Shortness of breath with heart failure
Heart failure is manifested by congestion in the small or large circle of blood circulation, as well as deterioration of the myocardium. This phenomenon is always accompanied by the onset of shortness of breath.
Content:
- Causes of shortness of breath in heart failure
- Symptoms of shortness of breath in heart failure
- Diagnostics
- First aid
- Treating shortness of breath in heart failure
- Prevention of attacks of shortness of breath in heart failure
Causes of shortness of breath in heart failure
When the heart does not cope with the loads assigned to it, shortness of breath develops. In the vascular system of the lungs, blood flow slows down, the pressure in the arteries increases. Small branches of the blood vessels that feed the lungs experience spasm, gas exchange is disrupted.
The mechanism of development of shortness of breath in heart failure:
- When the left side of the heart is affected, the volume of blood ejected decreases. Stagnation forms in the area of the lungs, as they are overfilled with blood.
- Congestion contributes to the disruption of gas exchange in the respiratory tract, which leads to a deterioration in their ventilation.
- The body stimulates the respiratory function, increases the frequency of breaths and their depth. Therefore, the person experiences shortness of breath.
- Interstitial pulmonary edema develops.
The brain receives a signal that the lungs are suffering from hypoxia. It activates the respiratory center, forcing a person to breathe more often and deeper.
Diseases that can provoke heart failure with shortness of breath:
- Arterial hypertension.
- Mitral valve stenosis.
- Ischemic heart disease.
- Cardiomyopathy.
- Heart defects.
- Inflammation of myocardial tissue.
- Cardiac dilatation.
- Poisoning with toxic substances.
If a person has diabetes mellitus or other endocrine pathologies, then chronic heart failure will rapidly progress. At the same time, attacks of shortness of breath will begin to turn into attacks of suffocation.
With damage to the right ventricle of the heart, shortness of breath may be absent altogether.
Symptoms of shortness of breath in heart failure
The fact that a person has shortness of breath occurs precisely with heart failure will be indicated by the following symptoms:
- It is very difficult for a patient to inhale.
- If heart failure has a chronic course, then respiratory failure occurs at any load. The more intense it is, the harder it will be for a person to breathe. Such shortness of breath will increase with neuropsychic stress.
- Shortness of breath will bother the person when he lies down. In a horizontal position, the heart fills with blood, so it starts to work harder. If a person sits down, then breathing more or less normalizes. Therefore, dyspnea attacks most often occur at night.
- If an attack of shortness of breath manifests at night, then the person wakes up from the fact that he has nothing to breathe. The attack turns into suffocation, a dry cough appears. Sometimes a small amount of phlegm is released. To alleviate his condition, a person intuitively gets up, or sits down, and lowers his legs down.
- A person breathes through his mouth, it is difficult for him to speak.
- The nasolabial triangle turns blue, the nail phalanges become blue.
With heart failure, there is always a risk of developing pulmonary edema. In this case, a person experiences severe weakness, breathing becomes heavy, his lips turn blue. It is not possible to cope with shortness of breath with the usual methods.
The lungs become rigid, congestive bronchitis and cardiogenic pneumosclerosis develop. In addition to shortness of breath, the patient often has a cough, during an attack, sputum with blood may be released. When bronchospasm occurs, the patency of the bronchi will be disrupted, therefore such shortness of breath is often confused with bronchial asthma.
A phenomenon such as cardiac asthma is characterized by a sudden attack of inspiratory dyspnea. This clinical syndrome is a manifestation of acute heart failure of the left heart. Shortness of breath in this case can turn into choking.
Diagnostics
Shortness of breath can disturb a person with various diseases. If the patient's heart failure has just begun to develop, then it will be weak, breathing difficulties appear only during physical activity and at night.
To identify the causes of shortness of breath, you need to contact a therapist or a cardiologist.
The doctor can prescribe the following diagnostic procedures to the patient:
- ECG.
- Donation of blood for general and biochemical analysis.
- Echocardiogram.
- Performing coronary angiography.
- Chest X-ray.
Based on the results of the study, it will be possible to diagnose and prescribe treatment.
First aid
If a person with heart failure develops a severe attack of shortness of breath, you need to immediately call an ambulance.
Until the arrival of the medical team, the following measures can be taken:
- Open the windows so that fresh air can enter the room.
