Pulmonary heart disease (synonym: cardio-pulmonary insufficiency, decompensated pulmonary heart) is a circulatory failure due to an increase in pressure in the pulmonary trunk as a result of pathological changes in the lungs and vessels of the pulmonary circulation. There are acute pulmonary heart disease (develops within hours, days) and chronic (for its development it takes years).
Acute pulmonary heart disease is an acutely occurring right heart failure as a result of a rapidly developing increase in pressure in the pulmonary trunk. Causes: embolism or thrombosis of small vessels, pneumothorax , severe attack of bronchial asthma, common pneumonia . Rarely encountered. Characterized by the sudden appearance of shortness of breath, asphyxiation, acute chest pain, cyanosis , cold sweat, often collapse (see). When examined against the background of pathological changes in the respiratory organs, a rapid pulse is determined, the expansion of the heart’s boundaries to the right and up, systolic murmur and accent of the second tone over the pulmonary trunk.
Treatment of acute pulmonary heart disease - complete rest, oxygen inhalation, prescription of papaverine (1-2 ml of a 2% solution under the skin), aminophylline (10 ml of a 2.4% solution in 20 ml of 40% glucose solution intravenously), atropine (1 ml 0.1% solution under the skin), and with anticoagulants for embolism, for pains (only as prescribed by a doctor) morphine preparations (1 ml of a 1-2% solution of pantopon under the skin). Rapid removal of the embolus does not often lead to recovery.Go
Chronic pulmonary heart disease occurs as a result of a gradual increase in pressure in the pulmonary trunk. Causes: small circle primary hypertension , developing in diseases of the pulmonary vessels (atherosclerosis of the pulmonary trunk, endarteritis , repeated embolism); diseases of the lungs, bronchi, pleura , leading to the development of pulmonary emphysema and pneumosclerosis and to an increase in pressure in the pulmonary circulation. At the same time, the increased pressure in the pulmonary trunk is initially compensated by right ventricular hypertrophy; later on, during physical exertion, symptoms of circulatory insufficiency of the right ventricular type gradually begin to appear, combined with increasing pulmonary insufficiency. Chronic pulmonary heart disease develops, as a rule, against the background of pulmonary insufficiency and always makes it heavier during the course of the main (pulmonary) disease. Characterized by the appearance of shortness of breath, first with physical exertion, and then at rest, general weakness, sometimes pain in the heart, palpitations, and further cyanosis of the glands of the cheeks, swelling of the veins of the neck. In the study on the background of pathological changes in the respiratory organs, mild tachycardia , an increase in the boundaries of the heart to the right (radiographically), deaf tones, sometimes systolic murmur at the apex, accent of the second tone over the pulmonary trunk, enlarged liver, sometimes pastos in the lower leg region are determined. Radiographically detect the expansion of the pulmonary trunk, right atrium and right ventricle.
Treatment comes down primarily to the treatment of the underlying disease, which has led to the development of chronic pulmonary heart disease (for example, during exacerbation of inflammatory processes in the lungs - sulfa drugs , antibiotics, bronchodilators).
In the treatment of pulmonary heart disease, all measures should be taken that are used in the treatment of circulatory failure (see) of any other origin. Effective inhalation oxygen therapy. It is advisable the appointment of aminophylline, which has an expanding effect on the vessels of the pulmonary circulation. Often observed in such patients low blood pressure and the possibility of vascular insufficiency in them require the use of vascular agents - 1 ml of 10% solution of caffeine-sodium benzoate under the skin, 2 ml of 20% camphor oil solution under the skin, etc. Inhibition of the respiratory center follows take extra care for drugs (morphine, pantopon , large doses of barbiturates, etc.). Only a doctor can prescribe them. Of great importance is the correct breathing of the patient, for which purpose one should apply breathing exercises, especially in the early phases of pulmonary heart disease.
Pulmonary heart disease (synonym: cardiopulmonary syndrome, cardiopulmonary insufficiency) - acute or chronic circulatory failure of the right ventricular type, resulting from acute or chronic hypertension of the pulmonary circulation.