Medical treatment

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In the period of rheumatic fever you must apply the complex Antirheumatic products (antibiotics, glukokortikoida, salicylates, drugs pirazolonovogo series, antihistamines, and others) in combination with drugs that improve the function of the heart muscle, impacting positively on metabolic processes in myocardium and thereby provide active effect on hemodynamics.
In the treatment of heart failure is currently used complex of medicinal substances, the main component of which is the heart glycosides.
Since 70-ies of the XVIII century after the publication of the wonderful works of the English doctor Wieringa (Withering, 1785) with a description of the therapeutic action of digitalis, heart glycosides firmly established in the Arsenal cardioactive funds.
According to G. F. lang, introduction of digitalis in therapy should be considered one of the biggest achievements of medicine.
Foxglove stood the test of time and for nearly two centuries was one of the most effective means for treatment of heart failure.
Currently, there is an extensive literature is devoted to the experimental and clinical investigations of the action of digitalis.
By the beginning of the purple Foxglove (Digitalis purpura) is a mixture of glycosides - digitoksina, gitoksin and Vitalina.
The positive impact of therapeutic doses of digitalis on hemodynamics associated with its glycosides directly on the heart muscle, nerve centers and peripheral end of the vagus nerve, blood vessels and kidneys. Foxglove, increasing airway fibers of the heart muscle, increased ventricular systole (positive inotropic effects). Heart under the influence of digitalis reduced with more force and faster, while the duration of diastole increases.
The positive inotropic effect of digitalis caused by the direct effect of it on the production and use of a myocardium of energy (A. I. Cherkes, 1970; B. F. Mel'nikov, 1972). The drug helps to increase the concentration of potassium ions inside myocardial cells (FS Meyerson, 1968) and restore normal potassium-sodium ratio, an increase in the content of calcium in the myocardium (Century A. Vinogradov and others, 1977).
Due to the action of digitalis on the vagus nerve, heart rate slows down, diastole is extended, therefore, increases the degree of diastolic filling cavities of the heart. This helps to increase its systolic volume. In addition, due to lengthening of diastole increase the recovery of energy for muscle contraction.
The action of digitalis on vessels is largely determined by the dose of the drug. The application of therapeutic doses of brain and skin blood vessels dilate. The literary data on the effect of digitalis on coronary blood contradictory. Perhaps this is because many researchers have studied the influence of drugs naperstanki on the coronary circulation in patients suffering from coronary insufficiency and circulatory failure. According to C. S. Nesterova (1974), digitalis no significant effect on coronary blood flow.
Kidney vessels under the influence of digitalis expanded. The enlargement of the leading artery of the ball increases filtering, and this causes an increase diureza.
Under the influence of digitalis in patients with heart failure increases systolic volume and minute volume of blood circulation, reduces heart rate, reduced Central venous pressure, decreases the amount of circulating blood, improves peripheral circulation, reduced congestion in the lungs.