If you are afraid of a heart attack, almost all elderly people, by diagnosis "Chronic heart failure" are quite complacent, It is presenting him only minor ailments. In fact, this is a serious diagnosis, mortality is almost 10 times higher than mortality myocardial infarction, and the average life expectancy from the beginning of the statement diagnosis is 5 years, which compare very favorably with fast growing cancer.
Tell about this disease, we asked Sergei Tereshchenko, doctor of medical sciences, professor, head of department of myocardial diseases and heart failure FGBI "Cardiology" Russian Ministry of Health, Executive Director of the Society of Emergency Cardiology.
- Sergey, but what is lacking heart, why there is such a disease?
- To begin with, that according to the Russian medical tradition, it is not a disease, oddly enough, as a complication of various cardiovascular diseases (coronary heart disease and various heart diseases, hypertension, myocarditis, rheumatic fever). The heart can not pump blood in the same volume. The body, trying to get as much blood as he needs, increases the volume of the heart chambers, ie, Body throws a little more blood. When the blood is greater, and the load is above and to cope with it, It increases the heart muscle (myocardium), and heart rate. For some time reigning calm, but then reduced the possibility of infarction. Besides , the body tries to compensate for the lack of blood yourself: narrows peripheral blood vessels that help the heart, brain and heart, which vital blood supply, it is prepared in an increased amount due to other organs. But these measures are temporary, and someday the body can not compensate for the situation. And it happens cardiac decompensation failure. Man gets tired quickly, there is no motivated by a feeling of weakness. The heart is unable to cope with the volume of blood which passes through it, and it begins to slowly excess "store" in the veins of the legs and abdomen - then appear swelling in the ankles and in the field stomach and increases body weight. As a result of processes increases pulmonary artery pressure and fluid accumulates in the lungs, due to which oxygen they hardly penetrate. In the blood is extremely low oxygen concentration, which causes rapid breathing reflex, i.e. shortness of breath. Patients often wake up from asthma attacks and can sleep only sitting. Unfortunately, nearly 30% of patients with decompensated die within a year After discharge from the hospital.
- Who in the group the risk?
- First of all hypertensive patients. In our country, a lot of people, which put this diagnosis, according to the latest figures of around 40%, and sometimes the pressure starts to rise at a young age - about 35 years. In second place - the coronary heart disease. Then - heart attacks and strokes. Even chronic kidney disease, anemia, serious infections (influenza with severe Over pneumonia) - all of this can also lead to a sad result. So do not run these diseases, as, indeed, any others. Everyone remembers the pattern - the earlier diagnosed, the easier treat. Most heart failure are diagnosed in women - they are more serious about their health and live longer. Furthermore, during menopause increases the risk of heart failure. The men, who rarely want to see a doctor, the diagnosis is already in the final stages, when help often impossible.
Well, we can not say about another kind of factor risk - age. In our country, heart failure rapidly -50-69 years younger compared to an average age of patients in the US and Europe - 70-89 years. We're now watching less traditional health and go to the doctor only critical cases.
- The dangerous decompensation?
- After each exacerbation (decompensation) is deteriorating the patient's condition and course of the disease. Almost 30% of patients with decompensation die within a year after discharge from hospital. You can compare this to the stair-escalator in the metro, which is just down. And each time accelerated movement of the ladder, as damaged heart muscle and target organs. In the physiological state, it looks like this: getting worse symptoms of heart failure - shortness of breath, swelling in the ankles and abdomen, and hence weight gain, difficulty breathing person, if he is, palpitations quickens. It is impossible to ignore, it is imperative to refer to the the doctor, and if a serious condition, then go to the hospital.
These symptoms everyone should know and try, if there is have at least one "cardiac diagnosis," to protect themselves from unnecessary stress, timely cure of infection, do not forget to take the medicine in need dosage. Abroad regularly distribute leaflets, which in simple terms It explains what congestive heart failure, and in Russia, few can say what it is.
- So how should it be surveyed not to miss such a terrible diagnosis, and how to treat?
- Developed standards survey in this pathology: ECG, echocardiogram, blood tests for markers of cardiovascular disease - cardiac proteins, the level of which varies in different diseases heart. Treatment is also not difficult: ACE inhibitors (angiotensin converting enzyme), beta-blockers, diuretics and aldosterone blockers. Here the challenge is to identify the cause of the heart failure to choose the optimum dosage of medication, and do not forget regularly taking it. It should be remembered that in the final stages of development heart failure is almost impossible to resist it, it is better to start be treated as early as possible.
- Is there a chance to avoid such a diagnosis?
