Cardiac asthma

Cardiac asthma (Gina cardiale, heavy breathing) - the sharp attacks of breathlessness associated with acute failure of the left ventricle and left atrium of the heart.
Acute failure of the left ventricle can develop when hypertension, aortic heart diseases, coronary heart disease, myocardial infarction, nephrite, etc. thus weakened left ventricle is not able to pump into the aorta of flowing blood from the lungs, while the right ventricle continues to pump it into small circle of blood circulation, which is flooded with blood. Consequently impaired gas exchange in the lungs, blood accumulates carbon dioxidecomes irritation of the respiratory centre and there is shortness of breath. The acute lack of the left atrium with the development of cardiac asthma may occur with mitral stenosis (see heart Defects). Contribute to the development of cardiac asthma physical and mental stress, the overflow of the gastrointestinal tract and other Attacks cardiac asthma are more likely to occur at night. This is due to the horizontal position of the body, which increases blood flow to the heart, and also with increase of a tone wandering nerve during sleep that causes narrowing of the coronary arteries and the deterioration of the power of the myocardium.
Sick that day was in good condition and could even perform light work, night suddenly awakened from a lack of air, sits up in bed. He observed sudden shortness of breath, weakness, cold sweat, anxiety. Pale skin with a bluish tinge. Appears coughing light frothy sputum. When breathing is difficult breath, may be heard at a distance of a gurgling in his chest, heard above the lungs wheezing, predominantly wet. The heart sounds are muffled, the pulmonary artery II tone strengthened; sometimes appears gallop rhythm (see Gallop rhythm). Pulse frequent, weak filling. In severe cases, cardiac asthma attack ends with pulmonary oedema (see). Differential diagnosis with bronchial asthma, see table.
Treatment of cardiac asthma requires fast actions. In a fit of cardiac asthma patient should comfortably seat in bed, dropping his feet. It is necessary to ensure supply of fresh air(open the window), allow to breathe oxygen, passed through 70% alcohol poured in a humidifier oxygen system. In the absence of the humidifier alcohol moisten a gauze, pulled on Nagorny the oxygen tent. To hands and feet, put a heating pad. Subcutaneously administered 2-3 ml of 20% solution of camphor; 1 ml of 1% solution of morphine together with 0.5 ml of 0.1% solution of atropine. If the patient does not receive constantly drugs digitalisa, slowly intravenously injected strofantin (0.5 - 0.7 ml 0.05% solution) or korglykonum (1 ml 0,06% solution) with 20 ml of 40% glucose solution; you can impose 1-2 ml of 12% solution of aminophylline (devilline) intramuscularly. Used diuretics: novori (0.5 to 1 ml intramuscularly or intravenously, lasix 40-80 mg orally in the same dose intravenous along with 20 ml of 40% glucose solution, etc. With the threat of pulmonary edema shown bloodletting 250-500 ml of blood. To restrict blood flow to the heart on a limb impose harness for 15-20 minutes without pressing of the arteries, which is controlled by the presence of pulse radial artery or arteries of the rear foot. With the protracted attack, cardiac asthma, beyond the emergency treatment, the patient should be hospitalized. After the attack, cardiac asthma patient must stay in bed for 2-3 weeks. At this time it is necessary diet with restriction of fluid and salt. Concomitant treatment of the disease against which developed cardiac asthma attack.

Differential diagnosis of heart and bronchial asthma
Signs Cardiac asthma Bronchial asthma
Diseases preceding the attack Heart disease (heart disease, coronarocardiosclerosis, myocardial infarction, and so on), hypertensive heart disease, nephritis Sometimes lung disease
Respiration Difficult breath, in the distance hear the gurgling breast Difficult to exhale. In the distance hear the dry, wheezing
Auscultation Wet fine basal rales, mainly in the lower lung Dry rales, mainly on the exhale. Very long exhale