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Left ventricular failure (cardiogenic pulmonary edema)

ICD-10 code
I50.1
Diagnostics
When diagnosed

Mandatory
Level of consciousness, respiratory rate and effectiveness, heart rate, pulse, blood pressure
ECG
R-graph of the chest
Laboratory studies: hemoglobin, blood gases, CBS indicators, electrolytes (K, Na, Mg, Ca, Cl), blood glucose, white blood cells, blood count, enzymes (CPK), urea, creatinine

Additional (according to indications)
Ultrasound of the heart
CVP
DZLA

During treatment
Monitoring according to clause 1.5. Repeatedly - ECG, hourly diuresis, R-graph of the chest organs (up to 4 days may be required to resolve pulmonary edema)

Treatment
Oxygen inhalation, raising the head end of the bed by 30 degrees, in addition - ventilation of the lungs with positive pressure
Vasodilators
IV nitroglycerin: starting dose -10-20 mcg / min., With an increase in dose every 5 minutes by 10-20 mcg / min., The oral route of administration is possible (0.4 mg every 5 min.)
I / O sodium nitroprusside: starting dose of 0.5 μg / kg / min., A dose increase of 0.5 μg / kg / min. every 5 minutes, it is undesirable to exceed a dose of 10 mcg / kg / min., more likely to develop hypotension compared with nitroglycerin
Diuretics:
Furosemide - in patients who have not received it before, the initial dose is 20 mg.
For those who have been prescribed furosemide for a long time - a doubled daily dose is administered slowly in 1-2 minutes. When using high doses (of the order of 1 g) in patients with renal failure, 20% of the dose (200 mg) is administered as a bolus, the rest - as a continuous infusion over 8 hours
Morphine is used as a venous vasodilator and anxiolytic, administered in fractions of 1-2 mg with careful monitoring of lung ventilation. Inhibitors of the angiotensin converting enzyme: captopril 12.5-25 mg sublingually, iv 0.16 mg / min. with an increase in dose of 0.08 mg / min. every 5 min until the desired effect
Vasopressors and inotropes:
Dobutamine 5-15 mcg / kg / min.
Dopamine 2-20 mcg / kg / min.
Inotropic drugs:
Digoxin 0.4-0.6 mg iv (attention to the state of renal function, potassium level). Do not use for stenotic disorders of the valvular apparatus of the heart. Correction of water-electrolyte disorders
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Left ventricular failure (cardiogenic pulmonary edema)

