/ 30.07.2018

Low ejection fraction. Exercise to treat heart failure. Risk factors, symptoms.

Before diagnosing a patient with chronic heart failure, the doctor makes a diagnosis with the obligatory determination of such an indicator as the ejection fraction. It reflects the amount of blood that the left ventricle pushes into the aortic lumen at the time of its contraction. That is, through such a study, it is possible to find out whether the heart is effectively coping with its work or there is a need to prescribe heart medications.

The measuring principle is as follows: if the cardiac output is higher, then the cold returns faster to the site and becomes less diluted. Conversely, if the cardiac output is low, it will take longer than the cold goes to the measurement site, and after that the cold will be more diluted. The method was calibrated by simultaneous measurement using other methods. Thermodilution measurement can be considered invasive insofar as it requires a Swan-Gantz catheter in the right side of the heart and lungs.

However, this does not indicate catheterization, and is mainly used where the catheter was inserted for other reasons, in particular for measuring pressure. The accuracy of the method is not perfect, so several measurements are taken sequentially and the result is averaged.

PV rate

To assess the work of the heart, namely the left ventricle, the Teicholz or Simpson formulas are used. It must be said that it is from this department that the blood enters the general circulation and with left ventricular failure, the clinical picture of heart failure most often develops.

Note: In this section, the blood that enters the lungs of the pulmonary arteries will be referred to as venous. The blood that flows into the pulmonary veins and then into the systemic arteries will be called arterial blood. Fick's principle is a simple application of the law of conservation of matter.

By entering into a relationship, we receive. Thus, cardiac output can be defined as. In this conclusion, we used the inflows and outflows of the amount of oxygen. Alternatively, we could use mass oxygen flows. Oxygen volumetric flows are sometimes also used. This expression is believed to represent the amount of oxygen that flows in and out of the blood when oxygen is in a gaseous state.

The closer this indicator is to the norm, the better the main "motor" of the organism is reduced and the more favorable the prediction for life and health. If the obtained value is much lacking to the norm, then we can conclude that the internal organs do not receive the required amount of oxygen and nutrients from the blood, which means that the heart muscle must be somehow supported.

Although this classical technique is relatively accurate, it is rarely used for its invasiveness. Fick's principle can be used for substances other than oxygen. This procedure avoids the need for arterial blood collection. Unfortunately, the method fails in the presence of poorly ventilated areas of the lungs, which, of course, can, in extreme cases, pass to pathological short circuits in the lungs.

This procedure can avoid the need for unpleasant central venous catheterization. The measurement takes place in such a way that the patient starts breathing a mixture containing the substance. Then the partial pressure of this substance in the arterial blood is measured. The advantage of this method is that when the gas is not normally present in the air, the venous inflow of this substance is zero before the measurement.

The calculation is performed directly on the equipment on which the patient is examined. In modern rooms for ultrasound diagnostics, preference is given to the Simpson method, which is considered more accurate, although the Teicholz formula is used no less often. The results of both methods can vary by up to 10%.

Ideally, the ejection fraction should be 50-60%. According to Simpson, the lower bound is 45%, and according to Teicholz, 55%. Both methods are distinguished by a fairly high level of information content regarding myocardial contraction capabilities. If the obtained value fluctuates between 35-40%, they speak of advanced heart failure. And even lower rates are fraught with fatal consequences.

And cardiac output after treatment is calculated as. This method also bypasses the need for central venous catheterization. Summary. Non-invasive or minimally invasive heart rate measurement methods based on the Fick principle may become an accurate and inexpensive method for measuring heart rate in the future. The potential use of oxygen and carbon dioxide has so far faced problems with the accuracy of the transfer of partial pressures to concentrations at which it depends, for example, on the influence of pH, mutual interaction of both gases with hemoglobin, etc. Lung heterogeneity can also cause problems.

Causes of EF decrease

Low values \u200b\u200bcan be caused by pathologies such as:

1. Cardiac ischemia. In this case, the blood flow through the coronary arteries decreases.
2. History of myocardial infarction. This leads to the replacement of normal heart muscles with scars, which do not possess the necessary ability to contract.
3. Arrhythmia, tachycardia and other ailments that disrupt the rhythm of the body's main "motor" and conduction.
4. Cardiomyopathy. It consists in an increase or lengthening of the heart muscle, which is caused by hormonal failure, prolonged hypertension, heart defects.

Magnetic Resonance: The resonant properties of protons in a nucleus change with speed. Magnetic resonance can be used as an accurate way to measure aortic flow. The method is expensive, it is used only experimentally. Pulse Wave Mathematical Analysis: The shape and amplitude of the pulse wave depends on cardiac output. The impulse wave is measured either using a classic inflatable cuff or a transducer that sticks to the skin at the site of the artery. Therefore, a mathematical analysis of this wave can be the value of cardiac output.

The problem is that the shape of the pulse wave is also highly dependent on the properties of the arteries. For example, in the elderly, where the elasticity of the aorta and its elastic effect is lost, systolic pressure usually increases, but diastolic pressure remains normal. This method can be useful after being calibrated on a person using a different method to continuously monitor the heart rate.

Symptoms of the disease

A diagnosis of decreased ejection fraction can be made on the basis of symptoms specific to the disease. Such patients often complain of dyspnea attacks, both during physical exertion and at rest. Breathlessness can be triggered by prolonged walking, as well as performing the simplest chores around the house: washing floors, cooking.

Chest impedance measurement: Chest electrical resistance can be measured with multiple chest electrodes. Resistance changes during a change in heart rate due to changes in blood volume in the heart and can therefore be used to calculate the pulse rate and subsequent cardiac output. The method is cheap and non-invasive, but unfortunately inaccurate.

Acute myocardial ischemia of the left ventricular muscle fibers impairs the possibility of spasm and adherence. These changes can be reversible if the ischemia does not last too long and does not end with ischemic fiber necrosis. In recent years, he announced a number of observations indicating that ultimately the fate of the muscle fibers covered in acute ischemia, acute myocardial infarction, is resolved in a few, maybe even a few hours after the onset of chest pain. It is therefore possible that appropriate action during this period - at least in some patients - to limit the volume of infarct necrosis.

Often attacks occur at night while lying down. Loss of consciousness, weakness, fatigue, and dizziness can mean that the brain and skeletal muscles are deficient in blood.

In the process of impaired blood circulation, fluid retention occurs, which leads to the appearance of edema, and in severe cases, they affect internal organs and tissues. A person begins to suffer from abdominal pain on the right side, and stagnation of venous blood in the vessels of the liver can be fraught with cirrhosis.

Additional loads, increasing the oxygen demand of myocardial necrosis, a threatening increase within the infarction, and can have an adverse effect on the fate of the patient, even when their effect is not constant. When the fibers shrink, the healthy area covered by ischemia does not shrink, but rather under the influence of increasing pressure in the chamber of the bulges, acting as a kind of valve. An increase in the residual volume after shrinkage, and a violation of the vulnerability of the left ventricle, due to its acute ischemia, leads to an increase in the pressure of the left ventricle, end-diastolic, and secondly, increased pressure in the left atrium and unorganized pulmonary veins exceeding the critical value of this pressure to the formation of pulmonary edema Contrary to the expectation of both of these complications do not always occur simultaneously: seen in both cases. isolated pulmonary edema and shock isolated cases. the simultaneous occurrence of shock and pulmonary edema in the process of acute infarction, as a rule, indicates very serious harm to the left ventricle and is subject to a significantly higher mortality rate than any of these complications in an isolated form.

These symptoms are characteristic of a decrease in the contractile function of the main "motor" of the body, but it often happens that the level of the ejection fraction remains normal, so it is very important to be examined at least once a year and do echocardioscopy, especially for people with heart disease.

An increase in EF to 70–80% should also be alarming, since this may be a sign that the heart muscle cannot compensate for the growing heart failure and tends to throw as much blood as possible into the aorta.

If the hemodynamic consequences of a heart attack develop less turbulent, they take the form of subacute or chronic left ventricular failure, and in extreme cases, the so-called character. low yield heart syndrome. The latter group is sometimes severe shock descent heart attacks in cases where therapeutic intervention temporarily saved the patient's life, but not restoring normal blood circulation. The boundaries separating the above clinical fluid syndromes from each other are understandable to their general pathogenesis.

As the disease progresses, the LV work indicator will decrease, and it is echocardioscopy in dynamics that will allow you to catch this moment. A high ejection fraction is typical for healthy people, in particular, athletes in whom the heart muscle is sufficiently trained and is able to contract with greater force than that of an ordinary person.

Section of hemodynamic monitoring, operating a physiological compensatory mechanism that makes left ventricular enlargement causes filling pressure - within certain limits - to increase stroke volume. Insufficient venous supply caused by absolute or relative hypovolemia can disrupt the mechanism. The only chance of improvement in such cases is to increase the contractility of the heart on the path of pharmacological or by improving the blood supply to the area affected by acute ischemia.

In patients with acute myocardial infarction, the hemodynamic equilibrium is often precarious. This balance can easily join arrhythmic complications, dangerously accelerating or dangerously slowing down the function of the ventricles. These arrhythmias interfere with the functioning of compensatory mechanisms that maintain the threatened appearance per minute, and further threaten to increase the range of ischemic necrosis. Rapid and stable restoration of the optimal heart rate plays a decisive role in all cases when arithmetic and hemodynamic complications of a heart attack coexist.

Treatment

It is possible to increase the reduced EF. For this, doctors use not only drug therapy, but also other methods:

1. Prescribe drugs to improve myocardial contractility. These include cardiac glycosides, after which there is a noticeable improvement.
2. To prevent overloading the heart with excess fluid, they are encouraged to follow a diet with restriction of table salt to 1.5 g per day and fluid intake to 1.5 liters per day. Along with this, diuretic drugs are prescribed.
3. Prescribe the intake of organoprotective agents that help protect the heart and blood vessels.
4. Make a decision about a surgical operation. For example, they carry out, install shunts on the coronary vessels, etc. However, an extremely low ejection fraction may become a contraindication for the operation.

Prevention

Prevention to prevent the development of heart disease is of great importance, especially in children. In an age of high technology, when most of the work is done by machines, as well as the constantly deteriorating environmental conditions of life and poor nutrition, the risk of developing heart ailments increases significantly.

