Under the concept of a pulmonary heart is understood a complex of symptoms that appears in the pathology of the right side of the heart. The ventricle and the atrium are enlarged and expanded due to increased pressure in the small circle of circulation, which is provoked by diseases of the lungs and bronchi.
Pulmonary heart forms
Depending on how quickly the clinical manifestations of this pathology show themselves, it is customary to classify it into:
- acute - develops extremely suddenly, literally in a few hours;
- subacute - the increase in symptoms of an increase in the right ventricle and atrium occurs within a few weeks;
- chronic - occurs against the background of major diseases of the respiratory system and makes itself felt in a few months or years.
Chronic pulmonary heart disease
In turn, the chronic form for etiology is classified as follows:
- Bronchopulmonary form. It occurs against the background of primary lesions of the respiratory system (emphysema, bronchial asthma , obstructive bronchitis, pneumoconiosis, tuberculosis, etc.).
- Vascular form. It is caused by the primary lesion of pulmonary vessels (mediastinal tumors, pulmonary embolism, atherosclerosis of the pulmonary artery, etc.).
- Thoracodiaphragmatic form. It is caused by primary lesions of the diaphragm or chest, which disrupts the ventilation of the lungs (kyphoscoliosis, poliomyelitis, obesity, pneumosclerosis, etc.).
Recently, doctors have noted that cases of pathology of the right side of the heart due to pulmonary embolism (PE) have become more frequent, and patients with ischemic disease, heart defects due to rheumatism and hypertension are at risk.
Acute pulmonary heart
The instantaneous increase in symptoms leads to:
- severe asthma attack;
- valve pneumothorax;
- massive PE;
- acute pneumonia.
Often, the pulmonary heart develops in subacute form, which is typical for repeated occlusions of small branches in the pulmonary artery due to myasthenia gravis, botulism, lymphangitis, parasites, etc.
Symptoms of the pulmonary heart develop abruptly in a patient who has never complained before. In the chest, there is pain, there is a cyanotic skin, shortness of breath and intense excitement. Within a few minutes or half an hour, pulmonary edema and a shock condition develop. When palpating the patient, the patient experiences pain, the cervical veins swell. If a patient does not immediately help, a lung infarction is likely. The patient begins coughing with the separation of sputum and blood, the heart rate is increased, wet wheezing sounds are heard over the affected lung.
Symptoms of subacute pulmonary heart are characterized by fainting, hemoptysis, shortness of breath, frequent palpitations.
Chronic pulmonary heart disease
The pathology of this form develops in two phases: compensation and decompensation.
In the first case, the patient is bored with the symptoms of the underlying disease, and gradually the right side of the heart increases, which is accompanied by a pulsation at the top of the abdomen, shortness of breath.
At the stage of decompensation the pulmonary heart is characterized by pain in the chest, cyanosis (cyanosis), swelling of the cervical veins, not only on exhalation, but also on inspiration, enlargement of the liver, peripheral edema.
Treatment of pulmonary heart disease
In the acute form of the patient's pathology, it is necessary to resuscitate and perform heart massage, mechanical ventilation or intubation. Later, surgically remove the thrombus, which clogged the artery.
In the treatment of chronic pulmonary hearts, emphasis is placed on the therapy of the underlying disease, and also combat symptoms using bronchodilators, respiratory analeptics, glucocorticoids (in case of decompensation). With heart failure prescribe diuretics and glycosides.