Heart swelling: causes and effects
Cardiac edema is a pathology that is accompanied by accumulation of fluid in soft tissues, namely in the intercellular space. Puffiness itself is not a disease. This is only a symptom that develops against the background of ailments affecting the organs of the cardiovascular system.
The statistics says that both men and women are subject to this pathology. Much more often, cardiac edema is observed in elderly patients. Of course, faced with a similar problem, it is worth finding out more about the causes and mechanism of the development of the disease. What is the problem? What treatments does medicine offer? Is it possible to get rid of puffiness at home?
What are swelling?
In medicine, the term "edema" refers to pathology, which is accompanied by the accumulation of an increased amount of fluid in the intercellular space. The accumulation of water is associated with a violation of the concentration of certain blood components.
- Proteins, in particular globulins and albumin, retain fluid within the vessel. Violation of protein concentration is accompanied by the formation of edema.
- Glucose also possesses osmotic activity - water accumulates in tissues with an increased concentration of sugar.
- Some hormones support the normal functioning of the vessels - they can expand or narrow the vascular lumen, affect the permeability of the walls of arteries and veins.
- The accumulation of sodium salts and other mineral substances can also be accompanied by the development of puffiness, because the liquid will be retained in tissues with a high concentration of salts in order to normalize the water-electrolyte balance.
Violation of the concentration of any of the above components can affect the state of the body and cause the accumulation of fluid in soft tissues. Water under the influence of gravity accumulates in the lower extremities, pelvis, in the lumbar region.
The mechanism of development of cardiac edema
Many patients faced with a similar problem are interested in the question of what the pathogenesis of cardiac edema looks like.The key point in this case is heart failure (HF), which is associated with circulatory disorders. The development mechanism is approximately as follows:
- Against the background of developing CH, the myocardium loses the ability to pump the entire volume of fluid. At first, blood is accumulated in large vessels of the large circulation. The pressure in the hollow veins rises, the vascular walls stretch and deform, with the result that the fluid enters the extracellular space much more easily.
- Disruption of the myocardium entails dangerous consequences, in particular hypoxia, because the tissues do not receive enough oxygen. Against the background of such violations, a protective mechanism is triggered - the sympathoadrenal system is activated, the level of vasopressin increases.
- In order to maintain normal blood pressure, processes are launched to ensure vasoconstriction. In turn, this leads to impaired filtration of blood in the kidneys: less urine is formed, but more and more body fluids accumulate in the body.
- Amid oxygen starvation, the synthesis of substances is activated,which increase the permeability of the vascular wall - water passes through cell membranes much more easily and accumulates in the intercellular space.
It is through these mechanisms that edema is formed in heart failure. Treatment should first be directed to the root cause - symptomatic therapy is unlikely to provide a significant result.
Heart swelling: causes
A similar pathology develops on the background of diseases of the cardiovascular system. In most cases, the cause is heart failure. The symptoms and treatment in this case are closely related, because this condition can be the result of various ailments. For example, myocardial insufficiency develops against the background of cardiomyopathies, congenital heart defects, arrhythmias, and some forms of pericarditis.
Other causes include chronic hypertension, amyloidosis, as well as illnesses associated with impaired blood supply to the myocardium, including inflammation of the heart muscle, and heart attack. Acute heart failure can be the result of a toxic effect, which is observed, for example, in case of Graves' disease
Puffiness associated with impaired heart function has some characteristic signs.
- Edemas in most cases are located symmetrically. First, the fluid begins to accumulate in the tissues of the ankles. Gradually, the process spreads, grabbing the lower limbs completely. If a person with heart failure is forced to adhere to bed rest, then water accumulates in the zone of the lower back and buttocks. Cardiac edema on the face is rare and, as a rule, in advanced stages of the disease.
- Swelling of the legs increases in the evening. This phenomenon is due to the fact that during the day a person usually walks, sits or stands - according to physical laws, the fluid moves to the lower parts of the body. In the morning (after a long stay in a horizontal position), the edema subsides, but only slightly.
- The formation of edema is associated with the stagnation of venous blood in the vessels. The result is tissue hypoxia. Due to the lack of oxygen, the activity of metabolism and energy production decreases - the skin over the affected areas becomes cold to the touch.
- Hypoxia leads to a change in skin color - it becomes bluish.
- Edema caused by irregular heart function, tight to the touch. The skin above them is taut. If you press the affected area with your finger, the trace will not disappear immediately.
- Palpation of edema is not accompanied by pain (this helps the doctor to determine that the accumulation of fluid is not associated with inflammation).
Heart edema is not the only symptom of heart failure. Other signs include constant weakness and shortness of breath, which appears after the slightest physical exertion. Patients complain of frequent dizziness, which often ends with fainting. For the disease is characterized by cyanosis of the skin, which is associated with oxygen starvation. The development of arrhythmia is observed. Patients complain of pain in the right hypochondrium, burning in the chest.
It should be understood that cardiac edema is practically not amenable to symptomatic treatment. In order to get rid of excess fluid, it is necessary to direct treatment to the cause of the development of edema - heart failure.
Effective diagnostic methods
It is quite easy to notice swelling of the legs in heart failure. Treatment, however, is directly dependent on the correct and timely diagnosis of the primary disease. For this purpose, various procedures are carried out.
- The initial examination includes a visual inspection, percussion, blood pressure measurement, history taking, auscultation.
- Standard tests are also required, in particular, laboratory testing of blood and urine.