This is usually a necessary condition for the successful treatment of hemodynamic complications. Elimination of these additional factors plays an important role in the prevention of hemodynamic complications of a heart attack, as well as in the treatment of complications already developed. Late intake of hemodynamic complications usually indicates a heart attack or mechanical complication. The diagnosis and treatment of acute pulmonary edema complicating recent myocardial infarction is based on the principles outlined in Ch. The improvement achieved with mechanical ventilation should be applied to fast-acting digitalis and furosemide.

Therefore, it is very important to eat right, play sports, and be more often in the fresh air. It is this lifestyle that will ensure the normal contractility of the heart and muscle fitness.

During medical examinations, many patients often hear incomprehensible concepts and diagnoses. When a person has problems with the heart muscle, trained professionals can calculate the efficiency of the heart. During the contraction of the heart muscle, blood is pumped, and the ejection fraction is the amount of blood plasma that enters the vessels. Experts measure this process as a percentage.

Morphine administration in the hope of controlling pulmonary edema in spontaneous respiratory patients contraindicated for reasons outlined on page 3. Stroke is even more than 50% of deaths in intensive care. There has been no universal consensus on the optimal pharmacological treatment for these patients, although much information has emerged on this issue in recent years. The immediate goal of treatment is to increase the left ventricular ejection volume to cover the metabolic tissue requirements.

Most often, doctors measure the left ventricle to measure the amount of blood. Since from it the blood moves along a large circle of blood circulation. If there is a decreased level of human left ventricular ejection fraction, it may contribute to heart failure.

Therefore, it is recommended to regularly contact a qualified specialist for diagnostics. Several methods can be used to investigate this process. The simplest of these is ultrasound. It is quite good because the doctor can find out how active and effective the contractions of the heart muscle are. This method is quite simple and convenient, and also does not provoke the appearance of side effects and is not dangerous for the human body.

Patients whose left ventricular filling pressure is only moderately elevated often achieve this goal by further increasing the filling pressure through rapid intravenous infusion of low molecular weight dextran. In terms of balance 4 - Intensive oxygen therapy 49 is the most economical way to increase the output; An increase in the volume of ejection obtained along this route increases the oxygen demand of the myocardium to a much lesser extent than a similar increase with heartbeats.

Only suitable for patients with severe shock syndrome who have no symptoms of pulmonary edema. In hemodynamically monitored patients, the decision to target dextran use can be measured at diastolic blood pressure. In patients eligible for treatment with low molecular weight dextran, we consider this drug to be the first choice in the fight against shock associated with recent myocardial infarction. At the same time as the dextran infusion, the patient should receive approximately 90 mEq of trisamine to compensate for the accompanying metabolic acidosis.

The second method of diagnostics is isotope ventriculography. When using this method, you can find out with what efficiency the ejection fraction from the right and left ventricles passes. This option is more expensive, therefore, patients are often diagnosed with ultrasound.

In order to draw any conclusions, it is necessary to know what is the rate of the ejection fraction of the heart in a person. After the diagnosis has been carried out, the obtained indicatively must be compared with the norm, and then the doctor must take stock and prescribe the correct and effective course of treatment. If the ejection fraction of the heart muscle is normal and the person does not feel any noticeable disturbances in the work of the heart, then everything is fine. The norm for this indicator is 55-70 percent. Even if a person is in a calm state, his left ventricle can eject more than half of the blood that is in it into the vessels.

If there is a low ejection fraction in a person, a qualified technician should send him to the necessary additional research in order to determine the cause of this process. Quite often, a factor of a reduced ejection fraction may suggest the development of various heart diseases, such as heart failure. It can appear due to defects of the heart muscle, as well as coronary artery disease. All these diseases are quite dangerous for human life, therefore, they must be detected as soon as possible and effective and efficient treatment should be started.

If problems and deviations from the norm of the ejection fraction of the heart are observed, it is imperative to contact a qualified specialist who will diagnose. After carrying out diagnostic measures, the doctor must find out the cause of this defect. Then, the doctor must prescribe the correct and effective treatment in order to prevent the symptoms and signs of heart disease. The main feature of preventing disease is the constant monitoring of the doctor and compliance with all his recommendations. In order to protect your health, it is necessary at the first symptoms to consult a qualified doctor for diagnostics.

site - a medical portal about the heart and blood vessels. Here you will find information about the causes, clinical manifestations, diagnostics, traditional and folk methods of treating cardiac diseases in adults and children. And also about how to keep the heart healthy and blood vessels clean until the very old age.

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The authors of the site are practicing medical specialists. Each article is a concentrate of their personal experience and knowledge, honed by years of study at the university, received from colleagues and in the process of postgraduate training. They not only share unique information in the articles, but also conduct a virtual appointment - they answer the questions you ask in the comments, give recommendations, and help to understand the results of examinations and appointments.

Everything, even very difficult to understand topics, are presented in a simple, understandable language and are designed for readers without medical training. For your convenience, all topics are divided into headings.

Arrhythmia

According to the World Health Organization, more than 40% of people over 50 suffer from arrhythmias - heart rhythm disturbances. However, not only them. This insidious ailment is detected even in children and often in the first or second year of life. Why is he cunning? And the fact that sometimes disguises the pathology of other vital organs under heart disease. Another unpleasant feature of arrhythmia is the secrecy of the course: until the disease goes too far, you can not guess about it ...

• how to detect arrhythmia at an early stage;
• what forms are the most dangerous and why;
• when the patient has enough, and in what cases it is impossible to do without surgery;
• how and how many people live with arrhythmia;
• which attacks of rhythm disturbance require an immediate call to an ambulance, and for which it is enough to take a sedative pill.

And also everything about the symptoms, prevention, diagnosis and treatment of various types of arrhythmias.

Atherosclerosis

The fact that the main role in the development of atherosclerosis is played by an excess of cholesterol in food is written in all newspapers, but why, then, in families where everyone eats the same, only one person often gets sick? Atherosclerosis has been known for over a century, but much of its nature has remained unsolved. Is this a reason to despair? Of course not! The site's experts tell you what success modern medicine has achieved in the fight against this ailment, how to prevent it and how to effectively treat it.

• why margarine is more harmful than butter for people with vascular lesions;
• and how dangerous it is;
• why cholesterol-free diets do not help;
• what patients will have to give up for life;
• how to avoid and maintain clarity of mind to a ripe old age.

Heart diseases

In addition to angina pectoris, hypertension, myocardial infarction and congenital heart defects, there are many other cardiac ailments that many have never heard of. Do you know, for example, that - not only a planet, but also a diagnosis? Or that a tumor can grow in the heart muscle? The heading of the same name tells about these and other heart diseases in adults and children.

• and how to provide emergency care to a patient in this condition;
• what and what to do so that the first does not go over to the second;
• why the heart of alcoholics increases in size;
• what is the danger of mitral valve prolapse;
• by what symptoms you can suspect heart disease in yourself and your child;
• which cardiac ailments threaten women more, and which men.

Vascular disease

Vessels permeate the entire human body, so the symptoms of their defeat are very, very diverse. At first, many vascular ailments do not bother the patient much, but they lead to severe complications, disability and even death. Can a person without medical education identify a vascular pathology? Of course, yes, if he knows their clinical manifestations, which this section will tell about.

In addition, it contains information:

• about medicines and folk remedies for the treatment of blood vessels;
• about which doctor to contact if you suspect vascular problems;
• what vascular pathologies are deadly;
• from which the veins are swollen;
• how to keep your veins and arteries healthy for life.

Varicose veins

Varicose veins (varicose veins) is a disease in which the lumens of certain veins (legs, esophagus, rectum, etc.) become too wide, which leads to impaired blood flow in the affected organ or body part. In advanced cases, this ailment is cured with great difficulty, but at the first stage it is quite possible to curb it. How to do it, read in the heading "Varicose veins".

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You will also learn from it:

• what ointments exist for the treatment of varicose veins and which one is more effective;
• why doctors forbid some patients with varicose veins of the lower extremities to run;
• and to whom it threatens;
• how to strengthen veins with folk remedies;
• how to avoid blood clots in the affected veins.

Pressure

- such a common ailment that many consider it ... a normal condition. Hence the statistics: only 9% of people suffering from high blood pressure keep it under control. And 20% of hypertensive patients consider themselves healthy at all, since their disease is asymptomatic. But the risk of getting a heart attack or stroke from this is no less! although it is less dangerous than high, it also causes a lot of problems and threatens with serious complications.

In addition, you will learn:

• how to "cheat" heredity if both parents suffered from hypertension;
• how to help yourself and loved ones with a hypertensive crisis;
• why the pressure rises at a young age;
• how to keep blood pressure under control without medication, using herbs and certain foods.

Diagnostics

The heading dedicated to the diagnosis of heart and vascular diseases contains articles on the types of examinations that cardiological patients undergo. And also about the indications and contraindications to them, the interpretation of the results, the effectiveness and order of the procedures.

You will also find answers to questions here:

• what types of diagnostic tests should even healthy people undergo;
• why angiography is prescribed for those who have suffered myocardial infarction and stroke;

Stroke

Stroke (acute violation of cerebral circulation) is consistently among the ten most dangerous diseases. People over 55 years of age, hypertensive patients, smokers and those who suffer from depression are at greatest risk of developing it. It turns out that optimism and good-naturedness reduce the risk of strokes by almost 2 times! But there are other factors that can effectively help avoid it.

The heading dedicated to strokes tells about the causes, types, symptoms and treatment of this insidious disease. And also - about rehabilitation measures that help restore lost functions to those who have had it.

In addition, from here you will learn:

• the difference in the clinical manifestations of strokes in men and women;
• about what a pre-stroke state is;
• about folk remedies for the treatment of the consequences of strokes;
• about modern methods of rapid recovery after a stroke.

Heart attack

Myocardial infarction is considered a disease of older men. But the greatest danger it still poses not for them, but for people of working age and women over 75 years old. It is in these groups that the mortality rates are highest. However, no one should relax: today, heart attacks overtake even young, athletic and healthy people. More precisely, under-examined.

In the heading "Heart attack" experts tell about everything that is important to know to everyone who wants to avoid this ailment. And those who have already suffered a myocardial infarction will find here a lot of useful advice on treatment and rehabilitation.

• about what diseases a heart attack is sometimes masked under;
• how to provide emergency care for acute pain in the heart area;
• about the differences in the clinic and course of myocardial infarction in men and women;
• anti-infarction diet and a heart-safe lifestyle;
• about why a patient with a heart attack must be brought to the doctor within 90 minutes.

