Cardiac asthma is an asthma attack that can last from a few minutes to several days. Cardiac asthma can occur with heart defects, cardiosclerosis, myocardial infarction, and other diseases that are associated with heart failure.
The main symptom of cardiac asthma is shortness of breath, which causes chest tightness. During an attack, a person experiences a feeling of fear and tries to listen intensely and understand what is happening in his body.
Diagnosis of cardiac asthma is relatively easy in young people and can be very difficult in older people. In the latter case, differential diagnosis is required. It is carried out in order to identify what kind of asthma the patient has (bronchial or cardiac). This kind of diagnostics is multifaceted and complex.
It is very important to provide emergency medical care, which in most cases is carried out on the spot. The goal of emergency medical care is to reduce blood flow to the pulmonary circulation and heart.
To solve this problem, the patient is given certain injections, bloodletting and the use of leeches are possible. It is often necessary to deliver the patient to the hospital after first aid. Providing emergency care is a whole range of measures.
In a hospital for patients with mitral stenosis, surgical removal of all symptoms of cardiac asthma is possible. This is carried out in parallel with the surgical treatment of the heart defect itself (mitral stenosis).
Preventive measures aimed specifically at preventing an attack of cardiac asthma are difficult to single out. This is due to the fact that the main preventive measures aimed at preventing cardiovascular diseases are also aimed at preventing the development of each of them (including cardiac asthma).
Cardiac asthma is an independent disease. No, it’s not. Cardiac asthma usually develops as a complication of other diseases. These can be congenital and acquired heart defects, hypertension, cardiosclerosis, or myocardial infarction.
Cardiac asthma most often occurs at night. It leads to the awakening of the patient with a feeling of acute shortage of air and tightness in the chest. Difficulty breathing and a dry cough are common symptoms of cardiac asthma. The patient usually begins to experience feelings of anxiety and fear. His face is covered with sweat. If cardiac asthma occurs during the day, then in most cases it is caused by a developed attack of angina pectoris, a sharp increase in blood pressure, or emotional and physical stress. Before the immediate onset of cardiac asthma, the patient may complain of increased heart rate and chest tightness. Still, it is worth remembering that cardiac asthma in most cases develops precisely at night.
Shortness of breath is the main symptom of advanced cardiac asthma. Shortness of breath is paroxysmal in nature. A noisy elongated inhalation is predominant. During such an attack, the patient usually begins to breathe through the mouth. With cardiac asthma that develops at night, the patient cannot continue to lie down - he goes into a sitting position or gets up. This is due to the fact that the upright position of the body, shortness of breath tends to decrease. Often, a patient who has cardiac asthma is forced to go to the window, the reason for which is the desire to breathe fresh air. The patient experiences severe difficulty in pronouncing words, which causes fear. This is reflected in his facial expressions - you can see fear and tension on the patient's face.
Cardiac asthma occurs as a result of changes in the heart. The development of cardiac asthma is caused by left ventricular heart failure or mitral stenosis. Mitral stenosis is a narrowing of the left atrioventricular opening. Thus, cardiac asthma occurs as a result of deep organic changes in the myocardium (heart muscle). These changes mainly affect the left ventricle of the heart. The basis for the occurrence of asthma attacks in people with heart disease is the weakness of the left ventricle of the heart. In this case, the right ventricle of the heart retains its strength. As a result, an increase in pressure reflexively appears in the small circle of blood circulation. Such hypertension is also called pulmonary and contributes to a sharp increase in the amount of blood and a decrease in the volume of pulmonary ventilation. The first (a rapid increase in the amount of blood) is also accompanied by overflow of the bronchial veins and slow blood flow in the pulmonary capillaries. All this causes the second (a decrease in the volume of ventilation of the lungs) and leads to a violation of gas exchange. Directly provoking an attack of suffocation, the cause is excessive irritation of the respiratory center in the brain. This is due to an increase in the content of carbon dioxide in the blood and a decrease in the content of oxygen in it. The respiratory surface of the lungs also decreases due to an increase in the permeability of the walls of the capillaries of the pulmonary circulation. As a result of this, liquid accumulates in the cavities of the alveoli, which, of course, makes gas exchange even more difficult.
Cardiac asthma is the onset of pulmonary edema. The latter can take place due to the accumulation of a very large amount of fluid in the alveolar cavity, which leads to a sharp obstruction of the lungs. Excessively accumulated fluid in the alveoli can begin to flow into the bronchi, which leads to an acute form of pulmonary edema. To prevent this from happening, immediately after the onset of the development of cardiac asthma, every effort should be made to prevent the development of this complication.
