Hypervolemia: symptoms and treatment
Hypervolemia is an increase in blood volume in the vascular bed. Depending on the characteristics of the hematocrit, oligocythemic, simple and polycythemic hypervolemia are distinguished.
If we are talking about hypervolemia of the pulmonary circulation, then this condition is called pulmonary hypertension. Hypervolemia is not just a physiological deviation from the norm, but a pathological syndrome that accompanies various disorders. Inside the blood vessels of a healthy person, such an amount of blood should constantly circulate, which corresponds to 6-8% of his weight. Thus, if the weight of an individual is 75 kg, then there should be about 5 liters of blood in his body. Exceeding these values is a deviation from the norm.
- Why does hypervolemia develop?
- Symptoms of hypervolemia
- Diagnosis of hypervolemia
- Hypervolemia treatment
- Hypervolemia of the small circle of blood circulation
- Why does the hypervolemia of the pulmonary circulation develop?
Why does hypervolemia develop?
An increase in the volume of blood circulating in the body does not occur by itself. Hypervolemia is always accompanied by a certain disorder in the body. Therefore, hypervolemia is not an independent pathology. It has a direct relationship with such a concept as hematocrit. Hematocrit refers to the volume of red blood cells in relation to total blood volume. Normally, 360-480 ml of cells should be present in a liter of blood, and the rest of its composition will be plasma. Therefore, the normal hematocrit in percentage terms looks like 36-48%.
Hypervolemia, depending on the cause of its development, can be of 3 types:
The approach to diagnosing and treating each type of hypervolemia will differ.
The photo below shows blood with polycythemic hypervolemia:
Simple hypervolemia develops when not only the volumes of red blood cells increase in parallel, but the level of blood plasma also increases. The relationship between them is not violated.
Simple hypervolemia is not often diagnosed. Its development can be caused by such reasons as:
- Blood transfusion in large volumes.
- Excessive physical activity.
- Finding a person in high temperatures.
- Oxygen starvation.
If a person receives a lot of blood, it naturally provokes an increase in its volume in the body. With increased physical exertion, while in the heat, with hypoxia, blood volumes increase due to the body's own reserves.
Oligocythemic hypervolemia is called hydremia. In this case, an increase in the volume of the liquid component of the blood occurs, while the level of red blood cells remains unchanged.
The following conditions can lead to oligocythemic hypervolemia:
- Conception of a child. In this case, an increase in the liquid component of the blood with a normal hematocrit is a variant of the norm. The body independently triggers such mechanisms to stabilize a woman's metabolism in accordance with her new position.
- Drinking plenty of fluids, transfusion of plasma and plasma analogs, fluid release from edema into the vascular bed.
- Acute or chronic renal failure, increased synthesis of antidiuretic hormone, sodium retention are situations that contribute to the retention of large volumes of fluid in the body.
Polycythemic hypervolemia is characterized by an increase in blood volume due to an increase in the number of red blood cells.
The reasons that can provoke this violation:
- Oxygen starvation of the chronic course, which leads to heart defects, pathologies of the respiratory system with chronic respiratory failure, finding a person at significant altitudes.
- Diseases of the blood: cancerous neoplasms (malignant and benign), increased formation of blood cells due to hereditary pathologies.
Symptoms of hypervolemia
If hypervolemia was provoked by physiological reasons, then after a short time the blood volumes will return to normal without any consequences for human health. No specialized treatment is required.
When the hypervolemia was caused by chronic or acute pathologies, it is necessary to direct efforts to eliminate the root cause that led to an increase in blood volumes. Symptomatic therapy is also carried out.
As for the symptoms of hypervolemia, they can be as follows:
- Blood pressure jumps in the direction of its increase.
- The development of heart failure or angina pectoris, as the heart works under high stress.
- Swelling of tissues.
- Shortness of breath. In general, it becomes difficult for a person to breathe, while the breathing rate increases.
- The patient gets tired faster.
- The skin becomes dry, dry mouth appears.
- Dysuric disorders develop.
- Headaches and pain in the lumbar region appear.
Diagnosis of hypervolemia
Revealing hypervolemia is a rather difficult task that confronts doctors. There are no specific symptoms of the disorder, and it is rather difficult to calculate the total blood volumes in the body. Therefore, the diagnosis of hypervolemia is reduced to the determination of hematocrit indicators. This study makes it possible not only to detect hypervolemia itself, but also to determine its type, as well as to clarify the cause of the development of this condition.
Therapy of hypervolemia should be aimed at the cause that provoked this violation:
- Treatment of kidney pathology.
- Treatment of heart defects.
- Therapy of disorders in the work of the endocrine glands.
- Surgical and drug treatment of tumor neoplasms.
- Treatment of blood diseases.
- Respiratory system diseases therapy.