Pulse disorders

When we talk about pulse disorders, we usually mean its frequency. However, the doctor assesses not only the patient's heart rate, but also other indicators of the pulse wave: rhythm, filling, tension, shape ... The Roman surgeon Galen once described as many as 27 of his characteristics!

Changes in individual pulse parameters reflect the state of not only the heart and blood vessels, but also other body systems, for example, the endocrine system. Want to know more about it? Read the materials of the section.

Here you will find answers to questions:

• why, if you complain of a pulse disorder, you may be referred for a thyroid examination;
• whether slowing your heart rate (bradycardia) can cause your heart to stop
• what it says and how it is dangerous;
• how pulse rate and fat burning rate are related to weight loss.

Operations

Many diseases of the heart and blood vessels, which even 20-30 years ago doomed people to permanent disability, are now being successfully cured. Usually surgically. Modern cardiac surgery saves even those who, until recently, did not leave any chance of life. And most of the operations are now done through tiny punctures, and not incisions, as before. This not only gives a high cosmetic effect, but is also much easier to tolerate. And also reduces the time of postoperative rehabilitation several times.

Under the heading "Operations" you will find materials on surgical methods of treating varicose veins, vascular bypass grafting, intravascular stents, heart valve replacement and much more.

And also learn:

• what technique does not leave scars;
• how operations on the heart and blood vessels affect the patient's quality of life;
• what are the differences between operations and vessels;
• under what diseases it is carried out and what is the duration of a healthy life after it;
• what is better for heart disease - to be treated with pills and injections or to have an operation.

Rest

The "Rest" includes materials that do not correspond to the subject of other sections of the site. Here you can find information about rare cardiac ailments, myths, misconceptions and interesting facts related to heart health, the incomprehensible symptoms of their meaning, the achievements of modern cardiology and much more.

• on providing first aid to oneself and others in various emergency conditions;
• about the child;
• about acute bleeding and methods of stopping them;
• o and eating habits;
• about folk methods of strengthening and improving the cardiovascular system.

Drugs

“Preparations” is perhaps the most important section of the site. After all, the most valuable information about a disease is how to treat it. We do not give here magic recipes for curing serious ailments with one pill, we honestly and truthfully tell everything about the drugs as they are. Why are they good and what are bad, who are shown and contraindicated, how they differ from analogues and how they affect the body. These are not calls for self-medication, it is necessary so that you have good command of the "weapons" that you have to fight with the disease.

Here you will find:

• reviews and comparison of drug groups;
• information about what can be taken without a doctor's prescription, and what should not be taken under any circumstances;
• a list of reasons for choosing a particular remedy;
• information on cheap analogues of expensive imported drugs;
• data on side effects of heart medications, which manufacturers are silent about.

And many more important, useful and valuable things that will make you healthier, stronger and happier!

May your heart and blood vessels always be healthy!

Heart ejection fraction (EF) is an indicator by which the quantitative volume of blood ejected into the aorta during the conduction of an electrical impulse in the left ventricle is recorded.

This indicator is calculated by the ratio of the blood that enters the largest vessel to the amount of blood that fills the left ventricle when its tissues weaken.

Heart ejection fraction

This value, simply calculated, and stores a lot of information regarding the possibility of contractions of the heart muscle. Determination of EF affects the prescribed medications for the heart, and EF is used to predict the life of people with heart failure.

The closer the EF values \u200b\u200bto normal, the better the heartbeat occurs. In case of deviation of the ejection fraction below normal values, this indicates that the heart is unable to contract at a normal rate, which leads to impaired blood circulation.

In such a situation, you urgently need to consult a doctor for qualified help.

How is PV calculated?

The calculation of this fraction is not difficult, but it stores a fairly large amount of information about the heart muscle and its ability to contract normally.

In many cases, Doppler ultrasound of the heart is used to determine the ejection fraction.

PV calculation.

The fraction indicator is calculated using the Teicholz formula, or by the Simpson formula. All miscalculations are performed using a program that automatically produces a result that depends on the amount of blood in the unstressed left ventricle, pushed into the aorta.

The main differences between the above formulas are:

• According to the Teicholz formula, the amount of blood ejected from the ventricle is determined using M-modal ultrasound examination. This formula was patented by Teicholz in one thousand nine hundred and seventy-six.
• A small part of the ventricle at its base is examined, the length is not taken into account. False results obtained by the formula can occur during ischemic attacks, when contractions are disturbed in certain areas of the heart muscle.
• The program takes into account the information about the volume in the relaxed and contracted left ventricle, giving the result automatically. This method is used on equipment that is outdated at the moment;
• According to the Simpson formula, a quantitative two-dimensional ultrasound examination of the heart is performed, with the help of which more accurate results are obtained. Simpson's algorithm was patented by him in one thousand nine hundred and eighty-nine. The identical name to this algorithm is the disk method. In this ejection fraction study, all important areas of the heart muscle are examined.

Fact! The results of the study of the same patient, according to different formulas, can fluctuate by ten percent.

What features does PV have?

The main features inherent in the ejection fraction are as follows:

Norms

Individual indicators of the ejection fraction are considered normal for a person, since for different age categories of people, its levels can vary. Also, the levels of the norm of the ejection fraction depend on the calculation formula and the equipment on which the analysis is carried out.

Average generally accepted normal value:

1. For Simpson's formula, it is between fifty and sixty percent, with an extreme low of forty-five percent;
2. According to the Teicholz formula, the lowest level is fifty-five percent. The indicator of the lower bar determines what exactly this percentage of blood needs to be squeezed into the aorta in order for the right amount of oxygen to enter the organs.
3. In the case of heart failure, the indicators range from thirty-five to forty percent. In such a condition, it is necessary to maintain the body with medication, or surgery.
4. With rates below 35 percent, early complications may occur, as well as death.

In childhood, the ejection fraction indicators are slightly increased. In newborns, it is no less than sixty percent and can reach eighty. As the body develops and the child grows, the level of the ejection fraction returns to normal.

With deviations, in most cases, there is a decline in the ejection fraction, rather than its growth. Various pathological conditions affect the decrease in EF marks.

When the ejection fraction is below normal, this indicates that the myocardium cannot contract at a normal rate. It leads to impaired blood circulation in the body and oxygen starvation of organs. Initially, the brain suffers from hypoxia.

In some cases, research results show ejection fraction boundaries above 60 percent. In many cases, they do not exceed 80 percent, since a healthy left ventricle cannot pour out more blood into the aorta due to its structural features.

The structure of the heart.

Also, with pathological enlargement of the heart muscle, an increased ejection fraction may indicate that the myocardium is unable to restore progressive heart failure and is trying to eject the largest amount of blood into the aorta.

As heart failure progresses, the ejection fraction decreases. That is why it is important to monitor the deviations of EF in one direction or another, and immediately go to the hospital for examination.

Why is the decline happening?

The initial stages of progression of heart disease do not affect the ejection fraction. This happens because the heart muscle is trying to adapt to the changes (the layer of the myocardium increases, accelerates its contractions, rebuilds the small vessels of the heart). Check out what the heart muscle is.

With the development of the disease, the muscle wears out more and more, which leads to deviations in functional abilities, which entail structural disorders. All this disrupts the amount of blood ejected by the left ventricle into the aorta, provoking disruptions in blood circulation.

Such deviations provoke everything that negatively affects the heart muscle:

Factor	Typical diseases
Decline in normal blood flow through the coronary arteries	Various forms of angina pectoris;
	Dying off of the heart muscles;
	Scarring on the walls of the myocardium;
	A form of ischemic attack that proceeds without symptoms;
	Expansion of the walls of the stomach;
	Constant pressure increase.
Diseases of infectious and inflammatory origin	Myocarditis (muscular layer is affected);
	Endocarditis (changes in the inner lining);
	Pericarditis (heart bursa disease).
Structural changes in the tissues of the heart muscle	All types of primary myocardial lesions not associated with inflammatory, tumor and ischemic excitations;
	The deviation of metabolism in the myocardium, which leads to the thinness of the heart walls.
Deviations in the structure of the structure of the heart, formed in the womb;
Disturbances in the structure of the heart due to damage to rheumatic diseases;
Increased pressure in the pulmonary circulation.
Pathological conditions of blood vessels	Inflammatory processes on the walls of blood vessels, which lead to their deformation;
	Congenital abnormalities in the structure of the heart (incorrect arrangement of blood vessels, large narrowing of the aorta, improper connection of large vessels);
	Dilation of the aorta, provoked by deformation of the vessel walls;
	Detachment of the aorta
	Deposition on the walls of atherosclerotic plaques;
	Narrowing of the aorta;
	Thrombosis of the pulmonary vessels.
Disruption in the endocrine system	Failure to produce hormones by the thyroid gland;
	Failure of glucose absorption in the body;
	The presence of diabetes mellitus;
	Tumor formations in the adrenal glands, or the pancreas;
	Excessive excess weight.
The influence of toxic agents	Alcoholic drinks;
	Drinks containing a high concentration of caffeine (strong tea, coffee, energy drinks, etc.);
	Cigarettes;
	Drug use;
	Taking certain medications (cardiac glycosides).

Rejection symptoms

Violation of physical and work activity - the main consequences of violation of the normal boundaries of the ejection fraction of the heart. There is a significant deterioration in the condition in which daily activities become difficult to perform.

In most cases, with circulatory disorders, the following symptoms appear:

If one of the above symptoms is detected, it is necessary to urgently go to the hospital for examination.

How are low rates treated?

Since a decrease in ejection fraction is not a separate disease, but is only provoked by initial diseases, a qualified physician should send the patient for additional hardware examinations that will help determine the root cause of a decrease in EF.

Depending on the reason that provoked a decrease in the ejection fraction, treatment can be:

1. Medication;
2. Surgical.

In ischemic attacks, it is necessary to take nitroglycerin to normalize EF, and in hypertension - antihypertensive drugs, etc.

It is important to understand that with a decrease in EF, heart failure progresses, which requires compliance with all the doctor's recommendations.

Drugs

The main drugs that act to increase ejection fraction are listed in the table below.