The duration of an attack of cardiac asthma is short. It is not entirely true, since the duration of such an attack can be calculated both in minutes and in hours and even days. An attack of cardiac asthma can lead to the death of the patient if the time failed to prevent pulmonary edema.
Diagnosing cardiac asthma is not difficult. This only applies to the diagnosis of cardiac asthma in young people in cases where asthma attacks are typical. In older people, the diagnosis of cardiac asthma is not so easy. This is due to the fact that in the elderly, cardiac asthma is often observed against the background of pulmonary emphysema or chronic bronchitis, which lubricate the clinical manifestations of immediate cardiac asthma. In this case, the diagnosis should be of a differential nature in order to determine what kind of asthma the patient has - bronchial or cardiac. However, cases are not uncommon. When and this kind of diagnosis is not effective. It does not allow one to be sure that asthma is recognized correctly. This primarily affects those patients in whom it is very difficult to separate bronchial asthma and cardiac asthma. This applies to those cases when bronchial asthma is accompanied by heart failure and pulmonary emphysema, and cardiac asthma is characterized by the presence of spasms of the muscles of the small bronchi. In this case, we are talking about the so-called "mixed asthma". In order to make a diagnosis in such a case, it is necessary to carry out a thorough comprehensive examination, after which it is desirable for the patient to stay under long-term clinical observation.
When providing emergency care, it is necessary to solve several problems at once. There are two of them. The first thing a doctor needs to do is to help reduce the amount of circulating blood in the pulmonary circulation by reducing its flow. The second is to try to solve the same problem, only by increasing the outflow of blood from the pulmonary circulation. To solve the first problem, you need to do the following. First, the patient must take a sitting position. This situation in this case can be attributed to a protective act, since it helps to reduce blood flow into the pulmonary circulation and the right ventricle of the heart. A sitting position leads to a slowdown in blood flow in the veins of the lower extremities, which leads to a restriction of blood flow. To a significant extent, blood flow can be reduced due to the imposition of tourniquets on the lower extremities. The residence time of the patient with tourniquets varies from one to one and a half hours. In severe cases of cardiac asthma, tourniquets may be applied not only to the lower extremities, but also to the upper ones. If an attack of cardiac asthma is mild, then it is possible to use dry cans, which are installed on the chest. Hot foot baths are also used. In severe cases of cardiac asthma, characterized, among other things, by the duration of the attack, leeches can be used. In this case, twelve to fifteen leeches are placed on the liver area. Bloodletting from the cubital vein is possible (from 400 to 500 ml). If there are neurovascular disorders, then the patient is prescribed aminophylline, caffeine, cordiamine, camphor. To solve the second problem, it is possible to take the following measures. The patient is inhaled with oxygen, aminophylline, strophanthin, neriolin, or other cardiovascular drugs are injected intravenously, which are diluted in 0.85% sodium chloride solution or glucose solution. Subcutaneous administration of lobelia or morphine is possible. The purpose of the latter is to regulate the act of breathing. These drugs act on the respiratory center of the brain.
Urgent measures for cardiac asthma must be carried out in a comprehensive manner. It is recommended that they be carried out directly on site. It is very important to help the patient to achieve mental and physical peace. If it is not possible to carry out the entire range of measures for emergency care for cardiac asthma, then only part of these measures are carried out. After the threat to life has passed, the patient is taken to the hospital. This requires certain precautions, in particular the use of a stretcher, possible injections of caffeine and camphor while on the way to the hospital. For such a patient, the quiet running of the machine must also be ensured. In the hospital, the patient is assigned a whole range of therapeutic measures. Proper care, adherence to a specific diet, etc. are essential.
Cardiac asthma is treated conservatively. In most cases, the patient is relieved of an attack using conservative methods. However, for example, in the case when a patient has mitral stenosis (a type of heart defect), it is possible to relieve asthma attacks (due to cardiac asthma) with the help of surgical treatment of mitral stenosis directly.
Prevention of cardiac asthma is similar to prevention of other cardiovascular diseases. Of course, each person cannot know what preventive measures he needs to take in order to avoid each specific disease of the cardiovascular system. Not every person knows about the existence of such attacks of asthma as cardiac asthma. But absolutely everyone should take good care of their health and take the following general preventive measures (a set of preventive measures). First, a decrease in the number of neuropsychic stresses - it is on their basis that diseases of the cardiovascular system often develop. Secondly, an active lifestyle. It is about providing your body with "muscle joy" (the expression belongs to Academician Pavlov). Thirdly, good rest. Fourth, good nutrition and giving up bad habits. Fifth, periodically repeated examinations by a cardiologist for the purpose of prevention. Here is a very simple set of measures that can program each person for health and practically exclude the possibility of developing any cardiovascular diseases, including cardiac asthma.