- Remove from the neck and chest of the person all items of clothing that may restrict breathing.
- To provide the patient with complete rest, you can offer him a nitroglycerin tablet, which is placed under the tongue.
- It is necessary that the person is in a sitting position with their legs down.
If the patient's consciousness is not impaired, then before the arrival of the medical team, his blood pressure can be measured.
Treating shortness of breath in heart failure
Cardiologists with shortness of breath against the background of heart failure may prescribe the following treatment:
- Medicines for the treatment of a disease that causes heart failure.
- Preparations from the group of beta-blockers.
- Diuretic drugs, which reduce the volume of blood in the body, thereby relieve stress on the heart.
It is imperative that a person adhere to a proper diet, reduce the amount of salt consumed, include fatty red fish, flaxseed oil and nuts in the menu.
It is possible to reduce shortness of breath in heart failure by taking anxiolytic drugs. They reduce anxiety, eliminate fear of suffocation, and help a person calm down. Breathing is normalized and leveled, the attack of shortness of breath recedes.
Prolonged inhalation of oxygen through ethyl alcohol helps to reduce the edema of the lung tissue.
In severe cases, the patient is indicated for an operation.
Taking medications
Since shortness of breath is only a symptom of heart failure, to get rid of it, you will need to direct efforts to correct the underlying pathology. The cure cannot be quick. It often lasts for many years and even until the end of a person's life.
Drugs that are prescribed to patients with heart failure:
- Glycosides that increase the performance of the heart muscle. These include drugs Digoxin, Korglikon, etc.
- ACE inhibitors. They help lower blood pressure by relieving stress on the heart and blood vessels that feed the lung tissue. These can be drugs such as Captopril, Ramipril, Trandolapril, etc. Their use allows you to dilate blood vessels, relieve spasm from them.
- Diuretic drugs (Furosemide, Britomar) reduce the burden on the heart by removing excess fluid from the body. Their reception will prevent the formation of edema.
- Vasodilators such as Minoxidil or Nitroglycerin. They are used to relieve tension from smooth muscle muscles.
- Beta-blockers, for example, Metoprolol, Celiprolol, etc. They can eliminate the phenomena of arrhythmia, reduce blood pressure, remove hypoxia from tissues.
- Anticoagulants prevent blood clots from forming, reduce the negative symptoms of heart failure, which includes shortness of breath. These can be drugs such as Warfarin, Fragmin, Sincumar, etc.
- Statins (Rosuvastatin, Lovastatin) are prescribed for patients with heart failure caused by vascular atherosclerosis.
If shortness of breath with heart failure is accompanied by pain, then the patient is prescribed analgesics.
Operative intervention
An emergency method of unloading the pulmonary circulation in venous stasis is bloodletting. In this case, a person can be released from 300 to 500 ml of blood.
Sometimes medications fail to cope with heart failure. In this case, the patient is referred for surgery. In the course of its implementation, a person can be installed with pacemakers. Sometimes surgery is performed on the valves of the heart, on its ventricles.
Surgical intervention is not directly related to shortness of breath, but it is aimed at eliminating the underlying pathology. If you can get rid of it, then breathing problems will disappear by themselves.
Prevention of attacks of shortness of breath in heart failure
There are non-drug methods for preventing shortness of breath that are applicable for people with chronic heart failure:
- It is necessary to limit the intake of salt with food.
- It is important to monitor your own weight, not to allow it to increase. The more a person's body weight, the heavier the heart and lungs will cope with the loads imposed on them.
- It is necessary to give up bad habits, eliminate alcohol and smoking from your life.
- Physical activity should be agreed with the doctor.
- It is imperative to control blood pressure and prevent it from rising.
- The person's headboard should be raised.
- You need to go to bed in clothes that do not restrict breathing.
It is impossible to completely recover from chronic insufficiency, but it is quite possible to improve the quality of your life and make attacks of shortness of breath easier. Comprehensive treatment allows you to maintain performance for many years. In general, the prognosis for heart failure depends on the underlying pathology that led to such a violation.
The author of the article: Molchanov Sergey Nikolaevich | Cardiologist
Education: Diploma in "Cardiology" received at the PMGMU. I. M. Sechenov (2015). Here I completed my postgraduate studies and received a diploma "Cardiologist".
