Syndrome swelling treatment

Treatment of edema with heart disease

Treatment of edema in chronic heart failure

Treatment of edema caused by chronicheart failure, is the adequate, systematic treatment of the most chronic heart failure. For successful treatment, the correct organization of the regime of the day and dietary nutrition is necessary. Exclude the load causing prolonged tachycardia and dyspnea. In case of significant insufficiency, there is a bed rest or a comfortable armchair. Diet - full, easily assimilated, rich in proteins, vitamins, potassium. Effective unloading days: milk (100 grams of milk 8 times a day, 20 grams of glucose for a night with 1/2 cup of tea), cottage cheese, apple, apple-rice, watermelon, etc. A moderate restriction of table salt 2-5 g / day) and fluid intake (about 1 liter per day). Apply cardiac glycosides: digoxin, Celanide (isolanide) in tablets of 0.00025 g 2-3 times a day for 2-3 days; then the daily dose is reduced by 1 1 / 2-2 times. In cases of chronic obstructive pulmonary disease, preparations that reduce venous tone are used, so-called peripheral vasodilators (nitroglycerin, nitrosorbide, sidnofarm (Corvatone).) The drugs of choice for the treatment of heart failure, even with monotherapy, are angiotensin-converting enzyme inhibitors (captopril, enalapril, lisinopril, ramipril). Currently, phosphodiesterase inhibitors (amprinon, phenoximon), sympathomimetic amines (dopamine, dobrex, and isadrin) are used.

A major role in the treatment of heart failureplay a diuretic. Diuretics are indicated not only for edema, liver enlargement, obvious stagnant changes in the lungs, but also for latent fluid retention (the latter criterion is an increase in diuresis and a decrease in dyspnea in response to a trial diuretic). For the treatment of HNC, moderate-acting diuretics (hypothiazide, hygroton, clopamide (brinaldix), strong (furosemide, ureate, bumetamide), potassium-sparing drugs (veroshpiron, aldactone, triamterene, amiloride), osmotic diuretics (urea, mannitol) are used. potassium-sparing drugs (triamterene, amiloride) .If there is no effect, then use thiazide diuretics with a minimum dose of 25 mg, can be triampur or hypothiazide with amiloride .If the effect of treatment with these drugs is insufficient, then prescribe strong diuretics ky (furosemide), starting with small doses, diuresis under the influence of diuretics can exceed by 800 ml-1.5 liters the amount of fluid drunk.

With more severe heart failurebegin treatment with strong diuretics. If there is no effect from such treatment, then combined strong diuretics (furosemide in tablets of 40 mg) with potassium-sparing drugs (veroshpiron in tablets of 0.025), and then add hypothiazide (from 25 mg to 100 mg per day). Usually the most effective is the intake of diuretics on an empty stomach 1-3 times in 7-10 days.

With refractory edematous syndrome, osmotic diuretics are prescribed intravenously.

Significant hydrothorax and ascites worsen functionexternal respiration and can lead to compression of the heart. If treatment with diuretics is not effective enough and does not cause a significant decrease in the amount of transudate within 2-3 days, then the puncture of the corresponding cavity and the partial removal of the fluid by mechanical means are shown. In this case, it is not recommended to remove one-time from the pleural cavity more than 1 liter, and from the abdominal cavity - more than 2 liters.

Treatment of tachistystolic form of atrial fibrillation

With tachysystolic form of atrial fibrillationand associated with her edema treatment is aimed at decreasing the heart rate or restoring sinus rhythm. Assign cardiac glycosides (digoxin, isolanide) in individually matched doses (for out-patient treatment-on 1/2 tablet 3 times a day) under the control of heart rate, pulse deficit and ECG parameters. Admission of these drugs must be done in combination with potassium preparations (pananginum, potassium orotate, etc.). If necessary, additionally used in a small dose of beta-blocker (trezikor, propranolol).

As an antiarrhythmic drug,use quinidine. After the test dose (0.2 g) drug administered according to the scheme in increasing the daily dose (0.2 g every 2-2.5 h) under ECG control. When restoring sinus rhythm in the subsequent maintenance therapy (0.2 g every 6 hours).

Treatment of chronic compressive pericardium

Treatment is surgical. When preparing for surgery, it is necessary to reduce heart failure as much as possible, mainly with the help of diuretics, since the effectiveness of the heart is limited. If radical treatment is not possible, then therapy for heart failure becomes the main one. An adequate treatment of the underlying disease (tuberculosis, kidney failure, etc.) is important