Chronic heart failure (CHF) is a syndrome in which the heart function is disturbed and it does not support blood circulation at a level sufficient to meet the needs of the body.
This means that blood does not deliver organs and tissues as much oxygen and nutrients as needed for their normal work. In addition, there is no complete removal of exchange products and tissue fluids.
Causes of chronic heart failure
The main causes of chronic heart failure are diseases that damage the myocardium or increase the load on the heart. HCN can complicate the course of virtually all diseases of the cardiovascular system, develop in chronic diseases of the lungs, anemia, hyperthyroidism. However, the most common causes of CHF are:
- Ischemic heart disease (and myocardial infarction, as one of its important manifestations);
- High blood pressure;
- Rheumatic heart defects.
Symptoms of chronic heart failure
The main symptoms of heart failure are due to accumulation and stagnation of the fluid:
- Gain in weight;
- Edema of the lower extremities;
- Abdominal enlargement in volume;
- Pain in the right hypochondrium;
- Loss of appetite.
For CHF characterized by insufficient blood supply to organs and tissues, manifested by weakness, increased fatigue, dizziness.
This is the most frequent and early symptom of chronic heart failure. According to the IMPROVEMENT study, dyspnea worries 98.4% of patients with CHF. At first, it only occurs during physical activity and passes after its termination, later it appears in peace and increases with the least physical activity.
The cause of shortness of breath is the development of congestive changes in the lungs. Shortness of breath can also be a concern for obese people and patients with bronchopulmonary diseases, so it should not be used as the only criterion in the diagnosis of CHF.
A more specific symptom of chronic heart failure is shortness of breath. This is a dyspnea that arises or increases in the lying position.
The appearance of orthopnetic due to the fact that in the horizontal position increases the flow of blood to the heart of the lower extremities, but the heart can not cope with the additional load, which leads to the development of stasis in the lungs and the emergence of a sense of lack of air. At the same time, shortness of breath appears literally after a few minutes of staying in bed and quickly passes as soon as he sits down.
To make it easier to breathe, the patients, falling into bed, put under their heads a few pillows and in such half-sitting position sleep all night.
Attacks at night breathlessness (cardiac asthma)
These are attacks of severe shortness of breath, often abruptly occur at night and accompanied by a disturbance of the patient and a fear of death.
Cough often accompanies shortness of breath, also occurs in the position of lying or under physical activity. Usually, the cough is dry, sometimes with a small amount of mucous membrane sputum.
The reason for the appearance of a cough is the long stagnation of blood in the lungs with swelling of the bronchial mucosa and irritation of the cough receptors. Unlike broncho-pulmonary diseases, in the case of "cardiac" cough there is no withdrawal of purulent sputum, and it passes after adequate treatment of cardiac insufficiency.
Edema on the legs
Edema is often a concern for patients with chronic heart failure. In the initial stages there is a slight pastoseness, later moderate puffiness of the feet and legs. With the progression of heart failure, edema becomes more pronounced and extends to the region of the thighs, the anterior abdominal wall, lumbar region.
However, edema is a low-sensitivity symptom of CHF, their appearance may also be due to massive obesity, liver, kidney, thyroid, varicose disease of the lower extremities.
Rapid increase in weight
A sharp set of weight indicates the accumulation of fluid in the body and is often observed with a deterioration of the course of chronic heart failure (development of decompensation). Patients with CHF should regularly monitor their body weight, with a weight gain of more than 2 kg in 3 days, they should seek medical advice or increase the dose of diuretics.
Feeling of heartbeat
Heartbeat is noted by about 80% of patients with chronic heart failure. At first the heartbeat appears at the physical and emotional load, and then at rest. It arises due to the development of neuroendocrine changes in patients with heart failure.
Fainting and dizziness
These conditions may bother patients with CHF due to a decrease in blood flow to the brain. The reason for them may be not heart failure itself, but the diseases that led to it, such as heart disease or heart rate abnormalities.
Loss of appetite
Appetite in chronic heart failure is reduced due to swelling of the intestinal wall, which prevents digestion. Loss of appetite and nausea are also often side effects of some medications used in the treatment of patients with cardiovascular disease.
Increased fatigue -The spread of a symptom of chronic heart failure. People with heart failure can experience constant fatigue and can hardly perform daily activities such as walking, climbing stairs, wearing bags with food.
Fatigue or fatigue arise, because less blood enters the muscles, and due to lack of oxygen in the muscles the formation of energy decreases. Fatigue also develops due to the fact that the body does not remove the slag as quickly as it should.
An increase in the amount of urine at night is also a characteristic symptom of CHF that appears already in the early stages of the disease. The reason for the prevalence of diuresis at night is insufficient blood supply to the kidneys in the daytime, which is due to the redistribution of blood flow: the body directs blood primarily in vital organs - the heart, the brain. At night, when their activity decreases, blood flow to the kidneys increases, which leads to an increase in the formation of urine.
It should be noted that in the later stages of the development of chronic heart failure, when the heart does not cope with its function and at rest, the blood flow through the kidneys is constantly reduced and there is a significant decrease in the separation of urine throughout the day.
In addition to physical symptoms, some patients, experiencing the severity of the current situation, suffer from emotional disorders: anxiety, depression. But careful management of patients with chronic heart failure can alleviate symptoms, improve prognosis and prolong life.