Groups of medicines	Characteristic
ACE inhibitors (Enalapril, Ramipril, Captopril)	Expand blood vessels;
	Improves nutrition of myocardial tissues;
	Increase the resistance of the heart muscle to stress;
	Increase the efficiency of the myocardium
Beta-blockers (Nebivolol, Bisoprolol, Metoprolol)	Reduce the needs of heart tissues for oxygen saturation and useful elements;
	Reduce the heart rate;
	Reduces rapid wear and tear of the heart muscle;
	They increase the number of zones that contract the heart muscle.
Aldosterone receptor antagonists (Eplerenone, Spironolactone)	Restoration of normal levels of potassium and sodium in the blood;
	Removal of fluids from the body, which reduces the load on the heart muscle.
Diuretics (Torasemide, Indapamide, Hypothiazide)	Remove accumulations of fluid;
	Reduces the effect on the heart muscle.
Cardiac glycosides (Digoxin, Strofantin)	Improvement of myocardial contractions;
	In case of impaired functionality of the heart muscle, the conduction of electrical impulses is restored.
Angiotensin 2 receptor antagonists (Olmesartan, Valsartan, Candesartan)	They have the same effect as ACE inhibitors, but the effective force is much greater.

Additional tools that can improve the ejection fraction in individual cases include the following.

There are also groups of drugs that are auxiliary and are prescribed, in

individual situations, in combination with the main therapy.

Drug groups	Characteristic
Peripheral vasodilators (Nitroglycerin, Sodium, Nitroprusside, Apressin)	Significantly reduce the load on the ventricles;
	They help to improve blood circulation in the vessels of the heart.
Calcium channel blockers (Nifedipine, Verapamil, Nimodipine)	Promote an increase in the lumen of the blood vessels of the heart, which leads to a greater intake of nutrients by tissues
Disaggregants (Plavix, Aspirin)	Prevents blood clots from forming.
Anti-arrhythmia drugs (Amiodarone, Diltiazem, Disopyramide)	Restore heart rhythm in case of its violation.

Surgical intervention

If the ejection fraction is rejected, surgical interventions can be used. The type of surgical operation depends on the individual parameters and pathological conditions of the patient.

In most cases, the following operational methods are used:

• Defibrillator or pacemaker implantation. Through open heart surgery, a device is installed that, in case of heart rhythm disturbances, restores normal blood circulation by electrical action on the heart;

Heart stimulant.

• Impact on different rhythms of the ventricles and atria. Achieve a slowdown in ventricular contractions using an artificial heart block. This restores the necessary blood flow to the ventricles.

What will help improve the condition, in addition to the main course of treatment?

For complex treatment, you must adhere to the following recommendations. Only by observing them, and a properly prescribed method of treatment.

Long-term normalization of the ejection fraction can be achieved:

• Normalize the daily routine, setting aside time for proper sleep (at least 8 hours);
• Moderate exercise. They are necessary for the speedy recovery of the myocardium damaged by the root causes. It is important not to overdo it so as not to damage the heart muscle;
• It is recommended to do not heavy sports (physical education, swimming, aerobics, etc.), and also allocate at least one hour a day for walking;
• Avoid strenuous physical activity;
• Eat properly. And also consume more food saturated with iron;
• Massage is recommended to improve blood circulation and relieve swelling;
• Avoid stressful situations. Strong emotional stress (both positive and negative), constant stress, depression - all this affects the deformation of the myocardium, due to its overstrain;
• Maintain normal water balance. Drink at least one and a half liters of clean drinking water a day;
• Reduce salt intake;
• Get rid of bad habits. The toxins supplied with alcoholic beverages and cigarettes irritate the myocardium.

It is possible to take blood thinners:

• Willow bark - prevents clots from forming, thinning the blood;
• Red clover. Concentrates salicylic and coumaric acids. Regular intake of such a decoction reduces blood density;
• Meadowsweet. Contains the same acids as clover, plus ascorbic acid. Has a positive effect on the body, strengthening blood vessels, fighting rheumatism, and killing bacteria;
• Melilot yellow. Contains a high concentration of coumarins, which slow down clotting;
• Hawthorn is a fairly common plant. Its leaves strengthen blood vessels, have a positive effect on the heart, and also thin the blood. For medical purposes, it is used in the form of an alcoholic tincture or extract;
• Rakita. A bushy plant with an increased concentration of flavonoids and salicylates. Prevents inflammation and tones, inhibits clotting processes and strengthens blood vessels. For treatment purposes, bark is used;
• Ginko Biloba. A powerful antioxidant that dilates blood vessels, preventing blood clots from forming. It has a positive effect on blood flow in the brain, improving memory and attention indicators.

Also, sometimes they use means to calm the body, since under emotional and nervous influence aggravations of heart diseases are aggravated.

These include:

There are also the following methods to calm the nervous system:

• Garlic with milk. For cooking, you need to grate a clove of garlic in milk, and use it half an hour before breakfast;
• Honey with water. Dissolve 50 grams of honey in half a liter of water, and drink in 4 doses throughout the day.

Attention! The use of any traditional medicine requires prior consultation with the attending physician. Taking them on their own can lead to complications.

Prevention

In order to maintain a healthy state of the body, you should adhere to the following recommendations:

• If you have excess weight, it is recommended to lose it;
• Avoid stressful situations and nervous tension;
• Adhere to the daily regimen, good rest and sleep;
• Monitor blood pressure readings;
• Eat less animal fats and more vegetable fats;
• Eat balanced;
• Get rid of a sedentary lifestyle, play sports;
• Quit smoking and drinking alcohol.

Correct lifestyle.

What is the prognosis for EF deviations?

If the ejection fraction indicators fall to forty percent, then the risk of death from sudden cardiac arrest is up to fifteen percent. Down to 35 percent, the risk is up to 25 percent. If the indicators fall below these levels, then the risk increases proportionally.

There is no way to completely cure the deviations of the ejection fraction, but early therapy will help to prolong life with a normal life process.

In case of detection of any symptoms, or already diagnosed diseases, you need to be constantly monitored by a cardiologist and regularly tested. This is done in order to prevent the progression of complications.

DO NOT self-medicate and be healthy!

What is heart ejection fraction?

FVS is called an indicator that is calculated using a special formula. The stroke volume of blood is taken, which enters the aorta after one contraction of the heart muscle, and its ratio is determined in accordance with the end-diastolic volume of the ventricle - the blood accumulated in the cavity during the relaxation period.

The resulting value is multiplied by one hundred percent, which makes it possible to obtain the final result. It is the percentage of blood that is pushed into the ventricle during systole according to the total volume of fluid it contains.

The calculation of the indicator is carried out by computer technology during ultrasonographic examination of the cardiac chambers. With this diagnostic method, only the left ventricle is examined.

Ultrasonography makes it possible to determine the ability of the left ventricle to perform its functions, which are to ensure adequate blood flow in the body.

Video about what the ejection fraction of the heart is.

Values: norm, deviations

If a person is in physiological rest, then the normal value of EF is a percentage. Significant physical activity in adults leads to an increase in the pre-percentage rate. No further increase is observed. This is due to the fact that the myocardium cannot throw out all the blood from the ventricle, as this causes cardiac arrest.

Values: norm, deviations

In modern medicine, only the reduced rate is assessed. This is the main criterion that allows you to determine the irrational work of the body. With a decrease in the indicator, most patients are diagnosed with contractile myocardial insufficiency. In this case, the fraction is less than 45 percent.

With contractile insufficiency, risks arise not only for health, but also for human life. With insufficient blood supply to the organs, a violation of their work is observed. Against this background, multiple organ dysfunction develops, which leads to death.

Decreased ejection volume is most commonly seen with systolic failure. It is completely impossible to get rid of this pathological condition. If certain conditions arise, then the treatment is carried out by an endovascular or vascular surgeon. The sex of a person has no influence on PV. In elderly patients, a physiological decrease in indicators is observed.

With a decrease in EF, we can talk about the individual rate. But, with a value of less than 45 percent, a pathological process is diagnosed. In a healthy person, the EF can increase if the heart rate and blood pressure increase. If radionucleide angiography is used to measure the indicator, then the rate is a percentage.

If a patient is diagnosed with an indicator of less than 35 percent, then this indicates the course of irreversible processes in the myocardium. In the first few years of a child's life, EF rates are higher and amount to a percentage.

The ejection fraction of the heart is a necessary indicator by which the prognosis of various cardiovascular diseases is determined.

Causes of heart weakness

A decrease in the EF is diagnosed against the background of a variety of diseases. In most cases, pathology is diagnosed if chronic heart failure develops. This disease appears when:

1. Ischemic disease. With this disease, blood flow to the coronary arteries, which provide oxygen to the heart muscle, decreases.
2. Myocardial infarction. In most cases, the pathology develops after transmural and large-focal heart attacks. After this critical condition, scar tissue is replaced by the muscle cells of the organ. It cannot contract, which leads to the formation of postinfarction cardiosclerosis
3. Conduction and rhythm disorders, which are often observed and are characterized by an acute course. Against this background, the muscle gradually wears out. Its contractions are irrational and irregular. In most cases, pathology is diagnosed during the course of a variety of pathological processes that lead to disruption of the organ
4. Cardiomyopathy. With this disease, structural disorders are observed in the configuration of the heart. They arise from stretching or hypertrophy of the organ muscle. The cause of this pathology can be a violation of the hormonal background, prolonged arterial hypertension, in which there are high blood pressure indicators, organ defects, etc.

A decrease in heart ejection fraction can be diagnosed against the background of a variety of cardiac diseases. That is why it is recommended to treat them in a timely manner.

Diagnostics

Values: norm, deviations

The pathological process is characterized by the presence of appropriate signs. Due to the symptomatology of the disease, doctors manage to correctly and timely diagnose.

Patients complain of pain in the right abdomen. It can also increase in size due to fluid retention in the abdominal cavity.

This condition is observed with venous congestion. If it is observed for a long period, then the patient may develop cardiac cirrhosis of the liver.

Patients may experience shortness of breath not only with physical overload, but also during rest. Patients claim that shortness of breath appears in the supine position, especially at night. With pathology, the development of swelling of the skin on the face, feet and legs is diagnosed.

Untimely treatment of pathology leads to swelling of the internal organs, which is explained by a violation of blood circulation in the vessels of the subcutaneous fat, which leads to stagnation of fluid in it.

A decrease in the ejection fraction of the heart is the cause of frequent weakness and excessive fatigue, even when doing normal activities. In some patients with pathology, the frequent appearance of dizziness was diagnosed. In some cases, loss of consciousness was diagnosed. This is due to insufficient blood supply to the brain and skeletal muscles.

