Pulmonary edema, myocardial infarction - the most severe complication. In this case, the disturbed respiratory function. Such a pathological condition, the effects can be different from the difficulties in the recovery period before death.Violations of this type of developing myocardial infarction often. It is important to timely detect signs and help.
Causes
Against the background of a heart attack pulmonary edema develops as a result of various disorders of the cardiovascular system:
- reduction of the lumen of coronary arteries that occurs due to sudden changes of atherosclerotic stenosis or vascular wall structure;
- diastolic dysfunction, the ventricles pump blood less intensively.
The cause of degradation of the myocardial tissue is the increased stiffness. As a result, the ventricles relax not completely, leading to the development of stagnation in the pulmonary capillaries, increasing hydrostatic pressure in them. As a result, the lymph enters the interstitial space of the lungs. This reduces the amount of oxygen in the cells, which leads to disruption of the respiratory function.
Possible causes stiffening of ventricular tissue:
- myocardial infarction;
- ischemia;
- chronic hypertension;
- hypertrophic cardiomyopathy.
The main factor contributing to ventricular malfunction when these diseases are changes in the muscle cells. Against the background of a heart attack develop necrotic processes. As a result, some of the cells become dysfunctional, it dies. It contributes to this pathological condition caused by ischemia, wherein the marked deficiency of glycogen and a number of trace elements, but the calcium content, water, sodium and lipids, on the contrary, increased.
symptoms
The first signs of cardiogenic pulmonary edema to timely pay attention to changes in the patient's condition:
- sharp pain in the chest, often - with the localization of the heart;
- rapidly increasing weakness in the whole body;
- heart rhythm changes abruptly: increases to the limit values (180-200 bpm);
- pressure increases, due to vessel lumen narrowing, development of stagnation;
- the patient is in a horizontal position, experiencing difficulty in breathing;
- rales appear: dry gradually moving in wet, which contributes to the appearance of cough accompanied by sputum;
- dyspnea (more pronounced during inhalation);
- increases the intensity of sweating;
- cyanosis of the individual parts of the skin, mucous membranes.
After some time, the body temperature increases. It does not reach critical values, in most cases does not exceed the level of + 38 ° C. Temperature may rise within a few hours after the first signs of cardiogenic pulmonary edema, and after 1 day. If time does not help, the lesion of the lung cells to increase. As a result of violation of the function of the alveoli can cause suffocation.
First aid and treatment
Until the arrival of emergency medical assistance should perform a number of manipulations that can save a life in myocardial pulmonary edema:
- You need to change body posture: the patient laid on a horizontal surface can not be recommended to help him take a half-sitting position.
- Sublingual nitroglycerin tablets to put (1-2 pcs.). This should be done every 10-15 minutes before the arrival of an ambulance.
- To reduce the risk of clot formation patient must take aspirin at a dosage of at least 150 mg, the upper limit of the amount recommended by the tool - 160 mg. Moreover, the drug should be chewed, which will hasten positive change.
Qualified medical assistance begins with intravenous nitroglycerin (make a dropper). Sufficient solution concentration - 1%. The rate of introduction of the substance into the body - 20 micrograms per minute. To eliminate the shock, the pain and reduce the heart rate, a combination of Digidrobenzperidol + fentanyl or analogs thereof.
Normalize the patient with lung edema allows humidified oxygen. It is delivered into the body in different ways: by intubation using a mask or nasal cannula. To reduce the intensity of foaming caused by filling the alveoli transudate used Antifomsilan agent or oxygen is supplied through an alcohol moistened gauze. To normalize the pressure required to remove excess fluid from the body. Recommend diuretics. They allow you to reduce the amount of circulating fluid.
Prevent shock to help preparations stimulating contraction of the heart muscles, normalizes blood circulation. Other medications that can be used:
- anticoagulants with antiagregatsionnym property;
- ganglioplegic;
- drugs that prevent the development of arrhythmias;
- beta-blockers;
- glucocorticosteroid agents;
- angiotensin-converting enzyme.
Diagnostics
A preliminary diagnosis may be doctors, ambulances, it is enough of a clinical picture. To determine the exact nature of the pathological state of a stethoscope is used (estimated heart rate), ECG performed. In hospital conditions used hardware diagnostic methods:
- Ultrasound of the heart, the lungs;
- X-ray (used to assess lung condition).
Myocardial infarction is performed biochemical analysis of blood. This makes it possible to assess the degree of destruction of cell death. Determine quantitative component series of indicators: leukocyte, platelet, erythrocyte sedimentation rate, etc. of specific proteins.
operative intervention
Medical care in this case is by forcing the expansion vessel which underwent stenosis. The method of balloon angioplasty. In the future, the balloon is removed, but it increases the risk of re-narrowing of the vessel lumen. To avoid this, set the stent. This type of prosthesis is positioned within the affected vessel. As a result, it eliminates the risk of narrowing of the lumen.
Traditional methods
Such therapeutic measure should be used only in the recovery phase following myocardial infarction. Take home remedies permitted only on doctor's advice. The recovery period may be taken broths nettle, motherwort, bog cudweed, Melilotus officinalis, hawthorn fruit, elecampane root. Positive effect provides a carrot juice, a mixture of honey and nuts. Thus necessarily the bulk drug therapy should be carried out.
preventive measures
It is necessary to exercise regularly. It is important to control weight. With an increase in body weight is recommended balanced diet. I have to give up smoking and alcohol. It is necessary to conduct regular examination of the patient. Timely detection of heart disease, lung or kidney disease can help prevent a breach of myocardial work.
Consequences and outlook
In cardiogenic pulmonary edema is a risk of death. Other complications:
- shock;
- cardio, developed on the background of myocardial infarction;
- with inflammation foci in the structure of the heart membranes;
- pulmonary infarction;
- cardioembolic stroke type.
Prediction is not positive in pulmonary edema, due to the high risk of death (30%). The earlier found signs of myocardial infarction, The less the likelihood of complications.
