Chronic heart failure: symptoms and treatment, classification, stages

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As is known, in practice acute and chronic heart failure is often encountered. So, chronic is called a condition where the cardiac muscle partially loses the ability to provide a normal outflow of blood. Chronic obstructive pulmonary disease can affect people of all ages, and develops complications during development until sudden death. That is why it is important to diagnose and start treating the disease in time.

Features of the disease

Most common CHF occurs in women, especially the elderly. Age features affect the treatment: older people are prescribed other groups of drugs than children.

• In women, heart failure arises from hypertension, and in men due to coronary artery disease.
• The most common cause of chronic heart failure in children is congenital cardiac muscle pathology.

The following visual video will tell you about how a person develops chronic heart failure:

Degrees

The basic classification of degrees separates chronic heart failure at the stage:

• Initial. It is only found on echocardiography.
• Expressed. The movement of blood is disturbed in one of the circles of the hemorrhage.
• Heavy. The movement of blood is disturbed in both circles.
• The ultimate. The movement of blood is heavy, the heart muscle and target organs like the brain undergo serious changes.

Chronic heart failure syndrome is also divided into functional classes:

• First. The main signs are shortness of breath and a decrease in stamina.
• Second. Physical activity is limited only slightly, with exercise manifested fatigue and dyspnea.
• Third. During physical exertion, the symptoms of CHF are clearly manifested in the patient.
• Fourth. The patient can not perform any exercises without unpleasant symptoms, which are manifested and at rest, but weakly.

There are also several types of chronic heart failure depending on the location of bloody stasis:

1. right ventricular - stasis in a small circle;
2. left ventricular - stasis in a large circle;
3. biventricular - stagnation in both circles;

On the causes of chronic cardiovascular insufficiency 1, 2, 3 degrees read further.

Chronic heart failure( schematic image)

Causes of

The mechanism of occurrence of CHF is associated with damage to the heart muscle or the inability to perform its normal work, that is, blood pumping through the vessels. This may occur due to:

• Ischemic heart disease. Myocardial infarction in anamnesis.
• Arterial hypertension.
• Cardiomyopathy, including postpartum.
• Excessive intake of medicines, especially antitumor drugs.
• Diabetes mellitus.
• Thyroid disease.
• Adrenal disease.
• Obesity.
• Cachexia( exhaustion of the body).
• Great deficiency of vitamins and other essential elements like selenium.
• Amyloidosis( deposition of amyloid in the organs).
• Sarcoidosis( dense nodules that squeeze normal parts of the organs).
• Renal failure. Atrial fibrillation
• .
• Blockade of the heart.
• Dry, effusive, constrictive or slippery pericarditis.

Also common causes, especially in infants, are congenital and acquired heart defects.

Even a relatively healthy person can get CHF.Doctors identify risk factors such as:

1. fat metabolism disorders;
2. diabetes mellitus;
3. obesity;
4. bad habits( taking alcohol, smoking);

On what signs have chronic heart failure, read on.

Symptoms of

Symptoms of chronic heart failure depend on a particular heart department that does not cope with the job. Most often, CHF is manifested:

1. by dyspnea;
2. increased fatigue;
3. heart palpitations;
4. peripheral edema: it begins with the swelling of the legs, which gradually rises to the hips, lower back and above;
5. orthopnea.

Often patients have cough, dry or with mild phlegm. With the development of the disease, impurities may appear in the sputum.

More details about the symptoms, diagnosis and treatment of chronic heart failure will be described by the following video:

Diagnosis

Because the symptoms of chronic heart failure are pronounced, early diagnosis is not difficult. As in the case of other diseases, the diagnosis begins with the collection of anamnesis of complaints and life. If the doctor reveals signs of CHF and possible causes, he conducts a physical examination of the skin for swelling, and also listens to the heart to detect noises.

