Cardiology: Heart failure — Cardioverter -defibrillator implantation. Treatment
Acute heart failure (AHF) is a condition arising from the sharp decline in cardiac contractility. In approximately 80% cases, the pathology development is caused by myocardial infarction, rheumatic heart disease and severe arrhythmias. AHF is treated in intensive care units.
The primary goals of therapy are alleviation of adverse symptoms (shortness of breath, weakness, and so on) and restoration of the normal heart rhythm.
The patient is monitored continuously using:
- blood oxygen saturation monitoring,
- blood pressure, pulse, breath rate and temperature monitoring.
A set of specific therapeutic interventions is selected in view of AHF type.
Right Ventricular Failure Correction
This form of therapy is to remove the pathology underlying its development. Thus, pulmonary embolism is corrected by administration of thrombolytics. When required, the patient undergoes thrombectomy. Antibiotics are prescribed for pulmonary infection or bacterial endocarditis. AHF manifestations are inhibited by diuretics and dopamine in low doses.
Left Ventricular Failure Correction
The following medications are used to treat the left ventricular failure:
- Narcotic analgesics. These drugs eliminate the shortness of breath, reduce agitation and pressure in the pulmonary circulation.
- Oxygen with defoamer. It is administered for pulmonary edema accompanied by foaming. The patient inhales the drug through the nasal cannula or face mask.
- Vasodilating drugs (nitroglycerin, aminophylline, pentamin). They dilate the blood vessels, reduce the workload on the heart and facilitate its work.
- Diuretics (furosemide). They also allow to "unload" the myocardium quickly. The drugs are not administered when the patient has low blood pressure.
- Clonidine. It is indicated for development of arterial hypertension.
- Dopamine. It is administered for hypotension.
Upon increase of respiratory failure signs, the patient receives an artificial respiration. Against the background of the developed cardiogenic shock, a special antishock therapy is conducted.
The struggle against AHF is continued until elimination of all its clinical signs. Then a rehabilitation treatment is selected for the patient.Hide
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