The disease can be accompanied by upset stools, as well as nausea and vomiting. Some people complain about the appearance of blood in the stool. Periodically, there may be impaired sensitivity in the limbs. With a long course of pathology, a rapid decrease in body weight is observed. Patients talk about the appearance of a pain syndrome in the region of the heart, which is characterized by varying degrees of intensity.

Determination of the indicator is carried out using an electrocardiogram. Also, patients are prescribed an ultrasound scan. Thanks to these examinations, the degree of cardiac output is determined. Diagnostics does not require specific training and is highly informative.

Diagnosis of ejection fraction of the heart provides an opportunity to determine the severity of the pathology and develop the correct therapy tactics.

Treatment

Heart ejection fraction: treatment

Pathology therapy is performed if the EF is less than 45 percent. This condition indicates that the functionality of the heart muscle is reduced against the background of various diseases.

Therapy is aimed at stabilizing pathological changes in the early stages. In most cases, drug therapy is carried out using:

• Angiotensin-covert enzyme inhibitors. With the help of this medication, the nutrition of the heart tissues improves, as well as the peripheral arteries expand. With the regular use of drugs, the efficiency of the heart muscles significantly increases, and the resistance of the myocardium to stress increases. Patients are recommended to take Ramipril, Enalapril, Captopril
• Beta-blockers. Thanks to these drugs, the organ's need for oxygen and other nutrients decreases. When using the drug, the heart rate is reduced, and the processes of natural cell death are reduced. It is recommended to take Metoporolol, Nebivol, Bisoprolol
• Aldosterone receptor antagonists. The action of drugs is aimed at stabilizing the amount of electrolytes. During the treatment period, excess fluid is removed and the load on the organ decreases. Patients are prescribed Eplerenone, Spironolactone
• Diuretic drugs or diuretics. The drugs remove excess fluid from the body and reduce the volumetric load on the body. The use of Indapamide, Torasemide, Hypothiazide is recommended
• Cardiac glycosides. The medicine improves the contractility of the heart muscles, increases conductivity in case of dysfunction of the myocardium. Patients are treated with Strofantin, Digoxin
• Peripheral vasodilators. Medicines are prescribed to reduce the load on the organ and improve blood flow in the area of \u200b\u200bthe heart vessels. Patients are recommended to take Nitroglycerin, Apressin, Sodium nitroprusside
• Calcium channel blockers. Thanks to medicines, the vessels of the heart expand, and the quality of tissue nutrition also increases. Therapy is carried out with Nifedipine, Nimodipine, Verapamil
• Disaggregants. The drugs are recommended to be used in order to eliminate the possibility of clot formation. For the treatment of pathology, it is recommended to take Aspirin, Plavix
• Antirhythmic drugs. Medicines stop violations in the rhythm of myocardial contractions. Therapy is carried out with Diltiazem, Disopyramide, Amiodarone

In severe cases, surgical intervention is recommended. Patients are given pacemakers or cardiovector-defiblators if there are life-threatening heart rhythm disturbances. In some cases, resynchronization therapy is used. With its help, contractions of the ventricles and atria are stimulated in different rhythms.

During the treatment of pathology, it is necessary to adhere to certain recommendations. The patient needs to be provided with normal nutrition that will fully meet the needs of his body. Also, the patient must strictly observe the regime of the day and rest.

Treatment of decreased cardiac ejection fraction may include a variety of treatments. The choice of a specific therapeutic method is carried out only by a qualified specialist in accordance with the individual characteristics of the patient and the severity of the pathology.

Prevention

If the patient does not have a genetic predisposition, then he can fully regulate the rate of the fraction. In this case, he is advised to follow certain prevention rules. A person must exercise every day. It is also recommended to eat foods that are high in iron.

In order to prevent pathology, it is necessary to quit smoking. A person should minimize the consumption of alcoholic beverages. Compliance with a healthy lifestyle is an excellent preventive method.

If possible, then a person should go to aerobics several times a week. Diet food will eliminate the threat of the development of pathology. It is best to give preference to dishes that contain the minimum amount of salt. With a hereditary predisposition to the disease, it is recommended that you refuse to visit gyms.

EF of the heart is a severe pathological process that can be fatal. The pathological process can develop with a variety of cardiac diseases. It is accompanied by certain symptoms, when they appear, it is necessary to carry out a diagnosis, which will allow prescribing the optimal treatment regimen. In order to avoid pathology, its prevention should be carried out in a timely manner.

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The normal value of the ejection fraction of the heart, the deviation of the indicator

From this article you will learn about the ejection fraction of the heart: the rate of the indicator, how it is calculated and what it shows. When the deviation of the ejection fraction (abbreviated as EF) is dangerous, why does a pathological change appear. Symptoms of the indicator going beyond normal limits, treatment principles and prognosis.

The ejection fraction (EF) is the ratio of the stroke volume (blood that enters the aorta in one contraction of the heart muscle) to the end-diastolic volume of the ventricle (blood that accumulates in the cavity during the period of relaxation, or diastole, of the myocardium). This value is multiplied by 100% to give the final value. That is, this is the percentage of blood that pushes out the ventricle during systole, of the total volume of fluid it contains.

The indicator is calculated by the computer during the ultrasonographic examination of the cardiac chambers (echocardiography or ultrasound). It is used only for the left ventricle and directly reflects its ability to perform its function, that is, to provide adequate blood flow throughout the body.

Under conditions of physiological rest, the normal value of EF is considered to be 50–75%, with physical exertion in healthy people, it increases to 80–85%. There is no further increase, since the myocardium cannot eject all the blood from the ventricular cavity, which will lead to cardiac arrest.

In medical terms, only a decrease in the indicator is assessed - this is one of the main criteria for the development of a decrease in heart performance, a sign of contractile myocardial failure. This is evidenced by the value of EF below 45%.

Such insufficiency poses a great danger to life - a small supply of blood to the organs disrupts their work, which ends with multiple organ dysfunction and ultimately leads to the death of the patient.

Considering that the reason for the decrease in the volume of left ventricular ejection is its systolic insufficiency (as the outcome of many chronic pathologies of the heart and blood vessels), this condition cannot be completely cured. Treatment is carried out that supports the myocardium and is aimed at stabilizing the state at one level.

The monitoring and selection of therapy for patients with low ejection fraction is the responsibility of cardiologists and therapists. Under certain conditions, the assistance of a vascular or endovascular surgeon may be required.

Indicator features

1. The ejection fraction does not depend on the sex of the person.
2. With age, a physiological decrease in the indicator is noted.
3. Low ejection fraction may be an individual norm, but values \u200b\u200bless than 45% are always considered pathological.
4. All healthy people have an increase in value with an increase in heart rate and blood pressure.
5. The norm of the indicator when measuring by radionucleic angiography is considered to be 45–65%.
6. For measurement, use the formulas of Simpson or Teicholz, normal values, depending on the method used, fluctuate up to 10%.
7. A critical level of decrease of 35% or less is a sign of irreversible changes in myocardial tissues.
8. For children in the first years of life, higher rates of 60–80% are characteristic.
9. The indicator is used to determine the prognosis of any cardiovascular disease in patients.

Reasons for the decrease in the indicator

At the initial stages of any disease, the ejection fraction remains normal due to the development of adaptation processes in the myocardium (thickening of the muscle layer, increased work, restructuring of small blood vessels). As the disease progresses, the capabilities of the heart exhaust themselves, there is a violation of the contractility of muscle fibers, and the volume of ejected blood decreases.

All influences and diseases that have a negative effect on the myocardium lead to such violations.

Acute myocardial infarction

Cicatricial changes in heart tissue (cardiosclerosis)

Painless form of ischemia

Tachy and bradyarrhythmias

Ventricular wall aneurysm

Endocarditis (changes in the inner lining)

Pericarditis (bursa disease)

Congenital disorders of the normal structure or defects (violation of the correct location, significant decrease in the lumen of the aorta, abnormal connection between large vessels)

Aneurysm of any part of the aorta

Aortoarteritis (damage by cells of their own immunity of the walls of the aorta and its branches)

Pulmonary thromboembolism

Diabetes mellitus and impaired glucose absorption

Hormone-active tumors of the adrenal glands, pancreas (pheochromocytoma, carcinoid)

Stimulant drugs

Symptoms of a decrease in the indicator

Low ejection fraction is one of the main criteria for cardiac dysfunction, so patients are forced to significantly limit their work and physical activity. Often, even simple household chores cause a deterioration, which makes you spend most of the time sitting or lying in bed.

The manifestations of a decrease in the indicator are distributed according to the frequency of occurrence from the most frequent to the rarer:

• significant loss of strength and fatigue from the usual stress;
• violation of breathing by the type of increase in frequency, up to attacks of suffocation;
• breathing problems worse when lying down;
• collaptoid states and loss of consciousness;
• changes in vision (darkening in the eyes, "flies");
• pain syndrome in the projection of the heart of varying intensity;
• an increase in the number of heart contractions;
• swelling of the legs and feet;
• accumulation of fluid in the chest and abdomen;
• a gradual increase in the size of the liver;
• progressive weight loss;
• episodes of impaired coordination and gait;
• periodic decrease in sensitivity and active mobility in the limbs;
• discomfort, moderate pain syndrome in the projection of the abdomen;
• unstable stools;
• bouts of nausea;
• vomiting mixed with blood;
• blood in the stool.

Treatment with a decrease in the indicator

Ejection fraction less than 45% is a consequence of changes in the functionality of the heart muscle against the background of progression of the underlying disease-cause. A decrease in the indicator is a sign of irreversible changes in the tissues of the myocardium, and the possibility of a complete cure is out of the question. All therapeutic measures are aimed at stabilizing pathological changes at their early stage and improving the patient's quality of life at a later stage.

The treatment package includes:

• correction of the main pathological process;
• therapy of left ventricular failure.

This article is devoted directly to left ventricular ejection fraction and the types of its violation, therefore, further we will focus only on this part of the treatment.

Drug correction

Basic drugs

Improving the nutrition of the heart tissue

Increasing myocardial resistance to stress

Reliable increase in the efficiency of the heart muscle

Decrease in heart rate

Reducing the processes of natural death of heart cells in conditions of increased work

Increase in the number of zones with active contraction in the myocardium

Removing excess fluid and reducing the load on the myocardium

Reducing the volumetric load on the myocardium

Increased conductivity in conditions of impaired myocardial function

Additional funds

Protection of blood vessels in conditions of altered blood flow

Prevention of clot formation against the background of venous stasis

Ancillary drugs

Improving blood flow in the heart vessels

Surgical correction

1. Installation of pacemakers or cardiovector-defibrillators for life-threatening cardiac arrhythmias.
2. Resynchronization therapy - stimulation of the contraction of the ventricles and atria in different rhythms (slowing down the contraction of the ventricles by creating an artificial heart block).

