Pulmonary infarction: causes, treatment and consequences

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2018-03-26 15:56:13

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Pulmonary Infarction — a disease caused by thromboembolic processes in the vascular system of the lungs. This is quite a serious illness, is capable, in extreme cases, lead to death.

Causes

To Develop the disease can by reason of the surgical intervention disrupt the normal functioning of the heart, bone fractures, malignant tumors, postpartum, after prolonged bed rest. The formed blood clot closes the vessel lumen, resulting in increased pressure in the system pulmonary artery and is bleeding into the lung tissue. In the affected area penetrate bacteria, leading to inflammation.pulmonary infarction

Development of pulmonary infarction

Acute pulmonary hypertension with increased load on the right departments of heart may be due to obstruction of the lumen of the vessel, vasoconstriction related to the release of biologically active substances: histamine, serotonin, thromboxane and reflex spasm of the pulmonary artery. When it fails, oxygen diffusion and occurs with arterial hypoxemia, which aggravates the emission of oxidized blood through intersystem and pulmonary arteriovenous anastomoses. The development of pulmonary infarction occurs on the background of the existing stagnation in the veins. A day after obscurely vessel of the lung is the formation of a heart attack, complete its development ends in about 7 hours.pulmonary infarction consequences

Pathological anatomy

The section of the lung affected by heart attack, has the shape of an irregular pyramid, the base directed to the periphery. The affected area can be of various sizes. In some cases, joins exudative pleurisy infarction or pneumonia. Under the microscope, the diseased tissue of the lungs has a dark red color, it is dense to the touch and protrudes above the level of healthy tissue. Pleura becomes dull, dull, often in the pleural cavity fluid is collected.

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Pulmonary Infarction: symptoms Illness

heart attack pneumonia lung

The Manifestations and severity of disease depend on the size, number and location of vessels covered by blood clots, and concomitant diseases of the heart and lungs. Minor heart attack Often makes almost no signs and is detected by x-ray examination. More severe heart attacks manifest with chest pain, often sudden, shortness of breath, cough, hemoptysis. A more objective examination reveals the pulse and temperature rise. Pronounced symptoms of heart attacks are: bronchial breathing with moist rales and crepitation, dullness of percussion sound. There are also such features as:

  • The pale, often in a light tone of skin;

  • Blue nose, lips, fingertips;

  • Reduction of blood pressure;

  • The appearance of atrial fibrillation.

The Defeat of the large branches of the artery of the lung may provoke right ventricular failure, suffocation. In the blood revealed leukocytosis, sed rate (ROE) is significantly accelerated.

Diagnostics

Often to establish the diagnosis Hard enough. It is important to detect diseases that potentially could complicate pulmonary infarction. It is necessary to conduct a thorough examination of the patient (especially lower limbs). During a heart attack, unlike pneumonia, flank pain occurs before fever and chills, sputum with blood appears also after severe pain in my side. For the diagnosis of disease the following methods:

  • X-ray — to detect the extension of the root of the lung and its deformation.

  • ECG-for signs of overload of right departments of heart.

  • Echocardiography-determined manifestations of right ventricular overload.

  • Doppler ultrasonography of the veins of the lower extremities — a diagnosis of deep vein thrombosis.

  • Radioisotope scanning of the lungs — to detect areas of lower perfusion of the lungs.

  • Angioplasty — to identify obstruction of the branches of the artery of the lung, intra-arterial filling defects.pulmonary edema after a heart attack

Pulmonary Infarction: implications

The disease is usually not be a big threat to human life. However, after this illness, such as pulmonary infarction, the consequences can be severe. Perhaps the development of various complications. For example, such as postinfarction pneumonia, abscess and spread of the inflammation to the pleura, pulmonary edema. After a heart attack have a large risk of getting septic embolus (blood clot) in a vessel. This, in turn, causes the suppurative process and contributes to the abscess at the site of infarction. Pulmonary edema myocardial infarction develops, first of all, by reducing the contractility of the heart muscle, while the delay of blood in the small circle. As the intensity of heart rate decreases suddenly, there is a acute syndrome of small emission, which causes severe hypoxia. There is an excitement of the brain, the release of biologically active substances that contribute to permeability of the alveolar-capillary membrane, andincreased redistribution of blood in the pulmonary circulation of the large. The prognosis of pulmonary infarction depends on the underlying disease, size of affected area and severity of the common symptoms.pulmonary edema myocardial infarction

Treatment

The detection of the first signs indicating pulmonary infarction, treatment should be started immediately. The patient is required to be taken to resuscitation unit of medical institution. Treatment starts with administration of the drug "Heparin", this tool will not dissolve the clot, but it prevents the increase of blood clot and is able to suspend the thrombotic process. The drug "Heparin" is able to reduce bronchospastic and vasoconstrictor effect of platelet histamine and serotonin, which helps to reduce spasm of the pulmonary arterioles and bronchioles. Heparin is carried out for 7-10 days, while the control for activated partial thromboplastin time (APTT). Also used low molecular weight heparin — dalteparin, enoxaparin, fraxiparin.pulmonary infarction treatment in order to ease pain, reduce the load on the pulmonary circulation, reduce shortness of breath, use of narcotic analgesics, for example, the tool "Morphine" (intravenous administration of 1 percent solution). If pulmonary infarction Causing pain pleural nature, which is affected by breathing, posture, cough, it is recommended to use non-narcotic analgesics, such as "Analgin" (intravenous administration of 50% solution). When the diagnosis podjeludochnoi failure or shock treatment using the vasopressors (dopamine, dobutamine). If there is bronchospasm (at atmospheric pressure), you need to slowly intravenously to impose a 2.4% solution of aminophylline. If it is a heart attackPneumonia lung, The treatment requires antibiotics. Relaxed hypotension and hypocones right ventricular involve the use of thrombolytic drugs ("Altalis", "Streptokinase"). In some cases, may require surgical intervention (thrombectomy). The average small infarcts eliminated in 8-12 days.pulmonary infarction symptoms

Prevention

In Order to prevent pulmonary infarction, Is necessary first of all to prevent venous congestion in the legs (deep vein thrombosis of the lower extremities). It is recommended to massage the limbs, for patients who underwent surgery, myocardial infarction, apply elastic bandage on the leg. It is also recommended to exclude the use of drugs that increase blood clotting, and limit the use of intravenous method of administration of medications. According to testimony, perhaps the appointment of the preparations reducing coagulability of blood. For the prevention of opportunistic infections is prescribed a course of antibiotics. In order to prevent pulmonary hypertension, it is recommended the use "Aminophylline".


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Alin Trodden - author of the article, editor
"Hi, I'm Alin Trodden. I write texts, read books, and look for impressions. And I'm not bad at telling you about it. I am always happy to participate in interesting projects."

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