Cardiac decompensation

Introduction Cardiac decompensation: When heart disease becomes worse and heart function declines beyond its compensatory function, cardiac decompensation occurs. Heart failure is a group of syndromes caused by various cardiac structural or functional diseases leading to impaired ventricular filling and/or ejection ability. Due to impaired ventricular systolic function and impaired ejection function, cardiac output can not meet the needs of the body's metabolism, blood perfusion of organs and tissues is insufficient, and pulmonary circulation and/or systemic congestion are present. The clinical manifestations are mainly dyspnea, weakness and physical strength. Limited mobility and edema. Treatment of the disease should include preventing and delaying the onset of heart failure, alleviating symptoms of clinical heart failure, improving long-term prognosis and reducing mortality.

Cause

(1) Water and sodium slippery

A decrease in cardiac output causes redistribution of blood and a decrease in renal blood flow. A decrease in renal blood flow may result in a decrease in glomerular filtration rate or an increase in renin secretion, which in turn acts on angiotensinogen produced by the liver to form angiotensin I. Angiotensin I undergoes pulmonary and renal circulation, and under the action of invertase, it forms angiotensin II, which in addition to causing systemic and renal arterioles to aggravate renal ischemia, also promotes the secretion of more aldosterone from the adrenal cortex. Increases sodium retention, increases plasma osmotic pressure, stimulates osmotic receptors near the suprachiasmatic nucleus of the hypothalamus, and reflexively increases secretion of antidiuretic hormone in the posterior pituitary, causing sodium, water retention, increased blood volume, veins and capillaries Congestion and increased pressure.

(B) increased ventricular end diastolic pressure

In heart failure, myocardial contractility is reduced, cardiac output is reduced, residual blood volume in the ventricular chamber is increased, ventricular end-diastolic pressure is increased, venous return is blocked, causing an increase in venous stasis and venous pressure, when capillary hydronephrosis When the pressure increases beyond the plasma osmotic pressure and tissue pressure, the capillary fluid is extravasated and the tissue is edematous.

an examination

Related inspection

Ultrasound diagnosis of cardiovascular disease

Early in heart failure, heart rate compensatory speeding, although it helps to increase cardiac output to or near normal levels, however, increased heart rate also increases myocardial oxygen consumption, and coronary blood supply and ventricular filling time is shortened, and The blood output per heart drop is reduced by the amount of blood per stroke.

Differential diagnosis

1, respiratory failure: the symptoms of this chronic pulmonary heart disease are mostly lung infection or improper use of sedatives as incentives, palpitations, shortness of breath, difficulty breathing, cyanosis, conjunctival congestion and edema, headache, head swelling, irritability, spirit Hemorrhoids, hallucinations, disorientation, lethargy, severe cases can appear madness, convulsions or tremors, and even coma, also known as pulmonary encephalopathy.

2, heart failure: mainly due to right heart failure. It is characterized by shortness of breath, increased purpura, jugular vein engorgement, hypertrophy of the liver, edema of both lower extremities or ascites, increased venous pressure, oliguria, loss of appetite, abdominal distension, nausea and vomiting, increased heart rate, severe shock or even shock death.

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