  1. Acute left ventricular failure - interstitial and alveolar pulmonary edema. Non-cardiogenic pulmonary edema.
    Cardiogenic and non-cardiogenic pulmonary edema are considered as the immediate cause of death in every fourth person who died. Pathogenesis. In a healthy person, the hydrostatic pressure in the pulmonary capillaries is 7–9 mm Hg. Art., it slightly exceeds that in interstitium. The liquid is retained in the capillaries due to its viscous properties, sufficiently high figures of oncotic
  2. Cardiogenic pulmonary edema
    Cardiogenic pulmonary edema results from a significant increase in hydrostatic pressure in the left atrium, pulmonary veins and pulmonary artery system. Its main symptom is acute left ventricular failure, accompanied by an increase in the pressure gradient in the pulmonary vessels and interstitial space and the release of part of the fluid from the vessels into the lung tissue. Weak left
  3. Cardiogenic pulmonary edema
    Pulmonary edema (cardiogenic) —critical condition caused by increasing left ventricular failure, leading to hypertension in the pulmonary circulation and congestion in the lungs. The main causes of pulmonary edema as a result of acute left ventricular failure: 1. Myocardial diseases in the stage of decompensation (myocarditis, cardiomyopathy of various origins). 2. Hemodynamic
  4. Cardiogenic pulmonary edema
    D-ka: Characteristic: asphyxiation, inspiratory dyspnea, aggravated in a prone position, which forces patients to sit down; tachycardia, acrocyanosis, tissue hyperhydration, dry wheezing, then moist rales in the lungs, profuse frothy sputum, ECG changes (hypertrophy or overload of the left atrium and ventricle, blockade of the left bundle branch block, etc.). History of myocardial infarction, malformation
  5. Cardiogenic shock and pulmonary edema
    Cardiogenic shock and edema
  6. Acute left ventricular failure syndrome
    Acute heart failure is a sudden decrease in the contractile function of the heart, which leads to circulatory disorders in the small and large circles of blood circulation. It is left ventricular and right ventricular. Left ventricular failure develops with an acute decrease in contractile function of the left ventricle and the resultant pulmonary edema. Leading symptoms:
  7. Left ventricular failure
    Congestive heart failure Diagnosis The term heart failure is often applied loosely to conditions in which the filling pressure of the left heart increases so much that it causes shortness of breath or weakness at rest or with little exertion. However, signs of stagnation can develop when the systolic function of the heart is not impaired (overload with a volume of fluid,
  8. Acute left ventricular and right ventricular failure
    The most common causes of acute heart failure (Marino P., 1998]: - supraventricular arrhythmias; - pulmonary embolism; - complete atrioventricular block; - ischemia (myocardial infarction, ventricular arrhythmias); - cardiac tamponade; - acute mitral insufficiency; - acute aortic insufficiency; - aortic dissection. The earliest sign of acute heart failure
  9. Acute Left Ventricular Heart Failure
    ETIOLOGY. The main causes of acute left ventricular heart failure are myocardial diseases - acute myocarditis, congenital carditis, cardiomyopathy, acute rheumatic heart disease. PATHOGENESIS. An acute weakening of the contractility of the left ventricular myocardium causes a decrease in stroke and cardiac output (Fig. 54). The heart is not able to pump the necessary volume
  10. ACUTE LEFT VENTRICULAR AND RAST VENTRICULAR INSUFFICIENCY
    The most common causes of acute heart failure (Marino P., 1998]: - supraventricular arrhythmias; - pulmonary embolism; - complete atrioventricular block; - ischemia (myocardial infarction, ventricular arrhythmias); - cardiac tamponade; - acute mitral insufficiency; - acute aortic insufficiency; - aortic dissection. The earliest sign of acute
  11. Acute Left Ventricular Heart Failure
    The main causes of acute left ventricular heart failure are myocardial diseases - acute myocarditis, congenital carditis, cardiomyopathy, acute rheumatic heart disease. An acute weakening of the contractility of the left ventricular myocardium causes a decrease in stroke and cardiac output. The heart is not able to pump the necessary amount of blood to the peripheral areas of the body.
  12. Acute left ventricular failure.
    Cardiac asthma. Pulmonary edema Cardiac asthma, an asthma attack that directly threatens the patient’s life and requires urgent medical attention, is not an independent disease, but a syndrome — a characteristic set of symptoms that complicate the course of various heart diseases. The most important of these symptoms is paroxysmal shortness of breath. Because shortness of breath in diseases
  13. Pulmonary edema with excessive dilution in the alveoli: laryngeal edema. Respiratory conditions caused by unspecified external agents. Adverse effects, unclassified elsewhere. Asphyxia. Choking (by squeezing)
    ICD-10 code Lung edema with excessive dilution in the alveoli: laryngeal edema J38.4 Respiratory conditions caused by unspecified external agents J70.9 Adverse effects, unclassified in other T78 sections Asphyxiation. Choking (by squeezing) T71 Diagnostics When a diagnosis is made Mandatory Level of consciousness, frequency and effectiveness of breathing, heart rate, pulse, blood pressure ECG
  14. Pulmonary edema
    Pulmonary edema is a pathological increase in the volume of extravascular fluid in the lungs. The main role is played by an increase in hydrostatic pressure in the pulmonary vessels, a decrease in the plasma COD, and an increase in the permeability of the vascular wall. In 1896, E.G. Starling substantiated the theory of vascular fluid resorption from connective tissue spaces into small vessels, according to which Qr = K (deltaR -
  15. Pulmonary edema
    A formidable complication that occurs in children with many diseases: severe confluent pneumonia, bronchial asthma, coma, brain tumors, poisoning of FOS, head and chest injuries, with congenital and acquired heart defects, accompanied by acute failure of the left heart, with severe renal and hepatic pathology. In recent years, due to passion
  16. Pulmonary edema
    In most cases of malignant arterial hypertension, pulmonary edema is primarily the result of excessive afterload of the left ventricle, rather than overloading the bloodstream with a volume of fluid, so it quickly responds to a decrease in peripheral vascular resistance. Increased afterload most often causes pulmonary edema in patients with preexisting impairment
  17. Pulmonary edema
    Pulmonary edema is a critical condition, due to increasing left ventricular failure, leading to hypertension in the pulmonary circulation and congestion in the lungs. ETIOLOGY AND PATHOGENESIS ¦ Myocardial diseases (myocarditis, cardiomyopathy) in the stage of decompensation. ¦ Hemodynamic overload of the left heart with congenital heart defects. ¦ Heart rhythm disturbances (paroxysmal
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