Non-drug correction

• Normalization of nutrition in accordance with the needs of the body to stabilize normal weight.
• Dosed, but mandatory physical activity.
• Normalization of the work-rest regime.
• Psychotherapeutic assistance.
• Physio and reflexology.

Forecast

• If the left ventricular ejection fraction decreases, being in the range of 40–45%, the risk of death due to cardiac arrest is about 10–15%.
• Reducing to 35-40% increases this risk to 20-25%.
• A further decrease in the indicator exponentially worsens the prognosis for patient survival.

There is no complete cure for pathology, but the therapy started on time allows you to prolong life and maintain its relatively satisfactory quality.

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Cardiac output: the rate and causes of deviation

When the patient receives the test results, he tries to figure out on his own what each received value means, how critical the deviation from the norm is. An important diagnostic value is the cardiac output indicator, the rate of which indicates a sufficient amount of blood ejected into the aorta, and the deviation indicates an approaching heart failure.

What is ejection fraction and why should it be assessed?

Assessment of the ejection fraction of the heart

When a patient comes to the clinic with complaints of pain in the heart, the doctor will prescribe a full diagnosis. A patient who encounters this problem for the first time may not understand what all the terms mean, when certain parameters are increased or decreased, how they are calculated.

The ejection fraction of the heart is determined with the following patient complaints:

• heartache;
• tachycardia;
• dyspnea;
• dizziness and fainting;
• increased fatigue;
• chest pain;
• interruptions in the work of the heart;
• swelling of the limbs.

A biochemical blood test and an electrocardiogram will be indicative for the doctor. If the data obtained is not enough, ultrasound, Holter monitoring of the electrocardiogram, and bicycle ergometry are performed.

The ejection fraction is determined by the following heart examinations:

• isotope ventriculography;
• radiopaque ventriculography.

The ejection fraction is not a difficult indicator to analyze, the data is shown even by the simplest ultrasound machine. As a result, the doctor receives data showing how efficiently the heart works with each heartbeat. During each contraction, a certain percentage of the blood is expelled from the ventricle into the vessels. This volume is designated by the ejection fraction. If from 100 ml of blood in the ventricle, 60 cm were delivered to the aorta, then cardiac output was 60%.

The work of the left ventricle is considered indicative, since blood from the left side of the heart muscle enters the systemic circulation. If the malfunctions of the left ventricle are not detected in time, then there is a risk of getting heart failure. A reduced cardiac output indicates the inability of the heart to contract at full strength, therefore, the body is not provided with the required volume of blood. In this case, the heart is supported with medication.

How is ejection fraction calculated?

For the calculation, the following formula is used: multiply the stroke volume by the heart rate. The result will show how much blood is pushed out by the heart in 1 minute. The average volume is 5.5 liters.

The formulas for calculating cardiac output are named.

1. Teicholz's formula. The calculation is performed automatically by the program into which data on the end systolic and diastolic volumes of the left ventricle are entered. The size of the organ also matters.
2. Simpson's formula. The main difference lies in the possibility of getting into the cut of the circumference of all sections of the myocardium. The study is more revealing, it requires modern equipment.

The data obtained using two different formulas may differ by 10%. The data are indicative for the diagnosis of any disease of the cardiovascular system.

Important nuances when measuring the percentage of cardiac output:

• the result is not affected by the sex of the person;
• the older the person, the lower the rate of the indicator;
• a pathological condition is considered an indicator below 45%;
• a decrease in the indicator less than 35% leads to irreversible consequences;
• a reduced rate may be an individual feature (but not lower than 45%);
• the indicator rises with hypertension;
• in the first few years of life, in children, the ejection rate exceeds the norm (60-80%).

Normal EF values

Normally, more blood passes through the left ventricle, regardless of whether the heart is currently loaded or at rest. Determining the percentage of cardiac output allows you to diagnose heart failure in time.

Normal heart ejection fraction

The rate of cardiac output is 55-70%, a reduced indicator reads 40-55%. If the indicator drops below 40%, heart failure is diagnosed, the indicator below 35% indicates possible irreversible heart failure in the near future, life-threatening.

Exceeding the norm is rare, since the heart is physically unable to expel more blood volume into the aorta than it should be. The indicator reaches 80% in trained people, in particular, athletes, people leading a healthy, active lifestyle.

An increase in cardiac output may indicate myocardial hypertrophy. At this point, the left ventricle tries to compensate for the initial stage of heart failure and pushes blood with greater force.

Even if the body is not affected by external irritating factors, then 50% of the blood is guaranteed to be pushed out with each contraction. If a person is worried about his health, then after the onset of 40 years, it is recommended to undergo an annual check-up with a cardiologist.

The correctness of the prescribed therapy also depends on the determination of the individual threshold. An insufficient amount of processed blood causes a deficiency of the supplied oxygen in all organs, including the brain.

Causes of the reduced ejection fraction of the heart

The following pathologies lead to a decrease in the level of cardiac output:

• cardiac ischemia;
• myocardial infarction;
• heart rhythm disturbances (arrhythmia, tachycardia);
• cardiomyopathy.

Each pathology of the heart muscle affects the work of the ventricle in its own way. During coronary heart disease, blood flow decreases, after a heart attack, the muscles become covered with scars that cannot contract. Violation of the rhythm leads to a deterioration in conduction, rapid deterioration of the heart, and cardiomyopathy leads to an increase in muscle size.

In the early stages of any disease, the ejection fraction does not change much. The heart muscle adapts to new conditions, the muscle layer grows, and small blood vessels are rebuilt. Gradually, the capabilities of the heart are exhausted, muscle fibers weaken, the volume of absorbed blood decreases.

Other diseases that decrease cardiac output:

• angina pectoris;
• hypertension;
• aneurysm of the ventricular wall;
• infectious and inflammatory diseases (pericarditis, myocarditis, endocarditis);
• myocardial dystrophy;
• cardiomyopathy;
• congenital pathologies, violation of the structure of the organ;
• vasculitis;
• vascular pathology;
• hormonal disruptions in the body;
• diabetes;
• obesity;
• tumors of the glands;
• intoxication.

Symptoms of a decreased ejection fraction

A low ejection fraction indicates serious cardiac abnormalities. Having received the diagnosis, the patient needs to reconsider the lifestyle, to exclude excessive stress on the heart. Deterioration can cause emotional distress.

The patient complains of the following symptoms:

• increased fatigue, weakness;
• a feeling of suffocation;
• breathing disorders;
• breathing hard while lying down;
• visual impairment;
• loss of consciousness;
• heartache;
• increased heart rate;
• swelling of the lower extremities.

At more advanced stages and with the development of secondary diseases, the following symptoms occur:

• decreased sensitivity of the limbs;
• enlarged liver;
• lack of coordination;
• losing weight;
• nausea, vomiting, blood in the stool;
• abdominal pain;
• accumulation of fluid in the lungs and abdomen.

Even if there are no symptoms, this does not mean that the person is not suffering from heart failure. Conversely, pronounced symptoms listed above do not always result in a reduced percentage of cardiac output.

Ultrasound - norms and decoding

Ultrasound examination of the heart

Ultrasound examination provides several indicators by which the doctor judges the state of the heart muscle, in particular, the functioning of the left ventricle.

1. Cardiac output, rate 55-60%;
2. The size of the atrium of the right chamber, the norm is 2.7-4.5 cm;
3. Aortic diameter, norm 2.1-4.1 cm;
4. The size of the atrium of the left chamber, the norm is 1.9-4 cm;
5. Stroke volume, normasm.

It is important to evaluate not each indicator separately, but the overall clinical picture. If there is a deviation from the norm in the greater or lesser direction of only one indicator, additional research will be required to determine the cause.

When is treatment for a reduced ejection fraction required?

Immediately after receiving the results of an ultrasound scan and determining the reduced percentage of cardiac output, the doctor will not be able to determine the treatment plan and prescribe medications. The cause of the pathology should be addressed, not the symptoms of a decreased ejection fraction.

Therapy is selected after a complete diagnosis, definition of the disease and its stage. In some cases, this is drug therapy, sometimes surgery.

How to increase the reduced ejection fraction?

First of all, medications are prescribed to eliminate the root cause of the reduced ejection fraction. A mandatory point of treatment is taking drugs that increase the contractility of the myocardium (cardiac glycosides). The doctor selects the dosage and duration of treatment based on the test results, uncontrolled intake can lead to glycosidic intoxication.

Heart failure isn't just treated with pills. The patient should control the drinking regimen, the daily volume of fluid drunk should not exceed 2 liters. Salt must be removed from the diet. Additionally, diuretics, beta-blockers, ACE inhibitors, Digoxin are prescribed. Medications that reduce the heart's need for oxygen will help alleviate the condition.

Modern surgical methods restore blood flow in ischemic disease and eliminate severe heart defects. An artificial heart driver can be installed against arrhythmia. The operation is not performed when the percentage of cardiac output drops below 20%.

Prevention

Preventive measures are aimed at improving the state of the cardiovascular system.

1. Active lifestyle.
2. Sports activities.
3. Proper nutrition.
4. Rejection of bad habits.
5. Outdoor recreation.
6. Relief from stress.

What is heart ejection fraction:

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According to statistics, it is a heart attack in most cases that causes the death of a patient with pathology of the cardiovascular system. People who have had an attack very often go to doctors with a problem of low blood pressure. This condition is caused by impaired blood circulation in the body. So, after a heart attack, the coronary vessels lose their previous elasticity, so the pressure must be constantly monitored, measured regularly and in case of unforeseen situations, seek qualified medical help. About the danger of low blood pressure after a heart attack, what to do, what measures to take in the first place and what prevention is, further in this article.

What to do with low pressure

This condition is quite common, therefore, after an attack, doctors often recommend that their patients engage in intense physical activity, limit themselves from negative emotional effects, shocks, and eliminate stress factors.

The first thing to do with an attack of low blood pressure is to lie down for a short time (the body should take a horizontal position), and then you should drink a mug of sweet coffee or tea. It is recommended to prepare a decoction of ginseng. If such measures do not help, then you need to call an ambulance. In order to prevent such attacks in the future, you need to observe a certain nutritional system.