- Of course, you only need to make some effort - quit, be physically active, but at the same time, avoid overloading , for example, in fitness clubs, eat right, maintain a healthy weight - these recipes are known to all health.
Interview by Oksana Gerasimenko
Tell about this disease, we asked Sergei Tereshchenko, doctor of medical sciences, professor, head of department of myocardial diseases and heart failure FGBI "Cardiology" Russian Ministry of Health, Executive Director of the Society of Emergency Cardiology.
- Sergey, but what is lacking heart, why there is such a disease?
- To begin with, that according to the Russian medical tradition, it is not a disease, oddly enough, as a complication of various cardiovascular diseases (coronary heart disease and various heart diseases, hypertension, myocarditis, rheumatic fever). The heart can not pump blood in the same volume. The body, trying to get as much blood as he needs, increases the volume of the heart chambers, ie, Body throws a little more blood. When the blood is greater, and the load is above and to cope with it, It increases the heart muscle (myocardium), and heart rate. For some time reigning calm, but then reduced the possibility of infarction. Besides , the body tries to compensate for the lack of blood yourself: narrows peripheral blood vessels that help the heart, brain and heart, which vital blood supply, it is prepared in an increased amount due to other organs. But these measures are temporary, and someday the body can not compensate for the situation. And it happens cardiac decompensation failure. Man gets tired quickly, there is no motivated by a feeling of weakness. The heart is unable to cope with the volume of blood which passes through it, and it begins to slowly excess "store" in the veins of the legs and abdomen - then appear swelling in the ankles and in the field stomach and increases body weight. As a result of processes increases pulmonary artery pressure and fluid accumulates in the lungs, due to which oxygen they hardly penetrate. In the blood is extremely low oxygen concentration, which causes rapid breathing reflex, i.e. shortness of breath. Patients often wake up from asthma attacks and can sleep only sitting. Unfortunately, nearly 30% of patients with decompensated die within a year After discharge from the hospital.
- Who in the group the risk?
- First of all hypertensive patients. In our country, a lot of people, which put this diagnosis, according to the latest figures of around 40%, and sometimes the pressure starts to rise at a young age - about 35 years. In second place - the coronary heart disease. Then - heart attacks and strokes. Even chronic kidney disease, anemia, serious infections (influenza with severe Over pneumonia) - all of this can also lead to a sad result. So do not run these diseases, as, indeed, any others. Everyone remembers the pattern - the earlier diagnosed, the easier treat. Most heart failure are diagnosed in women - they are more serious about their health and live longer. Furthermore, during menopause increases the risk of heart failure. The men, who rarely want to see a doctor, the diagnosis is already in the final stages, when help often impossible.
Well, we can not say about another kind of factor risk - age. In our country, heart failure rapidly -50-69 years younger compared to an average age of patients in the US and Europe - 70-89 years. We're now watching less traditional health and go to the doctor only critical cases.
- The dangerous decompensation?
- After each exacerbation (decompensation) is deteriorating the patient's condition and course of the disease. Almost 30% of patients with decompensation die within a year after discharge from hospital. You can compare this to the stair-escalator in the metro, which is just down. And each time accelerated movement of the ladder, as damaged heart muscle and target organs. In the physiological state, it looks like this: getting worse symptoms of heart failure - shortness of breath, swelling in the ankles and abdomen, and hence weight gain, difficulty breathing person, if he is, palpitations quickens. It is impossible to ignore, it is imperative to refer to the the doctor, and if a serious condition, then go to the hospital.
These symptoms everyone should know and try, if there is have at least one "cardiac diagnosis," to protect themselves from unnecessary stress, timely cure of infection, do not forget to take the medicine in need dosage. Abroad regularly distribute leaflets, which in simple terms It explains what congestive heart failure, and in Russia, few can say what it is.
- So how should it be surveyed not to miss such a terrible diagnosis, and how to treat?
- Developed standards survey in this pathology: ECG, echocardiogram, blood tests for markers of cardiovascular disease - cardiac proteins, the level of which varies in different diseases heart. Treatment is also not difficult: ACE inhibitors (angiotensin converting enzyme), beta-blockers, diuretics and aldosterone blockers. Here the challenge is to identify the cause of the heart failure to choose the optimum dosage of medication, and do not forget regularly taking it. It should be remembered that in the final stages of development heart failure is almost impossible to resist it, it is better to start be treated as early as possible.
- Is there a chance to avoid such a diagnosis?
- Of course, you only need to make some effort - quit, be physically active, but at the same time, avoid overloading , for example, in fitness clubs, eat right, maintain a healthy weight - these recipes are known to all health.
Interview by Oksana Gerasimenko
Treatment and prevention
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