and thus carbon dioxide accumulates, which leads to a disruption in the blood supply of the central nervous system, irritates the respiratory center and leads to shortness of breath. 
Symptoms and course of the disease
Most often, cardiac asthma manifests itselfat night, which is explained by the increased tone of the vagus nerve. So, the patient can feel great during the day and even perform a simple job, and at night wake up from a sharp shortage of air. He begins a painful gasp, accompanied by the fear of death. Immediately before the attack, the patient may complain of chest pain, giving to the left arm, palpitations or interruptions, headache and sensation of heaviness in the neck. A characteristic symptom of the disease is the inability to accept a horizontal position. The patient can only stand leaning on the sill or chair, and if there is no way to climb, then sit with the support of the hands, lowering his legs. The head is tilted forward, the shoulder girdle is overstrained, the thorax is enlarged, the swollen veins can be clearly seen on the neck. This position of the body helps to reduce shortness of breath. An attack of cardiac asthma has another typical symptom - it is a rapid breathing with difficulty in inhaling and exhaling, as well as a dry or sputum cough. When listening to the lungs, you can hear wet rattles in the lower parts and wheezing on an elongated exhalation (spasm of the bronchi). Swelling of the lungs occurs suddenly. Symptoms of its growth are characterized by small- and medium-bubbling wheezing, which are well audited in the region of the anterolateral region of the lungs. In this case, the appearance of a foamy, pink-tinged sputum (the yield of erythrocytes), which is another confirmation of the edema. A symptom to which attention should be paid at the beginning of an attack is a rapid pulse and an increase in blood pressure. But then the blood pressure gradually decreases, which is a signal about the joining of the collapse. Listening to the heart is impossible, because noisy breathing and an abundance of wheezing prevent it from doing so. The duration of an attack can range from a few minutes to many hours.
Diagnosis of the disease
Cardiac asthma has similar symptoms withbronchial, so its diagnosis is somewhat difficult. However, the correct diagnosis will be very important, as 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 dyspnea. Diagnosis of this disease is also carried out taking into account the suspicion of bronchial asthma, which usually occurs against the background of allergy. By external signs: when listening to breathing and if possible heartbeat - the doctor makes a primary diagnosis. To confirm this, ECG registration is required. If cardiac asthma has typical symptoms, then it will not be difficult to distinguish it. In this case, the exhalation will not be difficult, remote rales will be heard and the characteristic features of pulmonary distention will be present. However, the doctor may have questions if asthma cardiac will be accompanied by bronchospasm with dry wheezing. It is very important to learn about the presence of an allergic anamnesis or other pathology of the lungs, which will help to exclude cardiac asthma. The last confirming factor that had a place of cardiac asthma is the positive effect of stopping asthma by cardiac glycosides. 
First aid and further treatment
As soon as the first signs appearedbeginning of suffocation, the first emergency aid must be provided before the ambulance arrives. To do this, it is convenient to sit in bed or an armchair with his legs lowered. If possible, you can lower the upper and lower limbs in hot water. Also, to reduce the return to the heart of venous blood on the legs, you must apply tourniquets. They release from tightening clothes, 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 BP, which greatly facilitates the work of the heart. The rest of the appointments are carried out strictly according to the doctor's prescription. Initiated treatment with nitroglycerin in the first aid after the doctor's visit continues. Most often, a satisfactory condition is established after 7 ... 10 minutes. If the nitroglycerin is not effective enough, or if the neurosettlement is at the heart of the onset, the administration of 1% morphine under the skin or in the vein will have a calming effect and prevent further narrowing of the arterioles and veins. Extremely careful should be if there is a symptom that indicates a violation of cerebral circulation: the use of such a drug can be extremely negative for the excitability of the respiratory center. If there are signs of low diuresis, then for its stimulation is introduced in / in a 1% solution of furosemide. With symptoms of damage to the alveolar membrane, hypotension, mixed asthma, intravenous intravenous injection of prednisolone or hydrocortisone is administered. When foam appears, an electric pump is used or inhalation is carried out by defoamers (10% solution of antifosilane). In the absence of an opportunity to conduct internal bleeding for the redistribution of blood filling, it is replaced by alternately applying a tourniquet for 15 minutes on a limb or venous bleeding to 200 ... 300 ml. The decision about hospitalization is carried out either at the first signs of a beginning cardiac asthma, or after removal from a state of suffocation. Transportation of the patient is carried out with great care and according to the same rules as in stroke. Further treatment is carried out taking into account the underlying disease.
Treatment with folk remedies
Treatment of folk remedies primarilyis aimed at eliminating the causes of cardiac asthma, that is, curing the underlying disease. For these purposes, various broths of medicinal herbs, mummies and goat's milk with iodine are widely used. But I want to note that it is impossible to remove the attack with folk remedies, since it requires urgent medical assistance, which these methods can not give. And procrastination in this case, even if the first single symptom appears, can lead to disastrous consequences. Has a good effect of taking infusion of dried hips. Regular reception helps reduce the number and severity of seizures. For this 2 tbsp. l. well dried, washed and crushed berries should be placed in a thermos and pour boiling water. Wait 10-12 hours, then take 100 ml twice daily just before eating. Good folk remedies are herbal teas. To make such tea from the leaves of mother-and-stepmother, it will take 1 tsp. grass pour boiling water, soak in a water bath for 10 ... 12 minutes. Drink it several times a day with honey. By the same principle, the leaves of quinoa, nettle, reed are used. A good effect is a decoction of yarrow herb, infusion of walnut partitions, hawthorn fruit. It will be very useful to take a mummy, dissolved in the licorice root broth. For this, a decoction of 1 tbsp is prepared. l. root and 0.5 liters of water. In the resulting mixture, the mummy dissolves in an amount of 0.5 g and is taken in the morning on an empty stomach with one glass each. All the above tips have not only a curative effect, but also have an excellent preventive effect.