Among the main symptoms of low blood pressure are the following:

• frequent headache (pulsating tremors mainly in the occiput and temples);
• feeling of lethargy, tiredness, constant drowsiness;
• feeling of nausea in the morning, sometimes vomiting;
• disturbing chest pain (caused by a decrease in vascular tone).

Also, the main symptoms of low blood pressure after a heart attack include meteorological dependence and psychological problems. The person becomes irritable, he is worried about the constant change of mood, there are problems with memory. Against this background, the patient often develops depression.

The patient's condition can deteriorate sharply against the background of a sharp change in weather conditions. Magnetic storms also have a strong effect on health. As noted earlier, the patient after a heart attack is in a state of constant fatigue. Thus, by the end of the working day, even if the work is not exhausting and not associated with heavy loads, a person feels very exhausted mentally and physically.

Less noticeable symptoms of low blood pressure include a feeling of lack of breath, which manifests itself in the fact that a person very often yawns. Hypotension also affects the limbs. They often go numb and are sensitive to low temperatures.

Complications

Low blood pressure is very dangerous if systolic blood pressure readings fall below sixty millimeters of mercury. This is a wake-up call, as in most cases it leads to a sudden loss of consciousness. This condition is explained by the fact that after a heart attack, the blood vessels lose their former elasticity, and this negatively affects the blood circulation, and therefore the required dose of oxygen does not enter the brain.

Low blood pressure can also affect kidney function. Over time, they stop performing one of the most important functions - filtering urine, and then they can completely stop working.

Against the background of hypotension, the patient often has an increase in the heart. In addition, patients often complain that their limbs are swollen, the usual heart rhythm is disturbed. This condition is extremely dangerous, so a person should immediately consult a doctor to bring the state of the body back to normal.

As a prophylaxis for low pressure, most specialists advise their patients to undergo a course of treatment sessions in a pressure chamber. Thus, the level of oxygen and blood pressure in the body quickly normalizes, the patient's immunity is gradually strengthened.

Treatment

Currently, there are a fairly large number of methods for treating the symptoms of a postinfarction state. Therapy will directly depend on the patient's way and living / working conditions.

First of all, doctors recommend to gradually reduce the load, both physical and psychological. If the daily work is too exhausting and in the past has led to severe stress and overwork, then the doctor will most likely recommend a transfer to another position (less exhausting) or change the occupation altogether.

As noted earlier, during seizures, a person must independently help himself: take a horizontal position and try to relax. Sweet tea and coffee will help bring pressure back to normal.

In the case when a patient has symptoms of a postinfarction state constantly manifests itself, this means that he does not follow certain instructions from the attending physician.

The modern method of treatment involves the use of blood ozonation procedures. Such therapy is carried out only with the permission of the attending physician and consists in the introduction of saline solutions, which contain ozone, into the body through droppers.

This technique can achieve the normalization of metabolic processes in the body, cleanse it of toxins, toxins and other harmful substances, as well as strengthen the immune system. In addition, such a procedure promotes overall health and serves as an excellent prevention of colds. After the procedures, there is a noticeable improvement in the psycho-emotional state. The patient becomes less irritable, and against this background he is less and less tormented by insomnia and stress.

Conclusion

A heart attack is a fatal condition. People who have had a seizure often experience a systematic decrease in blood pressure. During such periods, not only regular consultation with a doctor is required, the patient must also closely monitor his health. First of all, it is imperative to follow all the doctor's recommendations, because if you do not take the necessary measures, a systematic decrease in pressure is guaranteed, and soon a second attack.

To get rid of the persistent symptoms of a post-infarction state, you should avoid stressful situations, minimize or eliminate physical activity, change your diet: doctors recommend refusing to eat starchy foods, fried, fatty and heavy foods. If necessary, the doctor can prescribe blood ozonation procedures.

How does heart failure manifest and what is it?

When heart failure develops, the patient learns what it is only in the process of development of pathology. Recently, many drugs and treatment methods have appeared, but the relevance of the topic is not lost, since it is not always possible to restore the patient's health even with the most modern approach.

With such a dangerous pathological condition, treatment, drugs, physiotherapy should be prescribed only by the attending physician, who can not only correctly assess the clinical picture, but also study the patient's card, because the presence of certain chronic diseases in the anamnesis will require correction of the standard course of therapy. To select the methods of therapy, the doctor must take into account the form of the course of the disease, the reasons that caused it, the severity of damage to the heart muscles and many other parameters, since only in this case will a positive effect be achieved.

The main causes of heart failure

Various illnesses adversely affect the ability of people to lead a fulfilling life. Various diseases of the cardiovascular system are especially negative on the human condition. Currently, many pathologies are known that, under certain circumstances, can provoke the development of heart failure. The provoking factors for the development of left ventricular, right ventricular and biventricular insufficiency include phenomena that contribute to a decrease in the contractile capabilities of the heart muscles, pulmonary and heart diseases, pathologies that provoke afterload and violation of the left ventricle, as well as primary vascular diseases. When acute and chronic heart failure develops, its causes can be rooted in the following conditions:

• myocardial infarction;
• ischemic disease;
• insufficiency of the aortic and mitral valves;
• aortic valve stenosis;
• tamponade;
• hypertrophy;
• dilated and hypertrophic cardiomyopathy;
• arterial hypertension;
• congenital heart defects;
• interstitial lung damage;
• obstructive pulmonary disease;
• pulmonary hypertension.

If the patient has chronic heart failure, the following conditions can significantly aggravate the condition and provoke the development of a decompensated form of pathology:

• pregnancy;
• taking alcohol and drugs;
• anemia;
• infectious diseases;
• hypothyroidism;
• heart rhythm disturbances;
• diabetes;
• fever;
• renal failure;
• pulmonary embolism;
• excessive salt intake;
• non-compliance with the drinking regime.

Most heart diseases sooner or later become the cause of heart failure. In addition to diseases of this organ, deficiency can develop against the background of taking some potent drugs, obesity, endocrine and rheumatological abnormalities. Any complex of pathological conditions that causes heart failure deserves attention. Often people themselves create the prerequisites for the deterioration of their condition. This happens especially often when the patient has chronic heart failure.

Prescribed medications, combined with drinking and dietary regimens, can improve overall health. However, CNS requires daily medication. Patients, feeling an improvement in their condition, ignore the doctor's recommendations and stop taking the medications they need. Heart failure in the stage of decompensation, which develops with such a careless attitude to health, is already extremely difficult for drug correction, therefore, more radical methods of therapy are required to reduce its manifestations.

The pathogenesis of heart failure

The mechanism of development of pathology largely depends on its type. For example, acute failure usually develops as a result of rupture or critical damage to the heart tissue, as a result of which there is a rapid impairment of its contractile function. When chronic heart failure develops, its pathogenesis is difficult to describe. There are 2 basic concepts of the pathology development mechanism. The first concept is retrograde and the second is antegrade. Both hypotheses are well founded. According to the retrograde hypothesis, venous stagnation of blood directly in front of the heart chamber can cause characteristic manifestations of pathology.

Such a violation is observed against the background of a violation of the contractility of the walls of heart failure, provoking a rapid increase in stagnant processes. According to the antegrade hypothesis, signs of pathology are associated with obstruction of blood flow and the flow of blood volume into the cardiac ventricles, which is less than required. Recent studies have shown that both of these mechanisms are of some importance in the development of chronic vascular insufficiency.

It should be borne in mind that myocardial dysfunctions trigger compensatory mechanisms that provide an adequate volume of cardiac output for a long time. Long-term work of the tissues of the heart in an enhanced mode causes a violation of intracardiac conduction and a gradual thickening of the walls of the organ. Myocardial hypertrophy and a decrease in electrical conductivity significantly aggravate the situation, since arrhythmia is constantly present, and the thickened walls of the heart create increased resistance and are more prone to rupture. Such adaptive phenomena, which improve the general condition, subsequently become the cause of aggravation of the damage to the heart tissues.

Overload of the organ ventricles is further characterized by the appearance of additional deviations. The myocardium is gradually stretched, but no stabilization of cardiac output is observed. In most cases, the sympathetic-adrenaline system is activated, accompanied by an increase in the production of adrenaline, norepinephrine, and renin-angiostensin.

Increased levels of these substances lead to increased heart rate. This adaptation mechanism can compensate for the insufficient release of blood, but later this leads to serious stagnant processes. Among other things, constantly present tachycardia causes myocardial fatigue, depletion of coronary blood flow, and shortening of diastole. These are not all the phenomena that are observed against the background of developing vascular insufficiency. Additional violations are added that negatively affect the work of the entire circulatory system.

Heart failure classification

There are many approaches to determining the degree, shape and other parameters of the course of pathology. Currently, several classifications are considered the most common. Depending on the characteristics of reducing the functional load on the ventricles, heart failure can be:

• right ventricular;
• left ventricular;
• biventricular.

According to the international classification of diseases, this pathological condition is listed under the code I150. Among other things, the NYHA classification is actively used, which was developed in New York by the Heart Association and is based on the principle of adequately assessing the severity of the patient's general condition. With this approach, the following classes are distinguished:

1. FC 1. During the study, the patient is diagnosed with heart disease, but there are no restrictions on physical activity. The course of the pathological condition is mild and does not affect the ability of people to lead a full life.
2. FC 2. Heart problems are detected. Physical activity restrictions are minor. The manifestations of pathology can be easily arrested with medication.
3. FC 3. The existing heart disease leads to a significant restriction of physical activity.
4. FC4. Pathology has obvious manifestations. Any physical activity provokes a deterioration.

Among other things, the classification developed by N.D. Storozhenko and V.Kh. Vasilenko. They proposed the following stages in the development of the pathological process:

1. Stage I. There is a hidden pathology, which is detected only with significant physical exertion, as well as with instrumental studies.
2. Stage II. There is pronounced CHF, in which the symptoms of the disease appear at rest.
3. II A. There are weak signs of hemodynamic disturbance, and only in the small or large circle of blood circulation.
4. II B. A profound disturbance of hemodynamics is revealed, characterized by pronounced stagnant processes in the large and small circles.
5. Stage III. This is the final decompensated period for the development of heart failure. In addition to hemodynamic disorders, there is a rapid increase in degenerative changes in the internal organs. These processes are the result of a decrease in tissue oxygenation and nutrient saturation.

