Pulmonary heart and its diagnostic features

Patients who suffer from chronic lung diseases tend to later complain of heart problems. If there is a defeat of the cardiovascular system and, as a consequence, a violation of the heart, this disease is called a pulmonary heart. Chronic pulmonary heart, as a rule, develops in 3% of these patients.

In general, the pulmonary heart is positioned as hypertrophy and dilatation (perhaps, only dilatation) of the right ventricle, which develops as a result of a small circle of blood circulation.

However, doctors have now concluded on the basis of research that dilatation and hypertrophy are signs that manifest themselves at a more serious, late stage of the pulmonary heart, which is much more difficult to treat. Therefore, the definition of the disease was corrected, noting that the pulmonary heart is a disturbance of dynamics in a small circle of circulation, which at the final stage is characterized by hypertrophy of the right ventricle and impaired blood circulation.

There are three groups of diseases, as a result of which a pulmonary heart can develop:

1. Diseases of the pulmonary system that affect the permeability of air and alveoli (chronic obstructive bronchitis, tuberculosis, pneumosclerosis, etc.). As a rule, similar diseases cause the development of pulmonary heart in about 60% of cases.
2. Diseases in which the chest and the diaphragm are initially affected, which limits their mobility (rib damages, Bechterew's disease, pleural suppuration, etc.)
3. Diseases that affect pulmonary vessels (arterial hypertension, aortic aneurysm, etc.)

There is no single classification of pulmonary heart types. The medicine of the post-Soviet space uses the classification, which is made according to the rates of the disease development:

1. An acute pulmonary heart that develops in a few hours, perhaps even minutes. Typically, this type of disease occurs as a result of embolism, valve pneumothorax, right-sided total pleurisy, as well as in the presence of bronchial asthma (directly during an asthmatic attack).
2. Subacute pulmonary heart, which occurs, as a rule, with recurrent thromboembolism of the pulmonary artery, severe attacks of bronchial asthma. The cause may be botulism, poliomyelitis, lung carcinomatosis and nodular periarteritis.
3. The chronic pulmonary heart can develop for several years and, depending on the level of pulmonary insufficiency, circulatory insufficiency and right ventricular hypertrophy is divided into 4 main stages:

• Stage one - pulmonary insufficiency of 1 degree. There is no circulatory failure, there is no violation of the gas composition. ECG does not display hypertrophy, and echocardiography shows this pathology.
• Pulmonary insufficiency of the second degree, at which oxygen saturation occurs only by 80%, some signs of hypertrophy appear, there is already dyspnea at rest.
• Pulmonary insufficiency 3 degrees, arterial blood is saturated with oxygen by about 50%, there are manifestations of direct signs indicating hypertrophy of the right ventricle and circulatory insufficiency.
• The fourth stage, which is characterized by oxygen saturation of less than 50%, hypertrophy is already manifested with dilatation, and the development of dystrophic circulatory insufficiency is also characteristic.

The basis of the principle of eliminating the disease of the pulmonary heart is the treatment of the disease that led to its occurrence, the treatment of the cause. As a rule, complex therapy is prescribed, which is aimed at reducing pressure in the pulmonary artery, eliminating the aggravation of obstructive diseases and treating heart failure.