- Performing blood transfusion in accordance with the available medical protocols, without violating the rules of the procedure.
To get rid of the symptoms of hypervolemia and alleviate the patient's condition, the following measures can be recommended:
- Taking medications to lower blood pressure. Diuretics are prescribed for this purpose.
- Reducing the load on the heart muscle.
- Control over the ambient temperature, ensuring a sufficient supply of oxygen to the tissues, which is aimed at eliminating hypoxia.
Alternative medicine methods can also be used in the treatment of hypervolemia:
- Treatment with leeches, which helps to reduce the volume of circulating blood in the body, reduce its viscosity, normalize the quality composition.
- Taking herbal diuretics. Bearberry, horsetail, viburnum, dill, fennel have such properties.
A doctor should be involved in the treatment of hypervolemia. Self-therapy can lead to serious health problems and even pose a threat to life.
Hypervolemia of the small circle of blood circulation
If we consider the distribution of blood in the vascular bed, then about 70% of its volume will be present all the time in the veins, about 15% - in the arteries and about 12% - in the capillaries. The remaining 3% are in the heart cavity.
The circulatory system consists of a large and a small circle. The systemic circulation includes the vessels of all organs and tissues, with the exception of the vessels of the lungs. The small circle of blood circulation includes vessels that provide blood to the lungs.
In the pulmonary circulation, about 25% of the total blood volume circulates, and the remaining 75% is in the systemic circulation.
With the development of hypervolemia of small blood circulation, the lungs are included in the pathological process, therefore the main symptoms will appear precisely from these organs.
Why does the hypervolemia of the pulmonary circulation develop?
The development of hypervolemia of the pulmonary circulation can occur for the following reasons:
- Alveolar hypoxia to which oxygen will not reach. The cause of such a violation is chronic bronchitis, chronic obstruction of the lungs, silicosis, anthracosis, bronchiectasis, etc.
- Spasm of small arteries of the lungs. Stress, pulmonary embolism, mitral stenosis can lead to the development of such a violation.
- High pressure in the airways, which leads to a strong cough, a jump in barometric pressure, violations of technology when performing mechanical ventilation.
Malfunctions of the left ventricle of the heart, which is observed with myocardial infarction, against the background of arrhythmia and with myocarditis.
- Thickening of the blood.
- Excessive ejection of blood from the right ventricle of the heart.
- Tumors, aneurysms, adhesions and other disorders that get in the way of the blood vessels that carry blood from the lungs.
- Chronic poisoning of the body with narcotic substances.
- Genetic disorders leading to enzymatic disruptions.
- Increased pressure in the portal vein system, which can occur due to cirrhosis, Budd-Chiari syndrome and disease.
- AIDS virus.
- Short-term respiratory stops during night rest.
In addition, there is a type of hypervolemia of the pulmonary circulation, which develops for unknown reasons.
Symptoms of pulmonary hypervolemia
When the disorder is just beginning to develop, the person will not experience any symptoms.
As the hypervolemia of the pulmonary circulation progresses, the following health problems are possible:
- A person quickly gets tired, he has mood swings, the weight goes away, he will suffer from insomnia.
- The patient often has dizziness.
- Shortness of breath increases, it will be very difficult to breathe with severe physical exertion.
- In severe cases, fainting is possible.
- The person begins to suffer from a paroxysmal cough, accompanied by the separation of sputum with blood.
- Periodically attacks of heart pain occur.
- The skin is pale, as the disease progresses, cyanosis increases.
- Development of ascites is possible.
- In the area of the liver, painful sensations begin to disturb.
- The heart works intermittently.
How to detect pulmonary hypervolemia?
A preliminary diagnosis is made based on the symptoms of hypervolemia. To confirm it, the doctor refers the patient to the following examinations:
- An electrocardiogram can detect abnormalities in the work of the heart.
- Chest X-ray provides information about the state of the lungs, with hypervolemia, their vascular pattern increases. The heart grows in size.
- CT scan.
- Ultrasound of the heart allows you to assess its size, to clarify the blood flow rate and the volume of pumped blood.
- The level of pressure in the pulmonary system can be determined using the method of pulmonary catheterization. This is an invasive procedure in which special sensors are inserted into the lumen of the blood vessels of the lungs. This study makes it possible to detect hypervolemia with a high degree of probability, even at the earliest stages of its development.
How to treat?
To eliminate the hypervolemia of the pulmonary circulation, it will be necessary to direct efforts to the cause that provoked such a violation. It makes no sense to treat hypervolemia without establishing an etiological factor.
Most often, drugs are used in therapy that are effective for correcting high blood pressure. A drug such as Euphyllin has proven itself well. You also need to carry out activities aimed at eliminating tissue hypoxia (oxygen therapy).
The author of the article: Shutov Maxim Evgenievich | Hematologist
Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.