Depending on the rate of increase in symptomatic manifestations, heart failure can occur in both acute and chronic forms. There are other approaches to the classification of this pathological condition, but they have found less application in cardiological practice. The correct comprehensive assessment of the patient's condition allows doctors to select the optimal treatment tactics.

Symptomatic manifestations of heart failure

Signs of pathology are quite typical. Symptoms get worse as the disease progresses. Acute vascular insufficiency is accompanied by a rapid disruption of the heart. This can have the most fatal consequences. The symptoms of CHF increase slowly. Heart failure is characterized by the following symptoms:

• extreme shortness of breath;
• weakness with any physical activity;
• causeless cough;
• disruption of the gastrointestinal tract;
• drowsiness;
• swelling and pulsation of the veins in the neck;
• signs of impaired renal function;
• pulmonary wheezing;
• arrhythmia;
• heartache;
• pallor of the skin;
• slight tremor;
• cold extremities;
• hemoptysis;
• swelling of the limbs.

Symptoms build up gradually, so a person may get used to a deteriorating health condition. In severe cases, there may be signs of damage to the central nervous system against the background of a decrease in the supply of oxygen to brain cells. In this case, there is a gradual deterioration of memory and intellectual abilities, headaches, increased distraction, etc.

Complications of heart failure

With a negligent attitude of the patient to his health, the consequences can be the most unfavorable. The syndromes developing against the background of this pathology are life-threatening, therefore, they often require additional targeted treatment to stabilize the condition. Severe complications of heart failure are grounds for assigning a disability group. The most typical pathologies that develop against the background of heart failure include:

• thrombosis and embolism;
• severe cardiac conduction disturbances;
• hyperkalemia;
• cardiac shock;
• pulmonary bleeding;
• hepatic cell failure;
• renal failure;
• cardiac cachexia;
• heart attacks of the digestive tract;
• collapse of the mitral valve;
• convulsions;
• coma.

In the absence of timely medication, these conditions can cause sudden death. Symptoms of developing complications usually increase rapidly, so urgent hospitalization is required. Heart failure syndrome, characterized by additional pathologies, can progress rapidly, therefore, it is often fatal.

Diagnosis of heart failure

If severe symptoms of heart pathology appear, it is very important to see a doctor for an examination. External examination and auscultation of heart murmurs are not enough to confirm the diagnosis and assess the general condition of the patient. Such studies are usually assigned:

• determination of gas composition;
• general and biochemical analysis of blood and urine;
• treadmill test;
• echocardiography;
• MRI of the heart;
• radiography;
• radioisotope ventriculography;
• Ultrasound of the abdominal organs.

Given that the symptoms do not always allow us to correctly assess the state of the heart, a comprehensive diagnosis helps to determine the areas of heart damage, the state of the myocardium and its functionality. This helps increase the chances of tissue repair. Only after a comprehensive examination can the attending cardiologist choose the best therapy option.

Possible approaches to treating heart failure

Heart failure is a pathological condition characterized by a chronic or acute decrease in the pumping function of the heart, leading to a violation of oxygen supply to all body tissues. To prescribe an effective therapeutic complex, it is necessary to understand the causes of the appearance of pathology.

The right combination of different treatments can significantly improve the quality of life of people suffering from heart failure. Currently, there are many types of medicines, folk recipes and physiotherapeutic procedures that can significantly increase the life expectancy of a person suffering from this pathology, but in order to achieve a positive effect, it is very important that a treatment regimen that includes certain means is drawn up taking into account all factors. To relieve symptomatic manifestations and improve a person's condition, the treatment regimen includes:

• aCE inhibitors;
• cardiac glycosides;
• diuretics;
• peripheral vasodilators;
• angiotensin receptor blockers;
• p-blockers;
• diuretics;
• statins;
• nitrates;
• anticoagulants;
• antiarrhythmics;
• drugs that improve metabolism in the myocardium.

If the initial stage of the development of the disease has not been missed, drug therapy can achieve a pronounced improvement. Reviews of such treatment are usually positive. The symptoms of the disease most often grow quite rapidly, therefore, when developing a treatment regimen, it is imperative to take into account the peculiarities of the patient's clinical picture of heart failure, since with the correct selection of drugs, the manifestations of this pathological condition can be stopped. An important point in the selection of drugs is the form of the course of the disease.

The acute variant of the course of the disease usually requires therapy in a hospital setting and frequent changes in medications to stop the existing life-threatening manifestations of the disease. The chronic form of the course of heart failure requires constant drug therapy, and patients need frequent changes in drugs to maintain the patient's normal condition and prevent further damage to the muscle fibers of the heart.

When a pathological condition such as heart failure occurs, pills and other methods of treatment are selected taking into account the individual characteristics of the course of the disease. The patient should understand as quickly as possible what heart failure is and the methods of its treatment, since neglect can cause the most adverse consequences. In severe cases, heart failure requires surgery. Currently, various types of operations can be performed, which can improve the patient's health and increase his life expectancy.

How is congestive heart failure treated?

Given that acute heart failure is a potentially life-threatening condition, after the onset of characteristic symptoms, the necessary measure is to take urgent measures and call an ambulance. An attack of heart failure can cause a number of adverse complications. As part of the emergency measures, it is required to seat the patient in a half-sitting position with the legs down. If possible, the victim should be reassured so that the increased emotional stress does not lead to a worsening of the condition. As part of an emergency, you can give the patient a nitroglycerin tablet. This will prevent tissue damage in case of vascular insufficiency.

As practice shows, nitroglycerin taken in time can significantly improve the prognosis. In case of cardiac arrest, it is necessary to perform indirect massage. Next, you need to wait for doctors who can provide the patient with additional emergency care. This will allow you to avoid deterioration before arriving at the hospital, where complex diagnostics and targeted treatment can be carried out. As part of an emergency, doctors perform:

• measurement of blood pressure and pulse rate;
• connection to a heart rate monitor;
• oxygen supply through a nasal catheter;
• vein catheterization.

To stabilize the patient's condition in acute heart failure, treatment is carried out with medication. The drug treatment regimen in this case will require constant correction. After the patient is taken to the hospital, it may be necessary to use strong pain relievers. To relieve pain caused by heart failure, morphine is given intravenously in fractional doses. This drug is not recommended for use if the patient has clear signs of a malfunction of the central nervous system.

Physiotherapeutic agents for the treatment of heart failure

Drug therapy allows you to maintain a stable condition, but physiotherapy is required to improve the functioning of the heart and stop pathological processes. It allows you to slow down and sometimes eliminate ischemic damage to the heart muscle, improve tissue contractility. The correct use of such therapy allows you to normalize the heart rate, correct the blood coagulation system and even improve metabolic processes in the damaged myocardium. The most commonly used physical therapies for heart failure include:

• oxygenobarotherapy;
• oxygen therapy;
• normobaric hypoxic therapy;
• ozone baths;
• transcranial electroanalgesia;
• electrosleep therapy;
• transcerebral UHF therapy;
• drug electrophoresis;
• thalassotherapy;
• galvanization;
• heliotherapy;
• infrared laser therapy;
• low-frequency magnetotherapy.

Exercise therapy for heart failure can be used only in the early stages of the development of pathology. The possibility of including physical activity can only be determined by a cardiologist who is familiar with the history of the disease. In addition to the exercise therapy course, under certain conditions, classes in the pool can be of significant benefit. A significant positive effect can be achieved during the spa treatment. In a condition such as progressive heart failure, pathophysiology plays a decisive role in determining the most appropriate sanatorium with a particular treatment program.

Lifestyle and diet for heart failure

Any diseases of the cardiovascular system require serious consideration. It is very important to radically change your lifestyle and diet. It is necessary to monitor the amount of fluid and salt consumed daily. The diagnosis of heart failure requires the patient to follow a special diet. Best suited in such cases, fractional meals, involving 6 meals a day. The following foods should be completely excluded from the diet:

• fatty foods;
• alcohol;
• smoked meats;
• dishes rich in hot spices;
• chocolate;
• strong tea and coffee;
• flour products;
• fat;
• semi-finished products;
• marinades;
• everything is fried.

Food should be easily digestible. No more than 5-6 g of salt is allowed per day. If possible, you should abandon it completely. Per day, depending on the stage of heart failure, it is permissible to consume from 0.8 to 1.5 liters of liquid. It is recommended to introduce raisins, dried apricots, Brussels sprouts, peaches, nuts, veal, oat and buckwheat groats, baked potatoes to the products that it is desirable to include in the diet of a person suffering from this pathological condition. All of these foods are high in potassium. Weight control is very important. In obese people with heart failure, body weight stabilization can significantly improve overall health. It is very important to weigh yourself several times a day to prevent the appearance of edema.

Among other things, you need to reconsider your life priorities. At least 8-9 hours should be allowed for a night's sleep. It is very important to create complete conditions for relaxation at this time. If possible, open windows for night ventilation. This contributes to the saturation of tissues with oxygen. You need to set aside time for daytime rest. Emotional and physical overload should be avoided. Bath and sauna should not be placed, stool frequency should be controlled. To prevent deterioration of the condition, it is recommended to avoid colds and infectious diseases whenever possible.

If the doctor prescribed the implementation of the exercise therapy complex, classes should be carried out regularly and necessarily on an empty stomach. It is necessary to get used to taking medications prescribed by your doctor, strictly on schedule. All bad habits should be abandoned. If fatigue or other obvious signs of an exacerbation of heart failure appear, you should consult a doctor for advice and correction of drug treatment.

Surgical treatment of chronic heart failure

Surgical methods of therapy are used only in cases where conservative drug treatment no longer allows improving the general condition. Surgery is performed when there is a high risk of death due to heart failure. Several types of surgical procedures are currently being performed. If the patient's condition allows, cardiomyoplasty can be performed. During this surgical intervention, the muscle is taken from the back of the patient. Further, the source material is used to envelop the organ. This helps to improve the contractile function of the heart and allows the patient to live longer and make it more fulfilling.

Organ transplantation is considered the most effective method of surgical treatment for heart failure. During such an operation, an organ transplant is performed, taken from a suitable donor. Considering that there is a certain deficit for donor organs, in case of a critical deterioration of the condition, an artificial heart can be installed. Special cardioprostheses implanted in the human body can significantly improve the contractile function of the heart, as well as improve the quality of life. But such a procedure can only be characterized as temporary. The use of cardiac prostheses allows you to delay death and give the patient a chance to survive until a suitable graft appears.