To confirm the diagnosis, the patient is prescribed:

• Biochemical and clinical blood tests, urine. Help to identify concomitant disorders and complications of CHF.
• Assay for thyroid hormones to determine organ pathologies.
• Coagulogram. Detects increased coagulability of blood.
• Blood test for BNP and proBNP, revealing CHF and its causes.
• ECG for assessing the rhythm of the heartbeat, detection of heart rhythm disturbances.
• Phonocardiogram. Helps detect systolic and diastolic murmur in the heart.
• Chest X-ray. Assesses the structure and size of the heart and lungs, the presence of fluid in the pleural cavity.
• Echocardiography. Evaluates the size of the heart muscle, wall thickness and other characteristics.
• MRI for accurate image of the heart.
• Endomyocardial biopsy. Appointed as a last resort to clarify the cause of CHF.

Patients are often consulted by other specialists, for example, a therapist and a cardiac surgeon.

Treatment of

Therapeutic way of

Chronic heart failure requires a complete revision of lifestyle. The patient is shown:

• Dietary nutrition with low salt and liquid content. It is necessary to watch, that in meal there were enough calories, fiber and vitamins, thus it should not be fat.
• Body weight control.
• Physical activity according to physician's recommendations.
• Psychological assistance in case of stressful situations.

The patient should consult a physician about physical activities at all times.

Medicated

Usually, patients are prescribed such drugs in the treatment of chronic heart failure:

• ACE, which slows the development of CHF, protecting the heart and target organs.
• Angiotensin receptor antagonist if patient does not tolerate ACE.
• Diuretics for the removal of excess salts and fluids.
• Cardiac glycosides if the patient has atrial fibrillation.
• Statins if the patient has ischemic disease. Reduce the formation of lipids in the liver.
• Anticoagulants if the patient has atrial fibrillation or is at risk for developing thromboembolism.
• Nitrates for improving blood flow.
• Calcium antagonists for the management of hypertension.

Additional medications may also be prescribed depending on the patient's condition.

The expert will describe in more detail the medical and other methods of treatment of chronic heart failure in the following video:

Operation

The operation is indicated for severe arrhythmias that threaten the patient's life. The most common operation is aortocoronary bypass surgery. As a result of the operation, an additional path is created for the movement of blood from the aorta to the vessels. Mammary-bypass surgery is also often performed - creating an additional pathway from the thoracic artery to the vessels.

Patient may be assigned:

• Correction of valvular defects surgically, if there is severe stenosis or insufficiency of the heart muscle.
• Heart transplantation if it is not amenable to drug treatment.
• Artificial ventricles of the heart, penetrating inside. The ventricles are connected to the batteries located on the patient's belt.

Others, if there is an

Often patients are assigned electrophysical therapy, consisting of:

• The setting of pacemakers creating and transmitting an electrical impulse to the heart.
• Resynchronizing therapy, i.e. the setting of pacemakers transmitting the electrical pulse to the right atrium and ventricles.
• In the formulation of a cardioverter-defibrillator, not only transmitting an electrical impulse, but also causing a strong discharge, if a life-threatening arrhythmia occurs.

Next we will talk about the prevention of chronic heart failure.

Prevention of

The prevention of chronic heart failure may be primary and secondary. Primary include funds aimed at preventing disease in people at high risk. These include:

• Moderate physical activity and exercise.
• Diets with a high content of vitamins and fish, a rejection of fat.
• Refusal from bad habits such as drinking alcohol or smoking.
• Normalization of body weight.

Secondary preventive measures are taken when the patient already has cardiovascular disease or heart failure, which can flow into the chronic form. To do this:

• Take medication that normalizes blood pressure.
• Take medications that protect the internal organs.
• Improve blood flow of the arteries.
• Treat heart rhythm disturbances.
• Cures diseases.

Timely prevention helps not only to prevent the onset of CHF, but also to improve the quality of life of patients and reduce the number of hospitalizations. And now let's find out what complications of chronic heart failure are possible.

Complications of

If the CHF is not treated, the disease can be complicated:

1. by conduction disorders of the heart muscle;
2. increase in the size of the heart muscle;
3. with thromboses;
4. with thromboembolism;
5. by cardiac cachexia;
6. by hepatic insufficiency;
7. Complications of chronic heart failure;

The most terrible complication is sudden death.

Forecast

The prognosis depends largely on the severity of CHF:

• With 1 class of CHF, 80% of patients survive for 5 years;
• with 2nd class - 60%
• with 3-4 classes - less than 29%.

Health to you and your families!