- Ultrasound is considered informative, especially when it comes to the presence of complications.
- Electrocardiography and EchoCG are required - these studies provide the physician with information about abnormalities in the structure and functioning of the heart.
- Additionally, patients are prescribed a procedure for measuring central venous pressure.
- If there are complications or it is impossible to establish the root cause of the development of heart failure, additional studies are carried out, including x-rays, computed tomography, etc.
Conservative treatment for edema
Treatment of chronic heart failure, as well as cardiac edema, must necessarily be comprehensive. The scheme of treatment is determined individually for each patient, because the doctor must pay attention to many factors, including age, sex and condition of the person, especially the course of the primary disease.
In chronic heart failure, ACE inhibitors are used without fail, which reduce blood pressure, normalize kidney function, affect blood composition, and gradually restore blood circulation. This group of drugs include "Ramipril", "Captopril", "Fosinopril", "Lisinopril".
Angiotensin II antagonists have approximately the same properties. They also improve the filtration processes of the blood in the kidneys - so the fluid is gradually excreted from the body, and the swelling disappears. Losartan, Kandesartan, Valsartan are considered effective drugs from this group.
Diuretics for heart swelling are widely used. These drugs enhance glomerular filtration, thereby contributing to the removal of fluid from the body. In the treatment can be used such drugs as "Bumetanide", "Furosemide", "Spironolactone". Diuretic drugs can affect the electrolyte balance, so using them alone is not recommended - the doctor selects such drugs individually.
Cardiac glycosides, which increase the contraction of the heart muscle,normalize the frequency of contractions, in short, improve the work of the myocardium.
Is surgery effective?
Surgical treatment of chronic heart failure is carried out only if there are appropriate indications. For example, bypassing blood flow in coronary vessels is recommended. In case of a heartbeat violation, the doctor may decide to install a pacemaker. If heart failure is caused by congenital valve defects, plastic surgery or transplantation may be performed. These procedures are aimed at normalizing the work of the heart muscle - cardiac edema disappears by itself after some time. On the other hand, severe edematous syndrome is a contraindication for surgical treatment.
Surgical intervention is also necessary for some complications. For example, for ascites, fluid is pumped out of the abdominal cavity, and trophic ulcers sometimes require special treatment.
If there are heart swelling, what to do? Traditional medicine
Many people are interested in how to remove heart swelling.Is it possible to do it yourself at home? Of course, folk remedies for heart edema can be effective, because many plants have diuretic and regenerative properties. The most commonly used broths:
- 150 g of chopped elderberry root pour 300 ml of vodka. Mixture insist in a dark cool place for 7-10 days. Next, infusion filter and take 10-20 drops three times a day before meals.
- Tincture of calendula also relieves swelling and has a positive effect on the heart. This tool can be purchased at the pharmacy already in finished form. It is recommended to take 20-30 drops three times a day. The drug is effective only with long-term and systematic intake - the first effect can be seen after 2-3 weeks.
- Flax seeds also have healing properties, which can also be purchased at a pharmacy. 4 tablespoons of seeds is poured with a liter of water, put on a small fire and brought to a boil. Next, the pan should be removed from the heat and wrap with a towel - the broth should be cooled slowly over 3-4 hours. The filtered means is taken 3-6 times a day, 100 ml.
It's worth understandingthat home remedies can only be used with the permission of the doctor - self-treatment for heart failure is unacceptable, because the inept use of any medication is fraught with dangerous consequences.
Proper diet is a guarantee of quick recovery.
Treatment of chronic heart failure and edema necessarily includes a special diet. The diet of a sick person should include foods rich in vitamins and minerals. The daily energy value should be 2200-2500 kcal. It is important to reduce the amount of consumed animal fats.
Patients are recommended to use fractional meals - the daily amount of food should be divided into 5-6 doses (as the digestive tract digests food and absorbs nutrients much better). Products must be crushed. Food is better to boil, bake or steam - fried foods should be avoided.
Puffiness is associated with accumulation of fluid in the body, so doctors recommend limiting the amount of drinking to 1-1.2 liters (in this case, it is not only about drinks, but also about soups, milk porridges, etc.). Salt retains water in the tissues, so its amount in the daily diet should be strictly limited.
Possible complications of edema syndrome
As already mentioned, cardiac edema is not an independent disease. However, in the absence of therapy, fluid accumulation can lead to very dangerous complications.
- Occasionally, trophic ulcers that are difficult to treat develop on the skin in the area of edema.
- Ascites can be attributed to the number of possible complications. This pathology is accompanied by accumulation of fluid in the abdominal cavity (sometimes even more than a dozen liters).
- Hydrothorax is a disease that is accompanied by fluid accumulation in the pleural cavity. In most cases, heart failure becomes the cause of the pathology (symptoms and treatment are described in the article).
- In the absence of therapy, pulmonary edema may develop.
- To the list of possible consequences you can add and hydropericardium. With a similar pathology, the transudate begins to accumulate between the sheets of the pericardium. In the people of the disease is often called "dropsy of the heart shirt."
- As already mentioned, a fairly common pathology is lymphedema (leg swelling) in heart failure. Treatment certainly helps to fix the problem. But the lack of therapy is fraught with a mass of complications, because the fluid quickly accumulates in the soft tissues of the limbs, and in large volumes.Perhaps the formation of cellulitis, and in more severe cases, lymphangiosarcoma develops.
In any case, you should not ignore the problem - when the slightest symptoms appear, you need to contact a specialist and immediately begin therapy.