Treatment of heart failure

Treatment of heart failure should be stepwise and integrated. At the first stage of treatment is necessary to create the ultimate getaway heart, at the second stage - the gradual training of the heart to restore his health.
Mode. If there HK1 stage it is necessary to limit physical activity, be sure to introduce restrictions in motor operation, refer to the additional day rest in bed. If such treatment does not reduce / eliminate the symptoms of circulatory failure, the patient should be placed on bed rest. If the reason for the development of heart failure was the new attack of rheumatism, it is absolutely necessary for the patient is in bed for a long time (1-1,5-2 months depending on the severity of heart failure).
Bed provides for active behavior of the patient in bed - patient himself eats at a bedside table, washed, combed. While in bed, he can read, draw, sculpt. Term of appointment of physical therapy with circulatory failure is very individual and depends largely on the degree of destruction of the heart. So, disorders of blood circulation due to isolated mitral valve insufficiency therapeutic exercise is assigned much earlier than when combined mitral Vice.
In the complex physical therapy sessions must be included exercises for muscle relaxation, breathing exercises, it is necessary to teach children a deeper breath through the nose extension of the expiration. Breathing exercises to reduce venous congestion and improve the blood supply to the myocardium.
Active exercises at the beginning of the exercises is only applicable for small muscle groups (flexion and extension of the hands, feet). The improvement in the complex therapy includes exercise and for medium-sized groups of muscles of the arms and legs. Such exercises improve venous return blood to the heart. The duration of physiotherapy exercises - from 5 to 10 minutes All exercises are done at a slow pace, active alternate with breathing exercises to relax. Classes are held in the prone position (C. M. Ivanov, I. F. Nazarov, K. A. Zaslavskaya, 1975; B. L. Starkovsky, 1969).
When remitting active rheumatic process and favorable reaction of the cardiovascular system functional tests with muscular load the patients are transferred to pruposely a mode in which it is allowed to get out of bed, using the toilet, eat in the dining room. At first most of the time and in this mode, the children are in bed, then movement expands, allowed a considerable amount of time to spend out of bed. While in this mode, the children begin to walk, but while walking recommended most of the time to sit.
When polumetallam mode complex exercise therapy is already in the initial position sitting on a chair. The complex also be included breathing exercises, active exercises for all muscle groups, relaxation exercises. Included exercises with gymnastic stick, ball, a Hoop. The duration of the exercises-15-20 min exercise slow and average.
On polumetallam mode, the children are on average 1-2 weeks. Then in the absence of outer signs of circulatory failure, they can be transferred to advanced training mode, which only provides for an afternoon rest in bed for the rest of time the child walks around the room, playing sedentary games, walks in the garden. Physiotherapy exercises are conducted from the initial position of sitting and standing. Introduced the exercise on shells, sedentary games.
If there HK2A and HK2B and HK3 stages required bed rest, in which the position of the bed should be a semi-sitting. The General condition of the patient, expressed events circulatory failure 5-10 days appointed strict bed rest, which provides for maximum peace of the patient. A child who is this mode, you need to wash, feed, comb, give him a vessel in bed. Therapeutic exercise such patients are not shown. At the improvement of General condition and decrease of the circulatory inefficiency patients transferred to a regular bed rest, which continues l,5-2 months.
Physiotherapy exercises for such patients begin stroking massage of hands and feet with a duration of 3-5 minutes 1-2 weeks later from the patient begins to physical therapy. Selection of physical exercises must be strictly individual given the nature of heart disease, symptoms of circulatory failure, the age of the patient. First, physiotherapy exercises for patients with NK are held in a semi-sitting position with bent knees. In this position, reduced congestion in the lungs, improves pulmonary ventilation. With the improvement of the condition of possible further extension of the motor mode, which is carried out in a strictly individual time in view of the functional state of the cardiovascular system of the patient. At the same time increases the load-carrying out of therapeutic physical training.
A diet. At HK1 stage it is recommended that a full and varied diet. The amount of proteins, fats and carbohydrates, as well as caloric intake must meet the age requirements of the patient. It is appropriate to introduce in the diet products that contain large amounts of vitamins C and group b (fresh fruit, vegetables), containing potassium (raisins, dried apricots). To exclude from a diet of salty dishes (salted fish, salted cucumbers and so on). The amount of fluid should not be excessive. Food should be taken regularly, 5 times a day in small portions. When NCV diet, it is advisable to somewhat limit the sodium-up to 1-5 g / day (gipohlorita diet). Floridna diet with circulatory failure not apply, as the sharp reduction of dietary sodium leads to a decrease of its concentration in the bloodstream, causing irritation of chemoreceptors vessels and increases the production of aldosterone. If there is swelling the number of the liquid somewhat limit (up to 800-1000 ml per day).
When seriously ill, caused by circulatory failure, it is expedient to apply fasting days 1-2 times a week, during which the child receives nutritious and varied diet with adequate protein, a large amount of potassium, vitamins. An example of such a diet for children of school age is the diet of the following composition: 400-500 g of milk or yogurt, 100-150 g of cheese, 300-400 g of potatoes, boiled or steamed milk, 400-500 g of fruit, 50-100 grams of sugar (table. 4).
It is desirable fruits and berries to combine with grated carrots. To improve the palatability of the diet, you can include up to 100 g of walnuts.

  • Medical treatment